Non-surgical Treatment of Coccygodynia with Manual Therapy - Case Report

Introduction: Coccygodynia – pain in the coccyx and tissues lying in its immediate vicinity is a known problem, however, little examined and assessed. The problem affects only 1% of people with spinal problems. This may be for many reasons – from organic to functional, to a number of extra-local causes. Study aim: The aim of the study is to present the diagnostic process and course of non-surgical – physiotherapeutic treatment – of a 12-year-old boy with idiopathic coccyx pain syndrome using the methodology of manual therapy proposed by Rakowski, with an assessment of immediate and final treatment points. Materials and methods: Research was carried out among a group of 13.793 subjects at the Centre of Manual Therapy in Sierosław near Poznań. From this group, individuals with tailbone pain were extracted, which accounts for 1.15% of the remaining participants. The following case report is a representative example selected from the above group. Diagnostics were based on subjective assessment and medical examination (performed at a children's hospital), including medical examination with access through the anus and physiotherapeutic manual examination. Results and conclusions: Coccygodynia requires detailed imaging and functional diagnostics, with particular attention being paid to the structures directly related to the sacro-coccygeal region, as well as to the place lying outside the area of the experienced ailments. The solution to idiopathic pain syndrome in the coccygeal region is targeted manual therapy, taking selected elements of the musculoskeletal structures into account. The described procedure is in line with the methods created by Rakowski, along with local and non-local therapeutic interventions. In the described case, total alleviation of the ailments was achieved, both in short-term assessment and 3 years after completion of treatment.