Abstract
Aim: To explain the term coccygodynia, define its kinesiological and neurophysiological basis, and present the diagnostic and therapeutic options. The aim of the experimental part is to evaluate the effect of physiotherapy in both the acute and chronic stages of primary coccygodynia and to evaluate the correlation between sonopalpation, X-ray assessment and the palpation of the coccyx per rectum.
Methods: Six female subjects with primary coccygodynia received five individual physiotherapy sessions during the first 3 months of the study, practicing self-treatment for the next 3 months. The Short Form-36 (SF-36) Quality of Life Questionnaire, The Female Sexual Function Index (FSFI) questionnaire and The Oswestry Questionnaire, Version 2.1a were used to subjectively assess the effect of therapy.
Gynaecological history (GA) was assessed, and the Ohmbelt device was used to verify abdominal wall activity. Skeletal pain was assessed by sonopalpation.
Results: The FSFI questionnaire showed a significant decrease in painful intercourse at the end of the study (3rd measurement) compared to baseline data (2.0 +- 2.1 vs 3.3 +- 2.5; P = 0.042). The SF-36 questionnaire showed a significant improvement in the Vitality domain when comparing the 1st and 2nd measurements (41.7 +- 21.8 vs 55.0 +- 25.3; P = 0.038).
Sonopalpation results correlated with per rectum examination in all subjects. Conclusion: The application of manual techniques including per rectum mobilization of the coccyx and pelvic floor soft tissues treatment at the very beginning of therapy, supplemented with neurophysiological methods and self-treatment, had a positive effect on the quality of life of patients with primary coccygodynia.
The findings of sonopalpation correlate with the per rectum examination.