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Clinical Research Article

Korean J Pain 2022; 35(1): 106-113

Published online January 1, 2022 https://doi.org/10.3344/kjp.2022.35.1.106

Copyright © The Korean Pain Society.

Comparison of treatment outcomes in chronic coccygodynia patients treated with ganglion impar blockade versus caudal epidural steroid injection: a prospective randomized comparison study

Savas Sencan1 , Gunay Yolcu2 , Serhad Bilim3 , Ozge Kenis-Coskun2 , Osman Hakan Gunduz1

1Division of Pain Medicine, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Marmara University, Istanbul, Turkey
2Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Marmara University, Istanbul, Turkey
3Pain Clinic, Adıyaman Education and Research Hospital, Adıyaman, Turkey

Correspondence to:Gunay Yolcu
Department of Physical Medicine and Rehabilitation, Marmara University Medical School Pendik Research and Training Hospital, Fevzi Çakmak Mahallesi, Tepe Sokak, No: 41, Üst Kaynarca, Pendik, Istanbul 34899, Turkey
Tel: +90 216 657 06 06
Fax: +90 216 625 46 39
E-mail: dryolcugunay@gmail.com

Handling Editor: Younghoon Jeon

Received: August 4, 2021; Revised: October 5, 2021; Accepted: October 6, 2021

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Coccygodynia is one of the chronic, refractory painful musculoskeletal disorders. Interventional procedures are applied to patients unresponsive to initial treatment in coccygodynia. This study aims to compare the treatment outcomes of ganglion impar block (GIB) and caudal epidural steroid injection (CESI) in patients with chronic coccygodynia.
Methods: This study was a prospective randomized comparison study conducted between June 2019 and January 2021. Patients diagnosed with chronic coccygodynia were randomly divided into two groups: the GIB group and the CESI group. The severity of pain, presence of neuropathic pain, and quality of life were evaluated using the Numeric Rating Scale, Leeds Assessment of the Neuropathic Symptoms and Signs Scale, and Short Form-12 Health Survey (SF-12), respectively.
Results: A total of 34 patients in each group were included in the final analyses. While there was a significant decrease in pain intensity in both groups in the 3-month follow-up, this decrease was more significant in the GIB group at the 3rd week. There was a significant improvement in the SF-12 physical score and the number of patients with neuropathic pain in both groups in the 3rd week, but this improvement was not observed in the 3rd month.
Conclusions: Although GIB may provide more pain relief in short term, both GIB and CESI are useful treatment methods in coccygodynia unresponsive to more conservative treatments.

Keywords: Chronic Pain, Coccyx, Ganglia, Sympathetic, Injections, Epidural, Musculoskeletal Pain, Neuralgia, Pain Measurement, Pelvic Girdle Pain, Quality of Life, Steroids, Treatment Outcome.