Platelet-rich plasma injections improve functional results over pulsed radiofrequency in ganglion impar treatments for coccydynia.

Introduction: Coccydynia is a painful condition commonly related to trauma or repetitive stress. While most cases respond to conservative management, a subset of patients requires minimally invasive interventions. Platelet-rich plasma (PRP) has recently emerged as a biological treatment alternative, promoting tissue repair. This study aimed to compare the clinical efficacy of PRP injections versus pulsed radiofrequency (PRF) at the ganglion impar in patients with coccydynia refractory to conservative treatment.

Methods: A retrospective cohort study was conducted on 40 consecutive patients treated for coccydynia. 20 received PRP injections and 20 underwent PRF at the ganglion impar. Functional disability was measured by the Oswestry Disability Index (ODI) and pain intensity was assessed using the Visual Analogue Scale (VAS) at baseline and at six months. Statistical analysis included t-tests and multivariable regression models adjusted for baseline characteristics.

Results: Both groups showed improvement in pain and function. There were no significant differences in pre- or post-treatment VAS scores between the two groups. However, the mean change in ODI scores was significantly greater in the PRP group (-9.6 ± 4.2) compared to the PRF group (-5.4 ± 6.3), with a statistically significant difference in functional improvement (p = 0.018), and a clinically relevant improvement (≥30% reduction in ODI) was achieved in 85% of cases versus 45%, respectively (p = 0.02). The adjusted analysis confirmed the superiority of PRP after controlling for baseline differences.

Conclusion: PRP injections at the ganglion impar demonstrated superior improvement in functional outcomes compared to PRF in patients with refractory coccydynia. These findings support the use of PRP as a potentially more effective minimally invasive treatment, though prospective studies with longer follow-up are needed to confirm these results.