RecruitingNot ApplicableNCT07426497

Osteopathic Manual Therapy vs Ganglion Impar Block for Chronic Coccydynia

Comparison of Osteopathic Manual Therapy and Ganglion Impar Block in Patients With Chronic Coccydynia

Sponsor

Istanbul Medeniyet University

Enrollment

100 participants

Start Date

Aug 28, 2025

Study Type

INTERVENTIONAL

Conditions

Chronic Pain Coccydynia Coccygodynia

Summary

Chronic coccydynia is a condition characterized by persistent pain in the coccyx region that can significantly impair sitting tolerance, daily activities, and quality of life. Various conservative and interventional treatment options have been described, including manual therapy techniques and ganglion impar block. However, the comparative effectiveness of these approaches remains unclear. The aim of this randomized controlled study is to compare the effects of osteopathic manual therapy and ganglion impar block on pain intensity and functional disability in patients with chronic coccydynia. Participants will be randomly assigned to one of the two treatment groups. Pain severity will be assessed using the Numeric Rating Scale (NRS), and functional status will be evaluated with the Oswestry Disability Index (ODI) at baseline, week 3, and month 3. The results of this study are expected to provide evidence regarding the relative effectiveness of these two commonly used treatment methods and to guide clinicians in selecting appropriate management strategies for patients with chronic coccydynia.

Eligibility

Min Age: 18 YearsMax Age: 75 Years

Inclusion Criteria7

Age 18-75 years
Chronic coccygodynia ≥3 months
Baseline NRS ≥4
ODI ≥20
Failure of prior conservative treatment
Imaging excludes fracture, infection, or malignancy
Ability to provide written informed consent

Exclusion Criteria8

Acute coccygodynia
Prior spinal or coccygeal surgery
Malignancy
Pelvic fracture
Pregnancy
Coagulation disorder
Severe psychiatric disease
Prior osteopathic manual therapy or ganglion impar block

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Interventions

PROCEDUREOsteopathic Manual Therapy

Osteopathic manual therapy was applied to the sacrococcygeal region. Techniques included myofascial release, ligamentous tension balancing, and gentle mobilization. Treatment was performed once weekly for three consecutive weeks by a certified practitioner.

PROCEDUREGanglion Impar Block

A single ganglion impar block was performed under fluoroscopic guidance using local anesthetic combined with corticosteroid. The procedure was carried out under sterile conditions without additional manual therapy.