Effectiveness of Ganglion Impar Block for the Management of Chronic Refractory Coccygodynia

Abstract

Chronic coccygodynia is a disorder characterized by intractable pain in the coccygeal region and is difficult to diagnose and treat. The etiologies of coccygodynia are varied, however in most patients, it is usually idiopathic or followed by external or internal trauma. The traumatic events related directly with coccygodynia are direct injuries, fall on back, obstructed labour, etc. Non traumatic coccygodynia can result from degenerative joint or disc disease, hypermobility or hypomobility of the sacrococcygeal joint, obesity, infectious etiology, variants of coccygeal morphology, and cancers of the pelvis and anorectal region. Many treatment options are available for this painful condition conservative treatment such as non-steroidal anti-inflammatory drugs (NSAIDs), local analgesics, hot or cold application, transcutaneous electrical nerve stimulation (TENS), modified wedge-shaped cushions, circular cushions (donut cushions) and levator ani relaxation exercises are available. However, in nonresponsive patients who fall under the category of chronic coccygodynia, direct injections around the coccyx, ganglion impar blocks, neurolysis and coccygectomy can be done for pain relief. The current study was conducted at IMS&SUM Hospital, Bhubaneswar, Siksha ‘O’ Anusandhan (Deemed to be University) to estimate the effectiveness of the Ganglion Impar block for the management of chronic refractory Coccygodynia patients who had failed to respond conservative management.