Extracorporeal shock wave therapy for the treatment of coccydynia: a series of 23 cases

  • Yousef MarwanEmail author
  • Bashar Dahrab
  • Ali Esmaeel
  • Samir Abdulrazik Ibrahim
  • Jassim Al-Failakawi
Original Article • SPINE - COCCYX



Coccydynia can lead to significant functional disability and worsening of quality of life if not properly managed. In this study, we aim to assess the outcomes of extracorporeal shock wave therapy in patients with coccydynia.


A prospective case series study was carried out from January to December 2015. Twenty-three patients, mean age of 38.3 ± 12.1 (range 18–64), were included. The majority were females (13; 56.5%), had pain for at least 6 weeks (17; 73.9%) and had trauma to the sacrococcygeal region (17; 73.9%). They had three sessions (one session per week for three consecutive weeks) of focused shock wave therapy directed to the maximal point of coccygeal tenderness. Numerical pain scale and Oswestry disability index were used to assess outcome.


Six (26.1%) patients did not complete the follow-up because of no, or minimal, improvement of their pain. After 6 months of follow-up, the median numerical pain scale significantly decreased from 7.0 ± 4.0 to 2.0 ± 2.0 among the 17 patients with coccydynia (p < 0.001). The median Oswestry disability index improved from 24.0 ± 9.0 before therapy to 8.0 ± 9.0 at final follow-up (p < 0.001). Before treatment, 12 (70.6%) patients had moderate-to-severe disability. In contrast, no patients had severe disability and only one (5.9%) patient had moderate disability at final follow-up (p < 0.001).


Extracorporeal shock wave therapy had favorable outcomes in treating coccydynia. The majority of patients had partial relief of their pain and disability following this therapy.


Coccydynia Coccygodynia Coccyx Pain Extracorporeal shock wave therapy 



We would like to thank the physiotherapy team of Al-Razi Orthopaedic hospital for their help throughout the study.

Compliance with ethical standards

Conflict of interest

All authors declare no conflict of interest.

Ethical standards

This research was given ethical approval from our institutional review board (IRB). The study complies with the current laws of our country.


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Copyright information

© Springer-Verlag France 2017

Authors and Affiliations

  • Yousef Marwan
    • 1
    • 2
    Email author
  • Bashar Dahrab
    • 1
  • Ali Esmaeel
    • 1
    • 3
  • Samir Abdulrazik Ibrahim
    • 1
  • Jassim Al-Failakawi
    • 1
  1. 1.Department of Orthopaedic SurgeryAl-Razi Orthopaedic HospitalSafat, Kuwait CityKuwait
  2. 2.Division of Orthopaedic Surgery, McGill University Health CentreMcGill UniversityMontrealCanada
  3. 3.Division of Orthopaedic Surgery, Department of Surgery, Faculty of Medicine, Health Sciences CenterKuwait UniversityKuwait CityKuwait

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