3 Different Injections for Tailbone Pain

Multiple different types of injections are done to decrease tailbone pain.

3 of the most common types of tailbone injections:
  1. Steroid injection: a steroid is an anti-inflammatory medication that can be placed at a site of inflammation, to decrease the inflammation and pain at that location.
  2. Sympathetic nerve block: Sometimes in addition to the musculoskeletal pain and inflammation there is a component of nerve pain. Performing an nerve block is when the doctor places a local anesthetic (such as lidocaine) onto specific nerves in order to temporarily shut them off. After a few hours when the nerves “wake up” again, the nerves may not be so hyper-sensitive and hyper-irritable. So the nerve pain can be dramatically decreased or even completely resolved.
  3. Nerve ablation (destruction): if none of the other injections are helping, then one option is to intentionally destroy/kill/deaden the nerves that are carrying pain from a specific site. If the nerves can not carry pain signals from your tailbone, then the pain signals will never be sent to your brain and your quality of life may be dramatically improved.
Sequence of Injections
  • Steroid injection: I typically start with a local steroid injection, ideally targeting the specific area that matches the individual patient’s diagnosis. For example,  if the pain seems to mainly be coming from a distal coccyx bone spur, then I would target that spot. If the pain seems to be coming mainly from a dislocated or unstable (hyper-mobile) joint then I would target that specific area. (This is why it is so important to have an accurate diagnosis first rather than just injecting without knowing where the pain is coming from.)
  • Sympathetic nerve block: Depending on the response to a local corticosteroid injection, I would consider a ganglion Impar sympathetic nerve block. Sometimes I will combine the steroid injection and the ganglion Impar sympathetic nerve block (the steroid helps treat the musculoskeletal pain/inflammation while the nerve block helps treat the nerve pain).
  • Nerve ablation (destruction): Most patients will get good relief from either the steroid injection or the sympathetic nerve block. For those who don’t, I consider nerve ablation.
  • Repeating injections: If any given injection gives great relief (in terms of the amount of relief and the duration of relief) then that same injection could be repeated if the pain comes back many months or years later.
Fluoroscopic guidance:
  • Improved relief: In general, these injections can be done under fluoroscopic guidance so that the physician can make sure the medication is placed in the location that is most likely to relieve your tailbone pain.
  • Decreased risks: Fluoroscopy also helps the physician to make sure that they do not accidentally inject the medication into an area that would cause complications or side effects.

There are also other types of injections done for tailbone pain, but the 3 noted above are the most common.

Please post below any thoughts, questions, or comments you have about tailbone injections for tailbone pain.

Patrick Foye, M.D.
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4 comments to 3 Different Injections for Tailbone Pain

  • Margaret Browne

    Hi Dr Foye,
    My name is Margaret,

    I have suffered for years with coccyx pain due to being born with spina bifida occulta.

    I had my coccyx bone removed 4 years ago,I now feel that the last bone in my sacrum spine area is moving as seems 2B rubbing on the inside of my scar which is making a weak spot and my scar had opened 4 times since the operation I was just wondering if you had come across this before.

    I also have scoliosis, I have had 1/7 thorasic fusid with bone from my hip, my last operation was march of this year ,I had a cervical fusion 4/5 5/6 6/7 using carbon fiber discs ,titanium mesh, a steel plate, and 6 screws.

    This will probably sound mad but I feel like my spine is pulling down or even dropped down, I am in pain 24/7

    Have you any idea what I could do to try help this pain ..

    Thank you

    • Hi, Margaret.

      First of all, I am very sorry to hear about the pain that you have been suffering with despite the coccygectomy (surgical removal of the tailbone).

      Here is a specific blog post that I wrote recently on exactly the topic of tailbone pain that persists despite coccygectomy:

    • Hi James,It’s not the first time I’ve heard someone ask, Does iscruanne cover spinal decompression? It’s a coin toss as to whether or not iscruanne companies cover spinal decompression. (BUT to be honest, most every time if you call heads, the coin comes up tails).A typical patient who chooses to undergo this type of care (spinal decompression) usually does just that chooses. Depending on the nature of your condition, the severity of the symptoms, the chronicity etc, it is usually several thousand dollars for the decompression part of the care. I, often times, incorporate other modalities into the treatment plan (again, based upon the uniqueness of each case). Some of these services may be covered by iscruanne and some not- each and every iscruanne policy is different. I may use the K-Laser, the ATM2, or sometimes it’s Functional Physical Medicine, or occasionally chiropractic. Due to the high success rate and low risk of non-surgical spinal decompression, it would seem logical to approve’ this type of care prior to even letting someone undergo back surgery, right? Meaning, if it works, the iscruanne company is out four figures vs sometimes six figures for some of the extensive back surgeries. But (illogically) that’s not how it works.This care type of care is for someone who truly wants to exhaust all the conservative therapies prior to succumbing to back surgery. So for most, it’s the principle. Its for people who understand the risk of invasive procedures. Regarding costs: I’m empathetic and understanding of the out-of-pocket costs. But I also know the priceless value it can provide if successful. So, at our policy is that if someone wants the care and needs it they can get it now. And due to the nature of the cash-out-of-pocket, well, we let the patient choose a payment plan that doesn’t stretch them too far or stress them too much. They get the care now and make payments that suit them over time or they can pay for the care up front.

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