Ganglion Impar Blocks via Coccygeal v Sacrococcygeal Joints

Regional Anesthesia and Pain Medicine

2008 May-June; 33 (3): 279-80

Patrick M. Foye, MD

Director, Coccyx Pain Service, Department of Physical Medicine and Rehabilitation, UMDNJ: New Jersey Medical School, 90 Bergen St., DOC-3100, Newark, NJ 07103-2499. Phone: (973)972-2802. Fax: (973)972-2825.


This publication is on the topic of ganglion Impar nerve blocks, within a journal for pain management physicians. The ganglion Impar is a network or hub of nerve fibers within the sympathetic nervous system, located just in front of the tailbone. Previous publications have shown that injections that provide a local anesthetic nerve block at the ganglion Impar can relieve tailbone pain. In this publication describing how to perform these ganglion Impar nerve blocks, Dr. Foye clarifies the difference between injecting at the sacrococcygeal joint (where the coccyx articulates with the sacrum) as compared with injecting through the joint spaces between the coccygeal bones. The approach between the coccygeal bones may often have some benefits in that 1) the injection is closer to the location of the ganglion Impar, 2) these joint spaces between the coccygeal bones are fused (obstructed) much less often than the sacrococcygeal joint, and 3) these sites are often easier for the physician to visualize while performing the procedure under fluoroscopic guidance. Knowing the difference approaches allows the educated physician to choose the most appropriate approach for any given patient, based on the individual patientís anatomy and fluoroscopic appearance.

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