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Coccydynia/ Perineal Neuralgia

Home Coccydynia/ Perineal Neuralgia


Coccydynia is a pain in the vicinity of coccyx. Commonly seen in the age group between 30 years to 50 years. Coccyx provides support for adjacent structures.

There are various causes for coccydynia like:
  • Congenital abnormality
  • Infection
  • Trauma
  • Tumors
  • Degenerative changes of sacrococcygeal joint

Patient will complain of pain worsened by sitting/defaecation. Pain will be relieved by standing/walking/lying down. Local tenderness over coccyx will be present. Movement of coccyx will aggravate the pain.

Pain Management:

  • Investigations
  • Treatment
    • Conservative
    • Pharmacological
    • Interventional
      • Local infiltration with LA+ steroid repeated at weekly intervals
      • Ganglion impar block to out sympathetic origin of pain
      • B/L S5 dorsal root ganglionotomy is done with RF
      • Surgery

Perineal Neuralgia:

This condition is seen often postmenopasually. Women complain of a kind of pulling or crawling sensation in the clitoral area. Patients prefer to stand rather than sit, because sitting aggravate the pain.

Pain Management:

  • Pharmacological methods
  • Interventional
    • Lumbar sympathectomy
    • Hypogastric plexus block
    • Ganglion impar block
    • Epidural Local Anaesthesia + steroid

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