Nadeem Akbar Baloch, Imtiaz Hashmi, Muhammad Khalid, Madiha Hashmi.
Local infilteration of steroid in conjunction with coccygel manipulation as a treatment of coccydynia.
J Surg Pak Jan ;17(2):65-7.

Objective: To asses the efficacy of local infiltration of steroid in conjunction with coccygel manipulation as a treatment of coccydynia. Study design: Interventional study. Place & Duration of study: Department of Orthopaedic Surgery, Ziauddin Hospital Karachi, from December 2000 to December 2008. Methodology: All selected patients who did not improve three to six month of conservative treatment, were enrolled. The patients were treated with local infiltration of steroid in conjuncation with coccygel manipulation and followed for up to 2 years. Results: A total of 172 patients were diagnosed with coccydynia. The average age of the patients was 38.3 year. There were 138 (80.2%) males and 34 (19.8%) females. Trauma was responsible for pain in 118 (68.6%) cases. Of the total patients, 97 (56.4%) recovered with conservative management and remaining 75 (43.6%) underwent manipulation of coccyx under sedation with local infiltration of steroid. Fifty three (70.7%) patients had excellent results, 14(18.7%) had good response and 8 (10.7%) had fair outcome on first visit. In 2 year follow up 60 (80%) patients showed good response. Second injection was given in 5(6.7%) patients and 3rd injection was needed in one (1.3%) patient. Nine (12%) patients were lost to follow up. Conclusions: We recommend manipulation along with local infiltration of steroid in all patients of coccydynia. This approach is less invasive and carried out under sedation as a daycare procedure.

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