Type of Article:  Case Report

Volume 5; Issue 3 (May 2017)

Page No.: 2010-2012

DOI: https://dx.doi.org/10.16965/ijpr.2017.116


Samina Ghulam *, Amjad Sharif.

Physiotherapist, Armed Forces Institute of Rabilitation Medicine, Rwawalpindi, Pakistan.

Address for Correspondence: Samina Ghulam, Physiotherapist, Armed Forces Institute of Rabilitation Medicine, Rwawalpindi, Pakistan E-Mail: Saminaghulam.sg@gmail.com


Introduction: Coccydynia is a painful disorder of the end portion of vertebral column. This is a relatively unusual condition with no universally accepted treatment. Patients with coccydynia should be managed conservative; conservative treatments include NSAIDs, local steroid injections, physiotherapy and precautions. Surgery can offer when failure of conservative treatment.

Case Description: A 28 years old female with chronic coccxydynia for two years after carrying a child, she had gone through physiotherapy, NSAIDs, and local steroids repeatedly. She was advised for coccygectomy. Her married and social life was extremely disturbed.

Procedure: Procedure of soft tissue mobilization (myofascial release) for pain management and sacrococcygeal joint mobilization was adopted to resume the mobility of joint.

Result: Before procedure, Score of Oswestry disability index was 38% that showed moderate disability, pain level on VAS was 6/10 and after treatment remarkable change in symptoms, Score of Oswestry disability index was 2% that showed minimal disability, pain level on VAS was 0/10

Purpose: This case report describes the successful management of chronic coccydynia by sacrococcygeal joint mobilization and soft tissue release. This report will also help clinician to select appropriate manual therapy measure and avoid unnecessary use of other techniques and therapies. It also will avoid the hesitation in application of maneuver.

Recommendation: The further research and clinical trials are needed to explore selection of manual therapy procedures in term of their effectiveness on patients with chronic coccydynia.

Key Words: Coccydynia, Manual Therapy, Myofascial Release, Sacrococcxygeal Mobilization, Coccygectomy.


  1. Marinko LN, Pecci M. Clinical decision making for the evaluation and management of coccydynia: 2 case reports. journal of orthopaedic & sports physical therapy. 2014;44(8):615-21.
  2. Ryder I, Alexander J. Coccydynia: a woman’s tail. Midwifery. 2000;16(2):155-60.
  3. Howard PD, Dolan AN, Falco AN, Holland BM, Wilkinson CF, Zink AM. A comparison of conservative interventions and their effectiveness for coccydynia: a systematic review. Journal of Manual & Manipulative Therapy. 2013;21(4):213-9.
  4. Lirette LS, Chaiban G, Tolba R, Eissa H. Coccydynia: an overview of the anatomy, etiology, and treatment of coccyx pain. The Ochsner Journal. 2014;14(1):84-7.
  5. Ravi Patel AA, and Peter G. Whangcorresponding author. Coccydynia. Musculoskeletal Med. Dec. 2008;1 (3-4).
  6. Mitra R, Cheung L, Perry P. Efficacy of fluoroscopically guided steroid injections in the management of coccydynia. Pain Physician. 2007;10(6):775.
  7. Hodges SD, Eck JC, Humphreys SC. A treatment and outcomes analysis of patients with coccydynia. The Spine Journal. 2004;4(2):138-40.
  8. Maigne J, Rusakiewicz F, Diouf M. Postpartum coccydynia: a case series study of 57 women. European journal of physical and rehabilitation medicine. 2012;48(3):387-92.
  9. Maigne J, Pigeau I, Aguer N, Doursounian L, Chatellier G. Chronic coccydynia in adolescents. A series of 53 patients. European journal of physical and rehabilitation medicine. 2011;47(2):245-51.
  10. Marc Heller D. The Coccyx Revisited: External and Internal Exam Correction Procedures. Dynamic Chiropractic. Feb. 12, 2004. .
  11. Maigne J-Y, Chatellier G. Comparison of three manual coccydynia treatments: a pilot study. Spine. 2001;26(20):E479-E83.
  12. Sutcliffe P, Clar C, Tsertsvadze A, Briscoe S, Clarke A. Clinical and cost-effectiveness of manual therapy for the management of a variety of musculoskeletal and non-musculoskeletal conditions: a systematic review and narrative synthesis. Coventry, UK: Warwick Medical School; 2013.
  13. Bronfort G, Haas M, Evans R, Leininger B, Triano J. Effectiveness of manual therapies: the UK evidence report. Chiropractic & Manual Therapies. 2010;18(1):3.

Cite this article: Samina Ghulam, Amjad Sharif. EFFECTIVENESS OF MANUAL THERAPY IN COCCYDYNIA: A CASE REPORT. Int J Physiother Res 2017;5(3):2010-2012. DOI: 10.16965/ijpr.2017.116