Ultrasound-Guided vs. Blind Coccygeal Corticosteroid Injections for Chronic Coccydynia: A Randomized, Clinical Trial

Document Type : RESEARCH PAPER


1 Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

2 Department of Geriatric, School of Medicine, Iran University of Medical Sciences, Tehran, Iran


Background: Corticosteroid injection is frequently used for chronic coccydynia management. Ultrasonography can
be used to improve the accuracy of the injection. This study aims to assess the clinical outcome of ultrasound-guided
compared to blind coccygeal injection in chronic coccydynia.
Methods: Thirty patients with chronic coccydynia were randomized into two groups and received a coccygeal
corticosteroid injection at maximum tenderness point: 15 patients with and 15 patients without ultrasound guidance. The
patient’s pain was evaluated with the visual analog scale (VAS) at 1-, 4-, 8-, and 24-week postinjection. Furthermore,
the Dallas Pain Questionnaire was assessed before injection; also, four and eight weeks after treatment. The quality of
life of patients was evaluated before an assessment and four weeks after the intervention by the SF-36 questionnaire.
Results: The VAS score decreased significantly 24-week after the intervention in both ultrasound-guided and blinded
groups (P < .001), without any significant difference between the groups (P = .964). Similarly, the Dallas pain scale had
a significant decrease at eight weeks after intervention in both groups (P < .001) with no significant difference between
the groups (P = .972). Although there was a significant improvement in the patient’s quality of life in each group eight
weeks after the intervention, it was not significantly different between the two groups. Neither of the treatment groups
had any adverse effects associated with the injection.
Conclusion: There were no significant differences in the clinical outcome of coccygeal ultrasound-guided vs. blind
steroid injection for chronic coccydynia.
Level of evidence: I


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Volume 10, Issue 10
October 2022
Pages 877-884
  • Receive Date: 27 June 2021
  • Revise Date: 08 March 2022
  • Accept Date: 09 March 2022
  • First Publish Date: 05 September 2022