Abstract
Background; Coccygodynia is a musculoskeletal disease that affects quality of life. The main complaint of coccygodynia is nociceptive and/or neuropathic pain. Vitamin D deficiency has been associated with the development of pain in various diseases.
Aims; In this study we aimed investigate the pain types (nociceptive, neuropathic, mixed) and the relationship between pain types and Vitamin D level in patients with coccygodynia.
Study design; Observational study
Materials and Methods; A total of 54 patients diagnosed with coccygodynia were included. Pain intensity, disablity and pain type were evaluated by Visual Analogue Scale (VAS), the Oswestry Disability Index (ODI), and the PainDETECT questionnaire, respectively. All participants had their vitamin D levels measured.
Results; Neuropathic pain was detected in 27.8% of the patients with coccygodynia. Vitamin D was determined to be insufficient or deficient in 81.5% of the patients. A statistical significant correlation was found between neuropathic pain and prolongation of coccygodynia and increased ODI values (p<0.05). The Vitamin D values were determined to show statistically similar distribution in the nociceptive, mixed type, and neuropathic pain groups (p=0.532).
Conclusion; The frequency of neuropathic pain in coccygodynia increases with increasing disability and disease duration. Although vitamin deficiency or insufficiency is common in coccygodynia, it is not associated with the type of pain.
References
Patijn J, Janssen M, Hayek S, Mekhail N, Van Zundert J, van Kleef M. 14. Coccygodynia. Pain Pract. 2010; 10 (6): 554-9. doi: 10.1111/j.1533-2500.2010.00404.x
Sir E, Eksert S. Comparison of block and pulsed radiofrequency of the ganglion impar in coccygodynia. Turk J Med Sci. 2019; 49 (5): 1555-9. doi: 10.3906/sag-1906-51
De Andres J, Chaves S. Coccygodynia: a proposal for an algorithm for treatment. J Pain. 2003; 4 (5): 257-66. doi: 10.1016/s1526-5900(03)00620-5
Sencan S, Kenis-Coskun O, Demir FGU, Cuce I, Ercalik T, Gunduz OH. Ganglion Impar block improves neuropathic pain in coccygodynia: A preliminary report. Neurol Neurochir Pol. 2018; 52 (5): 612-7. doi: 10.1016/j.pjnns.2018.08.006
Woolf CJ. Central sensitization: implications for the diagnosis and treatment of pain. Pain. 2011; 152 (3 Suppl): S2-S15. doi: 10.1016/j.pain.2010.09.030
Yesil H, Sungur U, Akdeniz S, Gurer G, Yalcin B, Dundar U. Association between serum vitamin D levels and neuropathic pain in rheumatoid arthritis patients: A cross-sectional study. Int J Rheum Dis. 2018; 21 (2): 431-9. doi: 10.1111/1756-185X.13160
Knutsen KV, Madar AA, Brekke M, Meyer HE, Natvig B, Mdala I, et al. Effect of vitamin D on musculoskeletal pain and headache: A randomized, double-blind, placebo-controlled trial among adult ethnic minorities in Norway. Pain. 2014; 155 (12): 2591-8. doi: 10.1016/j.pain.2014.09.024
Poisbeau P, Aouad M, Gazzo G, Lacaud A, Kemmel V, Landel V, et al. Cholecalciferol (Vitamin D3) Reduces Rat Neuropathic Pain by Modulating Opioid Signaling. Mol Neurobiol. 2019; 56 (10): 7208-2. doi: 10.1007/s12035-019-1582-6
Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al, Endocrine Society. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011; 96 (7): 1911-30.
doi: 10.1210/jc.2011-0385
Yakut E, Duger T, Oksuz C, Yorukan S, Ureten K, Turan D, et al. Validation of the Turkish version of the Oswestry Disability Index for patients with low back pain. Spine (Phila Pa 1976). 2004; 29 (5): 581-5; discussion 5. doi: 10.1097/01.brs.0000113869.13209.03
Freynhagen R, Baron R, Gockel U, Tolle TR. painDETECT: a new screening questionnaire to identify neuropathic components in patients with back pain. Curr Med Res Opin. 2006; 22 (10): 1911-20. doi: 10.1185/030079906X132488
Alkan H, Ardic F, Erdogan C, Sahin F, Sarsan A, Findikoglu G. Turkish version of the painDETECT questionnaire in the assessment of neuropathic pain: a validity and reliability study. Pain Med. 2013; 14 (12): 1933-43. doi: 10.1111/pme.12222
Patel R, Appannagari A, Whang PG. Coccydynia. Curr Rev Musculoskelet Med. 2008; 1 (3-4): 223-6. doi:10.1007/s12178-008-9028-1
IASP I, International Association for the Study of Pain (IASP) Taxonomy.
http://www.iasp-pain.org Taxonomy; 2012. (Accessed on 7.1.2022)
Nathan ST, Fisher BE, Roberts CS. Coccydynia: a review of pathoanatomy, aetiology, treatment and outcome. J Bone Joint Surg Br. 2010; 92 (12): 1622-7.
doi: 10.1302/0301-620X.92B12.25486
Trouvin AP, Perrot S. Pain in osteoarthritis. Implications for optimal management. Joint Bone Spine. 2018; 85 (4): 429-34. doi: 10.1016/j.jbspin.2017.08.002
Giske L, Bautz-Holter E, Sandvik L, Roe C. Relationship between pain and neuropathic symptoms in chronic musculoskeletal pain. Pain Med. 2009; 10 (5): 910-7.
doi:10.1111/j.1526-4637.2009.00622.x
Levesque A, Riant T, Ploteau S, Rigaud J, Labat JJ, Convergences PPN. Clinical Criteria of Central Sensitization in Chronic Pelvic and Perineal Pain (Convergences PP Criteria): Elaboration of a Clinical Evaluation Tool Based on Formal Expert Consensus. Pain Med. 2018; 19 (10): 2009-15. doi: 10.1093/pm/pny030
Baron R. Peripheral neuropathic pain: from mechanisms to symptoms. Clin J Pain. 2000; 16 (2 Suppl): S12-20. doi: 10.1097/00002508-200006001-00004
de Oliveira DL, Hirotsu C, Tufik S, Andersen ML. The interfaces between vitamin D, sleep and pain. J Endocrinol. 2017; 234 (1): R23-R36. doi: 10.1530/JOE-16-0514
Knutsen KV, Brekke M, Gjelstad S, Lagerlov P. Vitamin D status in patients with musculoskeletal pain, fatigue and headache: a cross-sectional descriptive study in a multi-ethnic general practice in Norway. Scand J Prim Health Care. 2010; 28 (3): 166-71. doi: 10.3109/02813432.2010.505407
Çidem M, Kara S, Sarı H, Özkaya M, Karacan İ. Yaygın kas-iskelet ağrısı olan hastalarda D vitamini eksikliği prevalansı ve risk faktörleri. Journal of Clinical & Experimental Investigations. 2013; 4 (4): 488-91. doi: 10.5799/ahinjs.01.2013.04.0330
von Kanel R, Muller-Hartmannsgruber V, Kokinogenis G, Egloff N. Vitamin D and central hypersensitivity in patients with chronic pain. Pain Med. 2014; 15 (9): 1609-18. doi: 10.1111/pme.12454
Banafshe HR, Khoshnoud MJ, Abed A, Saghazadeh M, Mesdaghinia A. Vitamin D supplementation attenuates the behavioral scores of neuropathic pain in rats. Nutr Neurosci. 2019; 22 (10): 700-5. doi: 10.1080/1028415X.2018.1435485
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.