Coccygodynia treated by pulsed radio frequency treatment to the Ganglion of Impar: a case series.

BACKGROUND: Chronic coccygodynia accounts for 1% of all back pain referrals and very difficult to treat with an enormous functional deficit. OBJECTIVE: The purpose of this case series was to examine the effectiveness of pulsed radiofrequency treatment to the Ganglion of Impar in chronic coccygodynia patients unresponsive to comprehensive medical management. METHODS: Coccygodynia is defined as pain in and around the coccyx [1,2]. This retrospective review of twenty patients with a clinical diagnosis of coccygodynia and failed medical management treated with pulsed radio frequency applied to the Ganglion of Impar between January 2009 to December 2011 was carried out. A successful outcome was defined as > 50% improvement in pain on the visual analogue scale at 6 and 12 months follow-up. RESULTS: The application of pulsed radio frequency to the Ganglion of Impar was successful in fifteen (75%) patients and their mean pre treatment visual analogue scale score of 6.53 was reduced to 0.93 at 6 and 12 months follow up. In five (25%) patients the treatment was not successful and there was no difference between mean pre and post treatment visual analogue scale scores. CONCLUSION: We conclude that pulsed radio frequency treatment of the Ganglion of Impar should be considered when coccygodynia has proven resistant to medical management.