Feasibility and early clinical outcomes of ultrasound-guided coccygeal nerve pulsed radiofrequency in refractory post-traumatic coccygodynia.

Abstract

Aims: To evaluate the feasibility, safety, early clinical outcomes of a staged ultrasound-guided coccygeal nerve intervention algorithm incorporating pulsed radiofrequency (PRF) in refractory post-traumatic coccydynia.

Material and methods: Twelve patients underwent a two-phase routine clinical protocol: ultrasound-guided bilateral coccygeal nerve block followed, if pain persisted at three weeks, by PRF combined with a repeat nerve block. Outcomes included Numeric Rating Scale-sitting (NRS-sitting), sitting tolerance, and Patient Global Impression of Change (PGIC) over 8 weeks.

Results: Feasibility endpoints were met with no complications. NRS-sitting decreased from 6.33±1.23 to 2.17±0.72 at week 8 (95% CI: 1.71-2.63; p<0.001). At week 8, 58.3% of patients could sit for >30 minutes, and 75% reported high satisfaction (PGIC scores of 6 or 7). Findings should be interpreted as preliminary feasibility and short-term clinical outcomes of the staged intervention algorithm.

Conclusion: These preliminary findings suggest that a staged ultrasound-guided approach incorporating PRF is feasible and safe for refractory coccydynia, with short-term improvements in pain and functional sitting tolerance reflecting the overall staged protocol rather than the isolated effect of PRF. Larger randomized controlled trials with longer follow-up are required to determine clinical efficacy, long-term durability, and the incremental contribution of PRF.