Comparison of Manual Treatment and Co-administration of Methylprednisolone Injection with Manipulation in Coccydynia

Abstract

Background: This study was conducted to evaluate the usefulness of manipulation along with local methylprednisolone acetate injection on the improvement of chronic coccydynia.

Methods: A randomized trial was designed. Thirty patients were recruited and divided randomly into two groups. The first group received three sessions of manual therapy based on Maigne and Thiele methods. The other group received manipulation with injection of methylprednisolone acetate around the coccyx and sacrococcygeal and intercoccygeal joints. Then, the patients were followed up for one day, a week, a month, and three months after the intervention. Severity of pain was assessed by Visual Analog Scale (VAS) and the Paris (functional coccydynia impact) Questionnaire during the follow-ups. Finally, the data were analyzed using a repeated measures analysis of variance (ANOVA) model.

Results: The mean duration of coccygeal pain was 23.3 ± 38.3 months. There were not any significant differences between the two groups regarding the age and duration of coccydynia. The results of repeated ANOVA indicated that the pain decreased during three months of the follow-up in both groups significantly (P < 0.0001). However, there was no statistically significant difference between the two groups regarding the pain reduction (P = 0.691).

Conclusion: One episode of injection of methylprednisolone acetate can limit the treatment sessions of manipulation to just one session without additive effect on pain reduction.