{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T11:03:08Z","timestamp":1790420588783,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,8,24]],"date-time":"2016-08-24T00:00:00Z","timestamp":1471996800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"David M. Crowley Foundation"},{"name":"Comprehensive Pelvic Rehabilitation Program"},{"name":"Department of Physical Medicine and Rehabilitation at the University of Texas Southwestern"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Coccydynia is a challenging disorder that often is refractory to treatments such as medications and injections. Physical therapy for coccydynia rarely has been studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the efficacy of pelvic floor physical therapy for reducing pain levels in patients with coccydynia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>The pelvic floor rehabilitation clinic of a major university hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>A total of 124 consecutive patients over age 18 with a chief complaint of coccydynia between 2009 and 2012. A subgroup of 17 of the 124 patients had previously undergone coccygectomy with continued pain postoperatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods or Interventions<\/jats:title><jats:p>The primary treatment intervention was pelvic floor physical therapy aimed at pelvic floor muscle relaxation. Secondary treatment interventions included the prescription of baclofen for muscle relaxation (19% of patients), ganglion impar blocks (8%), or coccygeus trigger point injections (17%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>Primary outcome measures included final minimum, average, and maximum pain numeric rating scales. A secondary outcome measure was the patient's subjective percent global improvement assessment. Baseline demographics were used to determine which pretreatment characteristics were correlated with treatment outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 124 patients, 93 participated in pelvic floor physical therapy and were included in statistical analysis. For the 79 patients who completed treatment (with a mean of 9 physical therapy sessions), the mean average pain ratings decreased from 5.08 to 1.91 (<jats:italic>P<\/jats:italic> &lt; .001) and mean highest pain ratings decreased from 8.81 to 4.75 (<jats:italic>P<\/jats:italic> &lt; .001). The mean percent global improvement was 71.9%. Mean average pain ratings in postcoccygectomy patients improved from 6.64 to 3.27 (<jats:italic>P<\/jats:italic> &lt; .001). Greater initial pain scores and a history of previous injections were correlated with <jats:italic>P<\/jats:italic> &lt; .001 pain scores on completion of physical therapy. Pain duration and history of trauma did not affect treatment outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Pelvic floor physical therapy is a safe and effective method of treating coccydynia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>III<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.pmrj.2016.08.007","type":"journal-article","created":{"date-parts":[[2016,8,26]],"date-time":"2016-08-26T01:01:11Z","timestamp":1472173271000},"page":"367-376","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["The Treatment of Chronic Coccydynia and Postcoccygectomy Pain With Pelvic Floor Physical Therapy"],"prefix":"10.1002","volume":"9","author":[{"given":"Kelly M.","family":"Scott","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren W.","family":"Fisher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ira H.","family":"Bernstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle H.","family":"Bradley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,8,24]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200110150-00024"},{"key":"e_1_2_7_3_2","first-page":"1","article-title":"Clinical lectures on the diseases of women. Lecture XVII: Coccydynia and diseases and deformities of the coccyx","volume":"40","author":"Simpson J.","year":"1859","journal-title":"Medical Times Gazette"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1937.02780420031008"},{"key":"e_1_2_7_5_2","volume-title":"The Science and Art of Joint Manipulation","author":"Mennel J.B.","year":"1949"},{"key":"e_1_2_7_6_2","first-page":"145","article-title":"The painful coccyx","volume":"14","author":"Howorth B.","year":"1959","journal-title":"Clin Orthop"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199404150-00011"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200012010-00015"},{"key":"e_1_2_7_9_2","doi-asserted-by":"crossref","first-page":"1622","DOI":"10.1302\/0301-620X.92B12.25486","article-title":"Coccydynia; A review of pathoanatomy, aetiology, treatment, and outcome","volume":"92","author":"Nathan S.T.","year":"2010","journal-title":"J Bone Joint Surg Br"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.3349\/ymj.1999.40.3.215"},{"key":"e_1_2_7_11_2","first-page":"717","article-title":"Tension myalgia of the pelvic floor","volume":"52","author":"Sinaki M.","year":"1977","journal-title":"Mayo Clin Proc"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000231895.72380.64"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.73B2.2005168"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2003.07.011"},{"key":"e_1_2_7_15_2","first-page":"554","article-title":"Coccygodynia","volume":"10","author":"Patjin J.","year":"2010","journal-title":"Pain Practice"},{"key":"e_1_2_7_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000219867.07683.7a"},{"key":"e_1_2_7_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-010-1617-1"},{"key":"e_1_2_7_18_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.92B2.23030"},{"key":"e_1_2_7_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12630-011-9489-3"},{"key":"e_1_2_7_20_2","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1016\/0002-9610(51)90362-5","article-title":"Herniation of the rectum following coccygectomy","volume":"82","author":"McClenahan J.","year":"1951","journal-title":"Am J Surg"},{"key":"e_1_2_7_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2009.01.003"},{"key":"e_1_2_7_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/ca.22233"},{"key":"e_1_2_7_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2004.02.008"},{"key":"e_1_2_7_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ogc.2014.04.003"},{"key":"e_1_2_7_25_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.phm.0000233174.86070.63"},{"key":"e_1_2_7_26_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000164099.92112.29"},{"key":"e_1_2_7_27_2","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-8-138"}],"container-title":["PM&amp;R"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1016%2Fj.pmrj.2016.08.007","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1934148216308802?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1934148216308802?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.pmrj.2016.08.007","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T17:06:16Z","timestamp":1694711176000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1016\/j.pmrj.2016.08.007"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,8,24]]},"references-count":26,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2017,4]]}},"alternative-id":["10.1016\/j.pmrj.2016.08.007"],"URL":"https:\/\/doi.org\/10.1016\/j.pmrj.2016.08.007","archive":["Portico"],"relation":{},"ISSN":["1934-1482","1934-1563"],"issn-type":[{"value":"1934-1482","type":"print"},{"value":"1934-1563","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,8,24]]},"assertion":[{"value":"2015-12-31","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-08-17","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-08-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}