COMPARATIVE EFFECTS OF COCCYGEAL NERVE BLOCK AND GANGLION IMPAR BLOCK ON PAIN, FUNCTION, AND QUALITY OF LIFE AMONG FEMALE PATIENTS WITH CHRONIC COCCYDYNIA

Abstract

Background: Chronic coccydynia causes disability and reduces quality of life due to extreme pain and intolerance to sitting. Certain blocks, such as a coccygeal nerve block (CnB) or a ganglion impar block (GIB), may be considered if conservative treatments are unsuccessful.

Objective: The aim of this study is to compare CnB and GIB on pain, function and quality of life among patients with chronic coccydynia.

Methods: This study was a randomized, parallel group trial. Forty-four (44) women, 40 to 60 years of age with chronic coccydynia were randomly assigned to undergo either a CnB or a GIB. Pain was measured with a 100 mm Visual Analog Scale (VAS), functional disability with the Oswestry Disability Index (ODI) and quality of life with the Short-Form 36-Item Health Survey (SF-36). All measures were completed prior to the block and at 4 and 12 weeks post block.

Results: The two groups were similar at baseline. Both blocks, at their respective time points, improved all measures. At 4 weeks post block, patients in the GIB group had a significantly lower VAS score than patients in the CnB group (3.02 vs. 4.66). The difference in VAS scores between the two groups was also significant at the 12 week time point (2.50 vs. 4.25). The GIB group also had greater improvement in ODI scores at 4 and 12 weeks when compared to the CnB group. At 12 weeks post block, all 8 domains of the SF-36 questionnaire were statistically higher in the GIB group when compared to the CnB group. Conclusions: In the sample population, GIB was more effective than CnB for the short to medium term improvement of the primary and secondary outcomes.