A sacrococcygeal ligament injection may help evaluate or temporarily reduce selected tailbone pain, coccydynia, or sacrococcygeal pain with sitting.
Learn how Dr. Siefferman performs sacrococcygeal ligament injections to help diagnose and treat tailbone pain, reducing discomfort and improving sitting tolerance.
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Hi, I’m Dr. Jason Siefferman, medical director at Manhattan Pain Medicine. A sacrococcygeal ligament injection may be performed if we think that tailbone pain is a result of strain or sprain of this ligament. The sacrococcygeal ligament is what attaches the tailbone to the sacrum and it runs right across here.
With a physical exam, if we notice moving the tailbone is painful, or pressing on that ligament directly is painful, then perhaps that ligament is the source of pain. The question then is why? Sometimes it will be inflammatory, and sometimes a steroid is helpful there. More often it’s from a sprain where someone has fallen on their tailbone and sprained that ligament. So in that situation, we’ll actually use regenerative medicine to tighten the ligament.
Other times, the ligament may actually be in pain because the muscles that attach to the tailbone are actually just playing tug-of-war with the tailbone and overusing or straining that ligament, in which case we actually want to treat that process and then the ligament will generally be fine.
A sacrococcygeal ligament injection is a targeted procedure used to evaluate or temporarily reduce selected pain near the tailbone, coccyx, or sacrococcygeal region. This area includes the lower end of the spine, the coccyx, nearby ligaments, and surrounding pelvic and soft tissue structures.
At Manhattan Pain Medicine, sacrococcygeal ligament injection NYC care begins with diagnosis-first evaluation. The goal is to determine whether pain is coming from the sacrococcygeal ligament, coccyx joint, coccygeal mobility changes, trauma, arthritis, pelvic floor dysfunction, pudendal neuralgia, ganglion impar pathway, endometriosis overlap, orthopedic pain, or central sensitization. The injection may provide diagnostic information and temporary relief in selected patients, but it is not a cure or universal solution for tailbone or pelvic pain.
MPM specialists evaluate whether a sacrococcygeal ligament injection may be appropriate by carefully mapping tailbone pain, sitting pain, pelvic symptoms, trauma history, childbirth-related onset, prior imaging, pelvic floor findings, nerve symptoms, pain triggers, prior treatment response, and red flags. Tailbone pain can come from several overlapping sources, including sacrococcygeal ligament irritation, coccyx joint pain, coccydynia, pelvic floor dysfunction, pudendal neuralgia, ganglion impar-mediated pain, endometriosis-related pain, arthritis, trauma, coccygeal instability, orthopedic pain, or centralized pain.
MPM reviews these possibilities before determining whether a sacrococcygeal ligament injection, ganglion impar block, pelvic floor trigger point injection, pudendal nerve block, medication management, pelvic floor therapy, pain psychology, or another pathway may be appropriate.
Patients often search for a sacrococcygeal ligament injection in Manhattan when they have chronic tailbone pain, coccyx pain, coccydynia, pain with sitting, pain after a fall, postpartum tailbone pain, or pelvic-region pain that has not improved enough with cushions, activity modification, medication, physical therapy, pelvic floor therapy, imaging, or prior injections.
MPM approaches sacrococcygeal ligament injections as a precision tool, not a generic pelvic pain injection. The goal is to determine whether the sacrococcygeal ligament or nearby coccygeal structures are contributing to symptoms. Temporary relief may help confirm the pain source and guide next steps. If the response is limited or absent, MPM may reassess whether the pain is more related to the ganglion impar, pelvic floor muscles, pudendal nerve, coccyx joint, inflammatory disease, orthopedic mechanics, or another pain generator.
Sacrococcygeal ligament injections fit within MPM’s Complex Chronic Pain, Musculoskeletal issues, and Pelvic Pain expertise because tailbone pain often involves overlapping mechanical, ligamentous, pelvic floor, nerve, and nervous system contributors.
A patient may have coccydynia, sacrococcygeal ligament irritation, coccyx joint pain, pelvic floor dysfunction, pudendal neuralgia overlap, ganglion impar-mediated pain, endometriosis-related pain, trauma-related pain, or chronic pain sensitization. MPM uses sacrococcygeal ligament injections as part of a broader diagnostic and treatment framework. The injection may provide useful information and temporary relief, but it is rarely the entire answer. Treatment planning may also include ganglion impar block, pelvic floor trigger point injections, pudendal nerve block, ultrasound-guided injections, medication management, pelvic floor therapy, pain psychology, or specialty coordination when appropriate.
Before a sacrococcygeal ligament injection, MPM reviews the pain pattern, suspected target, prior imaging, trauma history, pelvic symptoms, medication history, risks, alternatives, and post-procedure instructions. The injection is directed toward the sacrococcygeal ligament or related tailbone-region target. Image guidance may be used when appropriate to support precise placement and improve procedural planning.
Patients may feel pressure, brief discomfort, temporary numbness, soreness, or a short pain flare after the injection. Relief may be temporary and may last hours, days, weeks, or longer depending on the medication used, diagnosis, and pain mechanism. Some patients may not respond. MPM reviews the response to determine whether the sacrococcygeal ligament or coccygeal region appears clinically meaningful and whether additional pelvic, nerve, musculoskeletal, or pain-focused care should be considered.
I cannot say enough good things about Manhattan Pain Medicine. From the moment I walked in, I felt truly cared for and taken seriously. Dr. Nino Mikaberidze, Director of Rheumatology, is exceptional — knowledgeable, compassionate, and incredibly thorough. She takes the time to listen, explains every...
The best care I've received as a chronic pain patient. I traveled from out of state to visit Manhattan Pain Medicine because I could not find knowledgeable doctors in my hometown for my hypermobility, and Ehlers-Danlos syndrome symptoms and comorbidities. Let me tell you, it was worth every travel e...
I was injured in a bicycle accident over 8 years ago. I’ve suffered throughout the years since my accident with nothing seeming to work. PT, Yoga, lifestyle changes, NOTHNG! I finally made an appointment with Dr Kane and I’m feeling an improvement in my life. I no longer stay up all night in pain, a...
One of the best experiences, if not the best, I have ever had at the doctor’s office. From the front desk to the nurses to the PA assisting the doctor this was a great experience. Dr.Nino actually listened to me and came up with a game plan. Would recommend this practice to as many people as I could...
I have very unique & severe nerve pain from CRPS which has no known specific cure. Dr. Siefferman has a huge tool box, far greater than the other 23 Drs. I have seen. He saved me from jumping off a bridge and continues to help me with both treatments and advice. Dr. S. is in a different league!
After two years of searching and feeling lost and let down, I finally found real help at Manhattan Pain Medicine. With Dr. Siefferman, Adam Rosenberg, Dr. Mikaberidze, and the whole team, I feel heard, supported and understood. Every symptom is being considered and I’m finally getting answers with m...
Why is Dr Dr. Tayyaba Ahmed one of the top pevic Floor specialists - 1- She wants to know a full history of what led the patient to get to this point. 2 - She listens intensley to the patient 3- She does not rush you 4- Extremely skilled at giving pelvic floor injections 5- I thank my luck stars she...
The staff was friendly and helpful. Dr. Siefferman was thoughtful, listened, asked questions and proposed simple safe ways to come to further conclusions regarding my pain and discomfort. The office staff including Dr. Siefferman is responsive even after the initial in-person visit. Very pleased.
Dr. Siefferman is a brilliant provider. While my pain is still a work in progress, Dr Siefferman always gives me options and explains his reasoning behind things. He listens to my feedback and concerns. I never feel rushed; and am grateful he works to meet me where I am. I highly recommend him.
What a great find! They listen to me, I listen to them and the diagnosis is made and a plan developed to develop an approach to treat all of my chronic pain. I wish I could have discovered this type of treatment sooner. This doctor and group give me hope.
A sacrococcygeal ligament injection is a targeted injection placed near the ligamentous structures around the sacrum and coccyx, commonly called the tailbone. It may be used to evaluate or temporarily reduce selected tailbone-region pain, coccydynia, or pain with sitting. At MPM, the injection is considered only after diagnosis-first evaluation of the coccyx, pelvic floor, nerve pathways, trauma history, and related pain generators.
The sacrococcygeal ligament is part of the ligamentous support around the junction between the sacrum and coccyx. This region can become painful after trauma, repetitive pressure, childbirth, coccygeal mobility changes, inflammation, or surrounding pelvic muscle tension. Pain in this area may also overlap with coccyx joint pain, pelvic floor dysfunction, pudendal neuralgia, or ganglion impar-mediated pain.
A sacrococcygeal ligament injection may help selected patients when the sacrococcygeal ligament or nearby coccygeal structures appear to contribute to tailbone pain. The injection may provide temporary relief and may help clarify the pain source. It does not cure every form of tailbone pain, and it is not appropriate when symptoms are primarily caused by another pelvic, nerve, orthopedic, inflammatory, or urgent condition.
It may help selected patients with coccydynia when pain appears related to the sacrococcygeal ligament, coccyx region, or local inflammation. Coccydynia can have multiple contributors, including trauma, coccygeal instability, ligament irritation, pelvic floor dysfunction, nerve-related pain, or referred pain. MPM evaluates the likely pain generator before recommending a sacrococcygeal ligament injection.
A sacrococcygeal ligament injection may help selected patients whose sitting pain appears to come from the tailbone or sacrococcygeal region. Pain with sitting can also come from pudendal neuralgia, pelvic floor dysfunction, ganglion impar pathway involvement, coccyx joint pain, rectal or colorectal conditions, trauma, or central sensitization. MPM evaluates these possibilities before recommending treatment.
A sacrococcygeal ligament injection targets ligamentous or local tissue structures near the sacrum and coccyx. A ganglion impar block targets a sympathetic nerve structure near the front of the coccyx that may contribute to pelvic, perineal, rectal, genital, or tailbone-region pain. These treatments are not the same. MPM determines the most appropriate target based on the pain pattern, exam findings, and suspected pain pathway.
A coccyx joint injection targets the joint region of the coccyx or sacrococcygeal joint. A sacrococcygeal ligament injection focuses on ligamentous structures that may contribute to pain around the tailbone. These areas are close together and symptoms can overlap. MPM evaluates whether pain appears ligament-related, joint-related, nerve-related, pelvic floor-related, or related to another source before recommending an injection.
A sacrococcygeal ligament injection may be diagnostic, therapeutic, or both. A diagnostic injection helps determine whether the sacrococcygeal ligament or nearby coccygeal structures are contributing to pain. A therapeutic injection is intended to reduce symptoms for a period of time. Relief is often temporary, but the timing and location of relief can help guide the next step in care.
Image guidance may be used when appropriate to support accurate placement and procedural safety. The need for image guidance depends on the patient’s anatomy, pain location, suspected target, prior imaging, and treatment goal. Image guidance does not guarantee relief, but it can help support precise treatment planning in selected cases.
The injected medication depends on the treatment goal and clinical context. A sacrococcygeal ligament injection may include local anesthetic, corticosteroid, or another medication when clinically appropriate. MPM reviews the medication choice, expected response, risks, and alternatives before the procedure.
Relief varies by patient, diagnosis, medication used, and pain mechanism. Some patients may have relief for hours or days, while others may experience longer improvement. Some patients may not respond. Even temporary relief can be useful if it helps confirm that the sacrococcygeal ligament or coccygeal region is contributing to symptoms.
Temporary relief can still provide useful diagnostic information. It may suggest that the sacrococcygeal ligament or coccygeal region is part of the pain pattern. Depending on the response, MPM may consider additional treatment, pelvic floor therapy, ganglion impar block, pudendal nerve block, medication management, pain psychology, orthopedic evaluation, or further imaging. If relief does not match the expected pattern, the diagnosis may need to be refined.
Yes. Tailbone pain can overlap with pelvic floor dysfunction, pudendal neuralgia, pelvic dystonia, endometriosis-related pain, ganglion impar-mediated pain, orthopedic pain, and central sensitization. Some patients have more than one pain generator. MPM evaluates pelvic floor symptoms, nerve symptoms, sitting pain, pain distribution, and prior treatment response before recommending a procedure.
Risks may include pain flare, bruising, bleeding, infection, allergic reaction, temporary numbness, temporary weakness, vasovagal reaction, local anesthetic toxicity, steroid-related side effects when steroids are used, incomplete relief, temporary relief only, or no relief. MPM reviews these risks before treatment. Fever, spreading redness, severe pelvic or abdominal pain, rectal bleeding, blood in stool or urine, new bowel or bladder dysfunction, saddle anesthesia, new weakness, severe allergic reaction, or rapidly worsening symptoms require urgent evaluation.
Tailbone or pelvic pain should be evaluated urgently when it occurs with fever, spreading redness, severe pelvic or abdominal pain, rectal bleeding, blood in stool or urine, new bowel or bladder dysfunction, inability to urinate, saddle anesthesia, new weakness, severe tailbone pain after major trauma, pregnancy-related pelvic pain, unexplained weight loss, cancer-related red flags, severe allergic reaction, or rapidly worsening symptoms. MPM screens for urgent causes before recommending treatment.
Before care begins, our team helps patients understand the practical side of treatment, including insurance verification, out-of-network benefits, cost-share estimates, self-pay options, and billing questions. We believe patients should have as much clarity as possible before moving forward.
If you are considering a sacrococcygeal ligament injection in NYC for chronic tailbone pain, coccyx pain, coccydynia, pain with sitting, post-traumatic coccyx pain, postpartum tailbone pain, or pelvic pain overlap, MPM can help determine whether this treatment may be appropriate. Your evaluation will consider your symptoms, anatomy, prior care, safety factors, and treatment goals before any recommendation is made.
A sacrococcygeal ligament injection is a targeted procedure used to evaluate or temporarily reduce selected pain near the tailbone, coccyx, or sacrococcygeal region. This area includes the lower part of the spine, the coccyx, the sacrococcygeal joint, nearby ligaments, pelvic floor structures, and surrounding soft tissues.
At Manhattan Pain Medicine (MPM), sacrococcygeal ligament injection NYC care begins with diagnosis-first evaluation. The goal is to determine whether pain is coming from the sacrococcygeal ligament, coccyx joint, trauma-related irritation, pelvic floor dysfunction, pudendal neuralgia, ganglion impar pathway, endometriosis overlap, arthritis, orthopedic mechanics, or another pelvic pain generator.
The sacrococcygeal region is where the sacrum meets the coccyx, commonly known as the tailbone. Ligaments in this region help support the coccyx and surrounding pelvic structures. When this area becomes irritated, inflamed, injured, or mechanically stressed, patients may develop pain with sitting, pain when rising from a seated position, localized tailbone tenderness, or pain that overlaps with pelvic floor symptoms.
Tailbone pain can occur after a fall, childbirth, repetitive pressure, prolonged sitting, direct trauma, coccygeal mobility changes, arthritis, or pelvic muscle guarding. In some patients, pain develops gradually and does not have one clear trigger.
Tailbone pain is often described as coccydynia, but coccydynia can have several causes. Pain may come from the sacrococcygeal ligament, coccyx joint, coccygeal instability, fracture history, local inflammation, pelvic floor dysfunction, pudendal neuralgia, ganglion impar pathway involvement, endometriosis-related pelvic pain, rectal or colorectal conditions, orthopedic mechanics, or central sensitization.
This is why MPM does not treat sacrococcygeal ligament injection as a generic tailbone shot. The evaluation focuses on the patient’s pain location, sitting tolerance, trauma or childbirth history, pelvic symptoms, bowel or bladder symptoms, neurological symptoms, prior imaging, prior treatments, and red flags.
A sacrococcygeal ligament injection may be diagnostic, therapeutic, or both. A diagnostic injection helps determine whether the sacrococcygeal ligament or nearby coccygeal region is contributing to symptoms. If the patient experiences temporary relief in the expected area, that response may support the targeted structure as part of the pain picture.
A therapeutic injection is intended to reduce pain for a period of time. Relief may last hours, days, weeks, or longer depending on the medication used and the underlying pain mechanism. Some patients may not respond. MPM uses the degree, timing, and location of relief to help guide the next step.
A sacrococcygeal ligament injection targets the ligamentous or local musculoskeletal structures around the sacrum and coccyx. A ganglion impar block targets a sympathetic nerve structure near the front of the coccyx that may contribute to lower pelvic, perineal, rectal, genital, or tailbone-region pain.
The two procedures may be considered for different reasons. If pain appears local, mechanical, or ligament-related, sacrococcygeal ligament injection may be considered. If symptoms suggest sympathetic pathway involvement, deeper pelvic pain, rectal or perineal pain, or broader coccyx-region pain, ganglion impar block may be considered. MPM determines the target based on the pain pattern and clinical findings.
Tailbone pain can overlap with pelvic floor dysfunction. Some patients develop protective pelvic floor tightening because sitting hurts. Others have pelvic floor muscle spasm, pelvic dystonia, pudendal neuralgia, endometriosis overlap, or pelvic pain sensitization that contributes to tailbone discomfort.
This overlap matters because an injection alone may not address the full pattern. MPM may coordinate sacrococcygeal ligament injection with pelvic floor physical therapy, pelvic floor trigger point injections, pudendal nerve block, ganglion impar block, medication management, pain psychology, or gynecology, colorectal, or orthopedic evaluation when appropriate.
Relief after a sacrococcygeal ligament injection may suggest that the sacrococcygeal ligament or coccygeal region is contributing to pain. If the relief is temporary, it may still provide useful diagnostic information.
If the injection does not help, that does not mean the pain is not real. It may mean that the primary pain generator is different, such as the ganglion impar pathway, pudendal nerve, pelvic floor muscles, coccyx joint, rectal or colorectal condition, endometriosis-related pain, orthopedic mechanics, inflammatory disease, or central sensitization.
Persistent tailbone pain can affect sitting, driving, work, exercise, sleep, bowel movements, pelvic comfort, and emotional wellbeing. Some patients begin avoiding movement or sitting positions because of repeated pain flares. MPM evaluates both the local pain generator and the broader impact of the condition.
Depending on the clinical picture, care may include sacrococcygeal ligament injection, ganglion impar block, pelvic floor trigger point injections, pudendal nerve block, physical therapy, pelvic floor therapy, medication management, pain psychology, orthopedic evaluation, gynecology, colorectal evaluation, or additional imaging.
Risks may include pain flare, bruising, bleeding, infection, allergic reaction, temporary numbness, temporary weakness, vasovagal reaction, local anesthetic toxicity, steroid-related side effects when steroids are used, incomplete relief, temporary relief only, or no relief.
Patients should seek urgent evaluation for fever, spreading redness, severe pelvic or abdominal pain, rectal bleeding, blood in stool or urine, new bowel or bladder dysfunction, inability to urinate, saddle anesthesia, new weakness, severe tailbone pain after major trauma, pregnancy-related pelvic pain, unexplained weight loss, cancer-related red flags, severe allergic reaction, or rapidly worsening symptoms.
For selected patients, a sacrococcygeal ligament injection may be an important step in understanding chronic tailbone pain, coccydynia, or pelvic pain overlap. MPM’s role is to determine whether the target is clinically appropriate, whether the procedure can be performed safely, and how the injection fits within a coordinated pain care plan.
