Endoscopic Coccygeal Nerve Ablation

Treatment of chronic coccyx related pain can often be difficult, especially when it comes to long term improvement. As with other pain management options, coccyx treatments can be temporary in that the goal is to alleviate the pain while the body attempts to heal itself. If the coccyx pain has become chronic, meaning that it has been persisting for over 6 months, it is less likely to get better and longer term treatment options have been less likely to improve the condition.

Part of the problem is that the innervation to the coccyx is often diffuse. Nerve supply can come from multiple nerves, thus traditional radiofrequency procedures are less effective as these target a particular nerve. However, we have successfully been able to treat chronic coccygeal pain thorough a new minimally invasive technique. The technique was pioneered by innovative work from the doctors at The Spine and Pain Institute of New York.


The endoscopic radiofrequency ablation of the coccygeal nerves involves using an endoscope (small tube) through which the coccyx and its nerve supply can be directly visualized. Through the endoscope one can then insert small tools and then ablate/burn the nerves under direct visualization. The endoscope itself is similar to the small scope commonly used for arthroscopic surgery. Skin incision size is typically 0.5 cm long (less than ¼ inch) and requires only a small stitch under the skin to close.

In order to be a candidate for the procedure, you must first respond to a trial injection of a small amount of local anesthetic (1 cc total) into the coccyx using a small needle to adequately anesthetize/numb the posterior/backside of the coccyx. If you have chronic coccygeal pain and respond by getting sufficient pain relief for the duration of the local anesthetic then you are a candidate for the procedure.

If you are interested in learning more about endoscopic ablations of the coccygeal nerves please feel free to read our testimonials or call our office for a consultation. Our physicians at The Spine and Pain Institute of New York would be more than happy to discuss your condition and treatment options for an individualized treatment plan.