Effectiveness of physical therapy interventions for coccydynia: a systematic review with a narrative synthesis

Introduction: Various physical therapy interventions for coccydynia have been evaluated, but their effectiveness has not yet been comprehensively synthesized. This systematic review aims to evaluate the effectiveness of physical therapy interventions in adults with coccydynia.Methods: A systematic search of relevant randomized controlled trials (RCTs) was conducted in PubMed/MEDLINE, EMBASE, CINAHL, Scopus, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), and Physiotherapy Evidence Database (PEDro). Outcomes of interest included pain, function, mobility, and patient satisfaction. Due to the heterogeneity of the included studies, a narrative synthesis was performed.Results: A total of 515 adults with coccydynia across 10 studies were included in the review. Physical therapy interventions, including extracorporeal shock wave therapy, kinesiotaping plus exercise, levator anus stretching or massage, manipulation alone or manipulation plus electrotherapy or exercise, and muscle energy technique, showed significant improvements in pain and function in the short term. Additionally, kinesiotaping plus exercise showed significant short-term improvement in trunk mobility. In the intermediate term, manipulation alone and levator anus stretching or massage were effective at reducing pain, whereas manipulation alone was effective at improving function. In the long term, levator anus stretching or massage showed sustained improvement in pain.Conclusions: Overall, physical therapy interventions led to short-term improvements in pain and function for adults with coccydynia. However, there is a need for high-quality studies with long-term follow-ups to compare the efficacy of various physical therapy interventions, both in isolation and in combination.