Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc
Journal website https://jmc.elmerpub.com

Case Report

Volume 16, Number 12, December 2025, pages 467-474

Radial Extracorporeal Shockwave Therapy for the Treatment of Chronic Refractory Coccygodynia

Figures

Figure 1.
Figure 1. Sagittal MRI sacrococcygeal spine of the 39-year-old female patient affected by coccygodynia showing dehydrated L5S1 disc (withe arrow) with minimal posterior bulge (white dotted line arrow). No abnormalities were found on the tail bone (red arrow). On clinical examination, no lumbar pain or functional limitation of the lumbosacral spine was reported. MRI: magnetic resonance imaging.
Figure 2.
Figure 2. Changes in the pain perception measured with VAS (a) and PSEQ (b). The reduction in pain was already evident at 3 months and continued to improve until the last follow-up. VAS: Visual Analogue Scale; PSEQ: Pain Self Efficacy Questionnaire.
Figure 3.
Figure 3. Trends over time of the ODI (a) and TSK (b). Each score shows improved results over time. ODI: Oswestry Disability Index; TSK: Tampa Scale of Kinesiophobia.
Figure 4.
Figure 4. Trends over time of the DASS-21: stress score (a), depression score (b) and anxiety score (c). The charts show an improvement from a psychological perspective as well, with a reduction to normal levels of anxiety and stress at the 3-month follow-up, and to normal levels in each sub-scale at the final follow-up. DASS-21: Depression Anxiety Stress Scale-21.

Table

Table 1. Stretching and Mobility Exercises for Maintaining Flexibility and Promoting Circulation in the Coccygeal Region Scheduled for the Patient
 
ExerciseDescriptionDuration/repetitions
Pelvic tiltsLie on your back with your knees bent and feet flat on the floor. Tilt your pelvis upward to flatten your lower back against the floor, then return to start.8 - 10 repetitions
Cat-cow stretchStart on hands and knees. Inhale to arch your back (cow pose), exhale to round your back (cat pose), moving slowly between positions.8 - 10 repetitions
Child’s poseKneel with big toes touching and knees apart. Sit back on your heels, extend your arms forward, and lower your torso to the ground.Hold for 20 - 30 s, repeat as needed
Seated forward foldSit with legs extended. Hinge at the hips to lean forward, reaching towards your toes while keeping your back straight.Hold for 15 - 30 s, repeat 2 - 3 times
Knee-to-chest stretchLie on your back and bring one knee towards your chest, clasping your hands around the shin. Repeat with the opposite leg or both knees together.Hold each stretch for 20 - 30 s
Piriformis stretchSit with legs extended, and cross one ankle over the opposite knee. Lean forward gently to stretch the hip and glutes.Hold each side for 15 - 30 s
Hip circlesStand with feet shoulder-width apart, hands on hips. Make slow, controlled circles with your hips in both directions.10 circles in each direction