Ganglion Impar (coccyx) block

What is Ganglion Impar block?

Nerves carry pain signals. The Ganglion Impar is a nerve structure located close to the coccyx (tailbone). Ganglion Impar block is a procedure used to reduce some of the symptoms of coccyx, pelvic or rectal pain by blocking this nerve, using an injection of a local anaesthetic and steroid in this region.

What are the intended benefits?

Depending on the pain condition, duration & quality of pain relief following the block, the procedure may be repeated after few months. This decision is taken on individual case basis.

Are there any risks with this treatment?

No injection therapy is totally free of risks. As with most procedures, there is a small risk of bleeding, infection or allergic reaction to the medications used. Occasionally injection procedures may exacerbate pain. Diabetics may have a short-term increase in the blood sugars from the steroid. Very rare complications include injury to internal organs (back passage) or permanent nerve damage.

It is unsafe to perform the injection on patients with clotting problems, or for those taking anticoagulants (warfarin). It is also dangerous to perform the injection when there is an infection of the skin of the back. As x-rays are used during the procedure, inform the doctor if you are pregnant or planning for the same.

On the day of nerve block, is there a need for any specific preparation?

Unless advised by your doctor to fast, you do not have to skip any meals before your nerve block. Eat lightly and drink plenty of water. You may take your usual medications unless advised otherwise. Please bring a list of your medications with you.

What happens when I arrive at the hospital for the injection therapy?

Your stay in hospital may vary between 2 to 3 hours. The actual injection takes only few minutes to perform. You will be laying on your front in a trolley & will be awake during the procedure. The doctor will use x-ray when performing the block. After cleaning the tailbone area with antiseptic solution, numbing medicine will be injected to the skin. Then the Ganglion Impar block will be gently performed with a small needle.

Do I need to take any precautions after the block?

Arrange to have someone drive you home! Sometimes your legs may be a bit wobbly following the block. Ensure you are steady on your feet before getting out of the hospital bed. You may be sore or have more pain before you feel better. The treatment may take a few days to weeks to help with pain. There is no need for any bed rest, but avoid strenuous physical activity on the day of the block. From the next day onwards, you can resume back to your normal activities. You may continue to take your routine medications. The doctor may advise you about reducing your painkillers once you start getting benefits with the nerve block.

Rarely, if there is unbearable exacerbation of pain, unusual redness, persistently high temperature, discharge or swelling at the site of injection– you have to contact the doctor and go to the emergency department immediately.