The interdisciplinary management of coccydynia: A narrative review.

Autor: White WD; Department of Rehabilitation Medicine, MedStar Georgetown University Hospital, Washington, District of Columbia, USA.; MedStar National Rehabilitation Hospital, Physical Medicine & Rehabilitation, Washington, District of Columbia, USA.; International Spine, Pain & Performance Center, Washington, District of Columbia, USA., Avery M; International Spine, Pain & Performance Center, Washington, District of Columbia, USA., Jonely H; International Spine, Pain & Performance Center, Washington, District of Columbia, USA.; The George Washington University, School of Medicine and Health Sciences, Washington, District of Columbia, USA., Mansfield JT; Department of Rehabilitation Medicine, MedStar Georgetown University Hospital, Washington, District of Columbia, USA.; MedStar National Rehabilitation Hospital, Physical Medicine & Rehabilitation, Washington, District of Columbia, USA.; International Spine, Pain & Performance Center, Washington, District of Columbia, USA., Sayal PK; International Spine, Pain & Performance Center, Washington, District of Columbia, USA., Desai MJ; International Spine, Pain & Performance Center, Washington, District of Columbia, USA.; The George Washington University, School of Medicine and Health Sciences, Washington, District of Columbia, USA.
Jazyk: angličtina
Zdroj: PM & R : the journal of injury, function, and rehabilitation [PM R] 2022 Sep; Vol. 14 (9), pp. 1143-1154. Date of Electronic Publication: 2021 Sep 07.
DOI: 10.1002/pmrj.12683
Abstrakt: Pain that develops in the coccyx or surrounding tissues is known as coccydynia, which occurs as a result of many etiologies both traumatic and nontraumatic. Although coccydynia most commonly affects middle-aged women, it may be found in both sexes and in all age groups. The aim of this article is to provide an overview of the presentation, diagnostic imaging, and pathophysiology of coccydynia, and to comprehensively review the current treatment options. A review of publications from 1990 to 2020 using search words related to the treatment of coccydynia in PubMed and Google Scholar was completed. Level II evidence was found supporting stretching, manipulation, and extracorporeal shock wave therapy. There are no data from high-quality studies to support injection-based therapy including corticosteroids, prolotherapy, nerve blocks, and radiofrequency ablation, although there are small retrospective and prospective observational studies suggesting benefit. Level III evidence was found supporting coccygectomy for chronic/refractory coccydynia. There are no data from randomized controlled trials to support the use of neuromodulation (sacral burst and dorsal root ganglion stimulation), although there are case reports suggesting benefit. High-level, comparative studies are lacking to guide the treatment of coccydynia and should be a focus for future research studies.
(© 2021 American Academy of Physical Medicine and Rehabilitation.)
Databáze: MEDLINE
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