Peripheral nerve blocks for coccydynia pain
- Conditions
- Nerve root and plexus disorder, unspecified,
- Registration Number
- CTRI/2021/09/036418
- Lead Sponsor
- AIIMS Rishikesh
- Brief Summary
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|Coccydynia is a pain felt in the tailbone (coccyx), which is the last bone at the bottom of spine, It was originally attributed to the injury of the coccyx with inflammation of surrounding tissue by Simpson (1). The main clinical features are pain and tenderness in the area just above the buttocks, the pain may be dull and achy most of the time, with occasional sharp pains, it will be worse when sitting down, moving from sitting to standing, standing for long periods, during sex and defecation.
It is often for the patient to have difficulty in sleeping and carryout everyday activities such as driving or bending over. Some people also have back pain, shooting leg pains (sciatica) and painful buttocks and hips.
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|Common causes of coccydynia include; childbirth, an injury or accident such as fall, an injury or accident such as a fall, repeated or prolonged strain on the coccyx, poor posture, being overweight or underweight. Less common causes can include a bony growth on the coccyx, the coccyx being too flexible or too rigid and arthritis. Rare but serious causes include infection and cancer.
Current guidelines strongly recommend conservative treatment and discourage surgical option due to the risk of long-term complications (2). Non-surgical options for the treatment of coccydynia include non-steroidal anti-inflammatory and analgesic medications, rest, hot baths, massage, and a ring-shaped cushion to protect the coccyx from repetitive trauma. Physical therapy modalities include shortwave diathermy to relieve pain and muscle spasms by deep tissue heating, interferential current to provide temporary relief.
Ganglion impar block with local anaesthetic and steroids may be indicated if the conservative treatment fails. The Ganglion impar block is routinely performed in operation theatre set up in prone position with the help of fluoroscopy or ultrasound guidance.
We hypothesize that our spinal nerves are pseudo unipolar and carry the information in bi-directional, therefore, blocking the peripheral nerves should block the pain due to coccidynia (3), the case report by Hammodi has shown prolonged relief of coccidynia pain with peripheral nerve (posterior tibial) injections (4).
The present study will examine the efficacy of peripheral nerve block (posterior tibial nerve) in treatment of coccidynia in patients attending our pain clinic.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Not Yet Recruiting
- Sex
- All
- Target Recruitment
- 30
1.Patient suffering from coccidynia due to any cause, which is not responding to conservative treatment with numerical rating scale of > 4/10 2.Duration of pain >3months.
- 1.Coagulopathy and/or patients on anticoagulants.
- 2.Infection at the site of injection.
- 3.Hypersensitivity to local anesthetic agent 4.History of any major comorbid medical conditions, those interfere with recording of study outcomes, and pregnancy.
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method To assess the efficacy of bilateral posterior tibial nerve blocks in the treatment of coccidynia pain in terms of Immediately after the procedure | 15 days after the procedure | 1 month after the procedure | 2 months after the procedure | 3 months after the procedure 1.Pain relief as assessed by Numerical Rating Scale (NRS) on a scale of 1-10 (Annexure I) Immediately after the procedure | 15 days after the procedure | 1 month after the procedure | 2 months after the procedure | 3 months after the procedure 2.Global Perceived Effects (Annexure-II) Immediately after the procedure | 15 days after the procedure | 1 month after the procedure | 2 months after the procedure | 3 months after the procedure 3.Physical functioning as assessed by Modified Oswestry Disability scale (Annexure –III) Immediately after the procedure | 15 days after the procedure | 1 month after the procedure | 2 months after the procedure | 3 months after the procedure
- Secondary Outcome Measures
Name Time Method 1.To assess spontaneous reporting of adverse effects and the incidence of complications due to the procedure complications will be assessed immediately after the procedure
Trial Locations
- Locations (1)
AIIMS Rishikesh
🇮🇳Dehradun, UTTARANCHAL, India
AIIMS Rishikesh🇮🇳Dehradun, UTTARANCHAL, IndiaDr Praveen TalawarPrincipal investigator9654162941praveenrt64@gmail.com