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Abstract

Coccydynia is characterized by pain or discomfort in the coccyx region, most frequently caused by direct trauma. This condition, exacerbated by sitting on flat or hard surfaces, may cause immobility and adversely impact activities of daily living. Standard treatment options include ergonomic adaptations, manual or physical therapy, nerve blocks, and surgery. Currently, there is very little evidence supporting the use of osteopathic manipulative treatment (OMT) as a therapeutic option for patients with chronic coccydynia. The authors describe the case of a 26-year-old, previously healthy, highly active, female competitive volleyball player who developed chronic coccydynia following direct trauma to her coccyx.

At first visit, her pain levels were 10/10, requiring persistent use of a donut pillow and decreasing her engagement in physical activities. Yet, after one treatment session involving intrarectal manipulation of the coccyx using OMT, pain immediately decreased posttreatment and was nonexistent by 6-month follow-up. The patient no longer required a donut pillow and returned to competing in volleyball at a high level. Given the limited treatment options for coccydynia, OMT should be further explored as a standardized therapeutic option, considering the significant impact of coccydynia on patients’ quality of life and the excellent safety profile of OMT compared to current standard pharmaceutical or surgical options.

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