Effect of Manipulation on Coccydynia

Study Overview
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Brief Summary
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The aim of this study was to investigate the efficacy of manipulation combined with exercise as a treatment for patients with coccydynia.

Detailed Description
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Subject: Coccydynia is a painful condition characterized by inflammation and discomfort in the coccyx region, commonly known as the tailbone. It can significantly affect an individual's quality of life by impairing their ability to sit, stand, or engage in daily activities. Various treatment approaches have been explored to alleviate the symptoms of coccydynia, including manipulation techniques and exercise interventions. However, to date, there is a scarcity of research investigating the combined effects of manipulation and exercise for patients with coccydynia. Purpose: The purpose of this study is to evaluate the efficacy of combining manipulation techniques with exercise interventions for patients diagnosed with coccydynia, a painful condition affecting the coccyx region. Despite the debilitating impact of coccydynia on daily activities and quality of life, there is a limited understanding of the optimal treatment approach for this condition. This study aims to address this knowledge gap by investigating the potential benefits of combining manipulation and exercise in managing coccydynia.

Official Title
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The Effectiveness of Manipulation in Combination With Exercise for Patients With Coccydynia: A Randomized Controlled Trial

Conditions
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Coccyx Disorder, Pelvic Floor; Weak, Stretch

Intervention / Treatment
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* Other: Exercises
* Other: Coccyx Manipulation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: chronic (3 months) coccydynia age over 25 and under 60 years no ongoing antidepressant treatment no medicolegal litigation or occupational-accident etiology Exclusion Criteria: undergoing an operation aimed at the anal area those with additional diseases such as radiculopathy etc.

Ages Eligible for Study
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Minimum Age: 25 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Coccyx Manipulation<br>Manual therapy sessions, in addition to the exercise group, were performed once a week for four weeks. | Other: Exercises<br>* Stretching exercise for the piriformis and iliopsoas muscles. strengthening exercises for pelvic floor muscles<br>Other: Coccyx Manipulation<br>* Application of manipulation to relax the levetor ani muscle<br>|
| Active Comparator: Exercises<br>A total of 4 sessions were applied, 3 times a week. | Other: Exercises<br>* Stretching exercise for the piriformis and iliopsoas muscles. strengthening exercises for pelvic floor muscles<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline in Pain at 4 weeks and 6 months | A visual analog scale (VAS) numbered 0-10 will be used in the assessment of pain. | Baseline measurement before the treatment programs begin (pre-intervention), post-intervention at week 4, and 6 months follow-up | 
| Change from baseline in Paris questionnaire at 4 weeks and 6 months | Coccydynia-related symptoms were recorded using the Paris questionnaire, ranging from 0 (no symptoms) to 10 (maximum symptoms). The Paris questionnaire is a specific assessment tool designed to evaluate symptoms and functional limitations related to coccydynia, a condition characterized by pain in the coccyx region. The questionnaire consists of a series of questions that inquire about the severity and impact of coccyx pain on various activities and daily life. | Baseline measurement before the treatment programs begin (pre-intervention), post-intervention at week 4, and 6 months follow-up | 
| Change from baseline in The Oswestry Disability Index at 4 weeks and 6 months | The Oswestry Disability Index consists of ten sections, each addressing a different aspect of functional ability, including pain intensity, lifting, ability to walk, ability to sit, ability to stand, sleep quality, ability to socialize, ability to travel, ability to perform self-care tasks, and ability to perform household tasks. Each section contains multiple statements, and the individual rates their level of disability on a scale of 0 to 5, with higher scores indicating greater disability. | Baseline measurement before the treatment programs begin (pre-intervention), post-intervention at week 4, and 6 months follow-up |