How can it be treated?

The majority of patients settle down within a couple of months with conservative management which includes self-care, for example:

• avoiding sitting on hard surfaces
• not wearing tight-fitting clothes
• trying sitz baths
• taking care of posture
• using coccygeal cushions which encourage less weight to be taken through the coccyx

Other treatments include physical therapy modalities, including massage and mobilisation, extracorporeal shockwave therapy. Patients can also try over the counter painkillers if safe to do so.

Topical Capsaicin, non-steroid anti-inflammatory medication, sacrococcygeal and pericoocygeal injections and ganglion blocks may be tried for more refractory cases under specialist management. There is some evidence to suggest that Dorsal root ganglion stimulation may also help with coccydynia.

Very rarely, patients may be referred for surgery, although this can be associated with prolonged recovery times and a high complication rate.

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