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

Yousef Marwan, Bashar Dahrab, Ali Esmaeel, Samir Abdulrazik Ibrahim, Jassim Al-Failakawi

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.