European Spine Journal

, Volume 27, Issue 5, pp 1166–1171 | Cite as

Management of persistent coccydynia with transrectal manipulation: results of a combined procedure

  • Ali Seker
  • Ilker Abdullah Sarikaya
  • Ozgur Korkmaz
  • Sercan YalcinEmail author
  • Melih Malkoc
  • Ahmet Murat Bulbul
Ideas and Technical Innovations



We compared the results of manual therapy combined with steroid injection with single steroid injection in the treatment of persistent coccydynia.

Patients and methods

Combined therapy was performed in 21 patients (Group 1) and steroid injection in 23 patients (Group 2). We compared two groups and investigated the combined therapy group in details. Patients were classified according to the underlying cause, BMI, anatomic type of coccyx and duration of symptoms (< 6 or ≥ 6 months).


Mean age was 30.5 years at the time of procedures. Mean followup time was 27.8 months. VAS scores were decreased in both groups but combined therapy group had much more better results. Complete pain relief was achieved in 61.9% of patients in Group 1 whereas it was only 17.4% in Group 2. In 23.8% of Group 1, the VAS score was significantly decreased but the feeling of uncomfortability persisted. This was 73.9% in Group 2. We had no relapse in Group 1 but in Group 2 the relapse rate was 56.5%. Underlying cause, body mass index, anatomic type of coccyx and duration of symptoms had no effect on results.


Manual therapy combined with steroid injection would be an alternative method in case of persistent coccydynia. It is a safe and easy option before surgical treatment.


Coccydynia Manipulation Steroid injection 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Department of Orthopaedics and TraumatologyIstanbul Medipol UniversityIstanbulTurkey
  2. 2.Cocuk Ortopedi KlinigiIstanbulTurkey

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