{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T17:38:41Z","timestamp":1787506721601,"version":"build-2736575974"},"reference-count":48,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,9,7]],"date-time":"2021-09-07T00:00:00Z","timestamp":1630972800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Pain that develops in the coccyx or surrounding tissues is known as coccydynia, which occurs as a result of many etiologies both traumatic and nontraumatic. Although coccydynia most commonly affects middle\u2010aged women, it may be found in both sexes and in all age groups. The aim of this article is to provide an overview of the presentation, diagnostic imaging, and pathophysiology of coccydynia, and to comprehensively review the current treatment options. A review of publications from 1990 to 2020 using search words related to the treatment of coccydynia in PubMed and Google Scholar was completed. Level II evidence was found supporting stretching, manipulation, and extracorporeal shock wave therapy. There are no data from high\u2010quality studies to support injection\u2010based therapy including corticosteroids, prolotherapy, nerve blocks, and radiofrequency ablation, although there are small retrospective and prospective observational studies suggesting benefit. Level III evidence was found supporting coccygectomy for chronic\/refractory coccydynia. There are no data from randomized controlled trials to support the use of neuromodulation (sacral burst and dorsal root ganglion stimulation), although there are case reports suggesting benefit. High\u2010level, comparative studies are lacking to guide the treatment of coccydynia and should be a focus for future research studies.<\/jats:p>","DOI":"10.1002\/pmrj.12683","type":"journal-article","created":{"date-parts":[[2021,8,1]],"date-time":"2021-08-01T08:23:56Z","timestamp":1627806236000},"page":"1143-1154","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["The interdisciplinary management of coccydynia: A narrative review"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2969-2798","authenticated-orcid":false,"given":"William D.","family":"White","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine MedStar Georgetown University Hospital  Washington District of Columbia USA"},{"name":"MedStar National Rehabilitation Hospital, Physical Medicine &amp; Rehabilitation  Washington District of Columbia USA"},{"name":"International Spine, Pain &amp; Performance Center  Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melinda","family":"Avery","sequence":"additional","affiliation":[{"name":"International Spine, Pain &amp; Performance Center  Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly","family":"Jonely","sequence":"additional","affiliation":[{"name":"International Spine, Pain &amp; Performance Center  Washington District of Columbia USA"},{"name":"The George Washington University, School of Medicine and Health Sciences  Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5453-8170","authenticated-orcid":false,"given":"John T.","family":"Mansfield","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine MedStar Georgetown University Hospital  Washington District of Columbia USA"},{"name":"MedStar National Rehabilitation Hospital, Physical Medicine &amp; Rehabilitation  Washington District of Columbia USA"},{"name":"International Spine, Pain &amp; Performance Center  Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Puneet K.","family":"Sayal","sequence":"additional","affiliation":[{"name":"International Spine, Pain &amp; Performance Center  Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehul J.","family":"Desai","sequence":"additional","affiliation":[{"name":"International Spine, Pain &amp; Performance Center  Washington District of Columbia USA"},{"name":"The George Washington University, School of Medicine and Health Sciences  Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,9,7]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmr.2017.03.006"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.92B12.25486"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2005.08.00"},{"issue":"4","key":"e_1_2_12_5_1","first-page":"57","article-title":"Post partum pelvic floor changes","volume":"3","author":"Fonti Y","year":"2009","journal-title":"J Prenat Med"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318240df4f"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-008-9028-1"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tcr.2017.10.005"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.3349\/ymj.1999.40.3.215"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198365080-00011"},{"issue":"1","key":"e_1_2_12_11_1","first-page":"84","article-title":"Coccydynia: an overview of the anatomy, etiology, and treatment of coccyx pain","volume":"14","author":"Lirette LS","year":"2014","journal-title":"Ochsner J"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200401000-00007"},{"issue":"2","key":"e_1_2_12_13_1","first-page":"245","article-title":"Chronic coccydynia in adolescents. A series of 53 patients","volume":"47","author":"Maigne JY","year":"2011","journal-title":"Eur J Phys Rehabil Med"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200012010-00015"},{"issue":"3","key":"e_1_2_12_15_1","first-page":"387","article-title":"Postpartum coccydynia: a case series study of 57 women","volume":"48","author":"Maigne JY","year":"2012","journal-title":"Eur J Phys Rehabil Med"},{"key":"e_1_2_12_16_1","unstructured":"Mozrek J.(2016).Coccygeal Subluxation Syndrome. Musculoskeletal Key.https:\/\/musculoskeletalkey.com\/coccygeal-subluxation-syndrome\/"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1159\/000362337"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000231895.72380.64"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3182a45e07"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/ca.22233"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2004.02.008"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v17.i40.4447"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.5958\/0973-5674.2016.00014.9"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200110150-00024"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbmt.2017.03.024"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1937.02780420031008"},{"key":"e_1_2_12_27_1","volume-title":"The Science and Art of Joint Manipulation","author":"Mennell JB","year":"1952"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2006.07.029"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/1520-6777(2001)20:2<167::AID-NAU19>3.0.CO;2-4"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2016.08.007"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-016-1896-2"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0142475"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.36076\/ppj.2007\/10\/775"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.73B2.2005168"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijri.IJRI_294_16"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S134775"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S105506"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.5137\/1019-5149.JTN.2852-09.0"},{"issue":"6","key":"e_1_2_12_39_1","first-page":"1111","article-title":"Radiofrequency ablation in coccydynia: a case series and comprehensive, evidence\u2010based review","volume":"18","author":"Chen Y","year":"2017","journal-title":"Pain Med"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1177\/230949900801600107"},{"issue":"8","key":"e_1_2_12_41_1","first-page":"1","article-title":"Ultrasound guided dextrose prolotherapy for persistent coccygeal pain: a case series and review of literature","volume":"2","author":"Chen YT","year":"2013","journal-title":"Altern Integr Med"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.4111\/icu.2017.58.2.134"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8537(03)00085-3"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/ner.12808"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/5832401"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.4184\/asj.2014.8.6.705"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000002053"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-013-3010-3"},{"key":"e_1_2_12_49_1","doi-asserted-by":"publisher","DOI":"10.1308\/003588414X13814021676675"}],"container-title":["PM&amp;R"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pmrj.12683","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pmrj.12683","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pmrj.12683","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,16]],"date-time":"2023-11-16T08:05:06Z","timestamp":1700121906000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pmrj.12683"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,7]]},"references-count":48,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2022,9]]}},"alternative-id":["10.1002\/pmrj.12683"],"URL":"https:\/\/doi.org\/10.1002\/pmrj.12683","archive":["Portico"],"relation":{},"ISSN":["1934-1482","1934-1563"],"issn-type":[{"value":"1934-1482","type":"print"},{"value":"1934-1563","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,7]]},"assertion":[{"value":"2020-09-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-09-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}