Tailbone Injections AFTER Coccygectomy (Surgical Removal of the Coccyx)

  • Coccygectomy is surgical removal of the coccyx.
  • Fortunately, the vast majority of patients with coccydynia (coccyx pain, tailbone pain) respond well to NON-surgical treatment and therefore do NOT require coccygectomy. Typical treatments include coccyx cushions and tailbone injections.
  • For those small percentage of patients who fail to get adequate relief despite injections, etc., it may be worth considering coccygectomy.
  • Coccygectomy can give significant relief for coccyx pain, but after this surgery unfortunately most patients will still have some degree of persistent pain  at that region.
  • So, the question becomes: can you still do injections even AFTER the coccyx has been surgically removed? The answer is YES!
Tailbone Injections AFTER Coccygectomy
  • Many of the injections done AFTER coccygectomy are similar to those done BEFORE coccygectomy.
  • See: Tailbone Injections for Coccyx Pain
  • However, there are some important differences.
    • Firstly, it is important to look for the actual CAUSE of the ongoing tailbone pain. After coccygectomy, it is especially important to consider the following:
    • Secondly, the physician during the injection  must be aware of the CURRENT anatomy.
      • Some of the typical landmarks and reference points for doing injections will now be changed or completely absent because most or all of the coccyx has been removed by the surgery.
      • So, it is especially helpful to use image guidance such as fluoroscopy for tailbone injections.
    • Scar tissue from the surgery may obstruct the flow of the injected medications, making it more difficult for them to effectively cover the target area.
    • Despite these challenges,  many patients with persistent pain after coccygectomy can obtain substantial relief through a wisely and carefully performed injection.
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Patrick Foye, M.D.
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