Disclosures: Daniel Wang: No financial relationships or conflicts of interest

Case Diagnosis: A 45-year-old male presented with chronic coccyx pain and is treated with radiofrequency ablation (RFA) to the anococcygeal nerve.

Case Description: A 45-year-old male presented with chronic tailbone pain after a fall. X-ray of the coccyx revealed displacement of the distal segment. Physical therapy was tried, but yielded minimal improvement in pain. He underwent multiple ganglion impar blocks providing 6-8 weeks of relief. In order to provide longer duration in symptomatic relief, RFA of the anococcygeal nerves was proposed.

Setting: Outpatient clinicAssessment/

Results: Bipolar RFA was performed along the lateral aspect of the coccyx with fluoroscopic guidance. The patient reported 95% and 40% pain relief on the right and left sides, respectively, both immediately and at 2-year follow-up. Further, the patient had functional improvement in regards to sitting time, ambulation, and activities of daily living.

Discussion: The use of RFA for coccydynia has been previously described in the literature targeting various structures around the coccyx including first intercoccygeal disk, ganglion impar, and sacrococcygeal nerve. Currently, there is no consensus on which approach is most beneficial for patients with chronic coccydynia. To our knowledge, this approach has not been described in the literature and may serve as an alternative approach.

Conclusion: This technique is an alternative method that may be a safe and effective treatment approach for coccydynia in patients who do not respond to conservative modalities. Additional high quality studies are necessary to further evaluate the long term efficiency of this approach and how it compares to other interventional techniques.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/radiofrequency-ablation-of-the-anococcygeal-nerve-for-the-treatment-of-chronic-coccyx-pain-a-case-report/