What is a coccyx block or ganglion impar block?

The coccyx, or tailbone, is the bottom-most bone of the spine. The nearest nerve root is the ganglion impar. Irritation of the ganglion impar can cause pain in the tailbone. Injecting a fast-acting local anesthetic like lidocaine (which is used by dentists prior to filling a cavity) can provide immediate relief of this pain. This is called a ganglion impar block or coccyx block. Even after the pain-relieving effect subsides, the level of pain may be lower than it was originally. Further relief can be attained by additional injections into the ganglion impar block.

Am I a candidate for a coccyx block?

You are a candidate for ganglion impar block if you have significant pain in your coccyx, or tailbone, region that has not improved with rest, heat/ice therapy, physical therapy, and anti-inflammatory medications. As with any injection into the spinal cord, if you have an infection over the injection site or problems with your blood clotting, you are not a candidate for this procedure. Tell your doctor if you have allergies to anesthetic medications or contrast dye. Also, make sure your doctor knows if you are taking blood thinners like Coumadin, heparin, or aspirin. You will most likely be instructed to stop taking these medications prior to the procedure to reduce the risk of uncontrolled bleeding, but never stop blood thinners without discussing it with your provider.

How long will coccyx block take?

The ganglion impar block is not a lengthy procedure. However, you will have to stay in the office for about two hours following the procedure for observation. Your provider will likely perform this injection with guidance from fluoroscopy, or continuous x-ray with contrast medium. You might receive intravenous calming medicine prior to the procedure – your provider will talk to you about this. Your back will be cleansed and numbing medicine will be injected into the skin above your coccyx. This might sting briefly. Your doctor will inject a small amount of contrast dye into your spinal column to help visualize the structures in and around the spinal cord. The ganglion impar will be stimulated to ensure the proper site is located and the numbing medicine is injected. Your doctor will hold pressure over the site for five to ten minutes after the needle is removed. Often, patients feel relief before they get off the table following the procedure.

How long will it take to recover from coccyx block?

The recovery associated with ganglion impar blocks is minimal. You will be required to be observed in the office for up to two hours following the procedure. If you receive sedation medicine to keep you calm and comfortable during the procedure, you will need a responsible adult to drive you home. Pain relief may be immediate. If it is not complete, you may need multiple injections to find complete pain relief.

Reference:

Foye, P. (2017). Coccyx pain treatment and management. Medscape. Retrieved from http://emedicine.medscape.com/article/309486-treatment#d11