Effect of fluoroscopically guided corticosteroid injection versus oral nonsteroidal anti-inflammatory drugs for treatment of coccydynia: A randomized, controlled, single-blind study

Abstract

Background: Coccydynia is a major cause of coccyx pain that can result in chronic pain as well as reduced functional performance in patients. The aim of this study was to compare the efficacy of fluoroscopically guided corticosteroid injection with an oral nonsteroidal anti-inflammatory drug (NSAID) to relieve coccyx pain. Methods: In a clinical trial study, 28 patients with coccydynia who were randomly divided into two groups and matched based on sex, age, and body mass index. One group was treated with celecoxib 200\u2009mg (every 12\u2009hr) for 1\u2009mo along with regular use of a tailbone pillow while sitting on hard surfaces. The second group received local periarticular injection of methylprednisolone acetate 40\u2009mg along with lidocaine 1%, which was fluoroscopically guided. The patients were followed for 4\u2009mo. Results: There was a significant difference in pain severity of the patients when compared with their condition at the beginning of the study in each group (P<0.001). The final pain severity of NSAID group and steroid group was 37.9±14.2\u2009mm and 38.7±16.1\u2009mm, respectively, which was not significantly different. Also the trend of pain severity was similar between the two groups. Conclusions: Corticosteroid injection for coccydynia treatment at least has the same advantages of oral NSAID medication. Regarding its single-dose administration and reasonable price, it can be considered as an alternative modality in treatment of this disease if the target patient is selected correctly. Level of Evidence: Level I.