Landmark-Guided Dextrose Prolotherapy for Coccydynia: A Retrospective Study

NCT07564362 | Completed

• 1 other identifier: 01
• Study Type: observational
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

Coccydynia is a musculoskeletal pain condition that can lead to chronic pain and functional impairment, significantly affecting quality of life. Although conservative treatment is effective in many cases, the number of patients with refractory symptoms appears to be increasing, highlighting the need for effective and accessible treatment options. Prolotherapy is a regenerative injection therapy that aims to stimulate tissue healing and reduce pain through the modulation of nociceptive signaling, most commonly using dextrose solutions. This retrospective study aims to evaluate the effectiveness of landmark-guided (blind) dextrose prolotherapy in reducing pain and improving functional status in patients with mechanical or idiopathic coccydynia. The study includes patients who underwent prolotherapy to coccygeal ligaments between January 1, 2024, and June 1, 2025, with a treatment protocol consisting of 3-6 sessions administered at 3-week intervals using a 15% dextrose solution.

Conditions

Coccydynia

Keywords

Coccydynia; Dextrose Prolotherapy; Landmark-Guided Injection

Outcome Measures

Primary Outcomes (1)

• Visual Analog Scale (VAS)

  Primary Outcome Measure Visual Analog Scale for Pain (VAS): Change in pain intensity assessed using the Visual Analog Scale (VAS).The VAS is a 10-cm horizontal scale ranging from 0 (no pain) to 10 (worst imaginable pain).Higher scores indicate greater pain intensity, and a reduction in VAS score represents clinical improvement.

  Baseline and 1 month after completion of treatment

Secondary Outcomes (1)

• Dallas Pain Questionnaire (DPQ)

  Baseline and 1 month after completion of treatment

Study Arms (1)

Landmark-Guided Dextrose Prolotherapy

This cohort includes patients with mechanical or idiopathic coccydynia who underwent landmark-guided (blind) dextrose prolotherapy using a 15% dextrose solution. Injections were performed to the coccygeal ligamentous structures based on anatomical reference points without ultrasound guidance.

Procedure: Dextrose prolotherapy

Interventions

Dextrose prolotherapy PROCEDURE

Landmark-guided (blind) prolotherapy was performed using a 15% dextrose solution under sterile conditions. The procedure was carried out based on anatomical reference points without ultrasound guidance. The coccygeal and sacrococcygeal ligamentous structures were targeted, and injections were administered to 3-4 periosteal insertion points using a 27G needle. A maximum of 0.5 mL was injected per site, with a total volume not exceeding 2-2.5 mL per session. The treatment protocol consisted of 3 to 6 sessions performed at 3-week intervals.

Landmark-Guided Dextrose Prolotherapy

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The study population consists of patients aged 18 to 75 years diagnosed with mechanical or idiopathic coccydynia, with symptoms persisting for at least 3 months and refractory to conservative treatment, who underwent landmark-guided (blind) dextrose prolotherapy at the Physical Medicine and Rehabilitation Clinic of Gaziosmanpasa Training and Research Hospital between January 1, 2024, and June 1, 2025.

You may qualify if:

• Age between 18 and 75 years
• Diagnosis of mechanical or idiopathic coccydynia
• Pain persisting for at least 3 months
• Refractory to conservative treatment

You may not qualify if:

• Pregnancy
• Allergy to the proliferant solution
• Active infection
• Use of anticoagulant medications
• Presence of malignancy
• Local abscess
• Documented hemorrhagic diathesis
• Certain types of septic arthritis
• Parafunctional habits

Sponsors & Collaborators

• Gaziosmanpasa Research and Education Hospital: lead

Study Sites (1)

Health Sciences University Gaziosmanpaşa Physical Medicine and Rehabilitation Training and Research Hospital, Istanbul, 34255

Istanbul, Turkey (Türkiye)

Location

Related Publications (4)

• Assiri K, Alqarni A, Almubarak H, Mohammed Kaleem S, Alassiri S, Baig FAH, Muhammed A, Kota MZ, Dawasaz AA, Alqahtani AM, Assiri HA, Arem SA, Abubaker Abbas Ali S, Luqman Mannakandath M. Efficacy of Prolotherapy for Temporomandibular Joint Dysfunction: An Interventional Clinical Study. Med Sci Monit. 2025 May 14;31:e946650. doi: 10.12659/MSM.946650.

  PMID: 40364487 BACKGROUND

• Mociu SI, Nedelcu AD, Lupu AA, Uzun AB, Iliescu DM, Ionescu EV, Iliescu MG. Prolotherapy as a Regenerative Treatment in the Management of Chronic Low Back Pain: A Systematic Review. Medicina (Kaunas). 2025 Sep 2;61(9):1588. doi: 10.3390/medicina61091588.

  PMID: 41010979 BACKGROUND

• Benditz A, Thoma R. Coccygodynia-Diagnosis and Treatment. Dtsch Arztebl Int. 2025 Nov 14;122(23):638-644. doi: 10.3238/arztebl.m2025.0154.

  PMID: 40991348 BACKGROUND

• Khan SA, Kumar A, Varshney MK, Trikha V, Yadav CS. Dextrose prolotherapy for recalcitrant coccygodynia. J Orthop Surg (Hong Kong). 2008 Apr;16(1):27-9. doi: 10.1177/230949900801600107.

  PMID: 18453654 BACKGROUND

Study Officials

• Merve Dikici Yagli

  Gaziosmanpasa Educational and Training Hospital

  STUDY CHAIR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Physician

Study Record Dates

• First Submitted: April 27, 2026
• First Posted: May 4, 2026
• Study Start: January 15, 2026
• Primary Completion: March 15, 2026
• Study Completion: March 15, 2026
• Last Updated: May 4, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)