The effectiveness of manipulation in combination with exercise for patients with coccydynia: Six months follow-up of a randomized controlled trial

Tufekci O., Yilmaz K., Gercek H., Unuvar B. S.

INTERNATIONAL JOURNAL OF OSTEOPATHIC MEDICINE, vol.51, 2024 (SCI-Expanded, Scopus)

Abstract

Background: Limited evidence exists concerning the long-term follow-up of pain management in individuals with coccydynia. Objective: This study aimed to examine the effectiveness of combining manipulation and exercise as a treatment approach for patients with coccydynia, while also assessing its long-term outcomes. Design: Six months follow-up of a randomized controlled trial. Setting: This study was conducted in a private hospital. Methods: The control group (n = 23) received exercise alone, while the experimental group (n = 23) received both exercise and manipulation. All participants performed exercises three days a week for four weeks, and the manipulation sessions were conducted once a week for a total of four sessions. Pain levels were assessed using the Visual Analog Scale (VAS), coccydynia symptoms were evaluated using the Paris questionnaire, and pain-related disability was measured with the Oswestry Disability Index (ODI). Participants: Forty-six participants were enrolled in the study. Results: No statistically significant differences were observed in the demographic characteristics between the two groups (p > 0.05). However, participants in the manipulation group showed a statistically significant improvement in pain, symptoms, and ODI scores compared to the control group, both immediately after treatment and at the 6-month follow-up (p < 0.05). Conclusion: This study demonstrates that the combination of exercise and intrarectal manipulation over a fourweek period significantly reduced pain, coccydynia-related symptoms, and disability scores in chronic coccydynia patients. However, no therapeutic superiority was observed in the long-term follow-up of six months.