Ganglion Impar Block

The ganglion impar is a group of nerve cells located in front of the coccyx (tailbone) and is part of the sympathetic nervous system. Ganglion impar block is a minimally invasive procedure done to help relieve chronic pain in the coccyx, pelvis, or anorectal area. Coccydynia (coccyx pain) can occur due to trauma to the coccyx (pressure during a fall, pregnancy, or birth). Abnormal signaling in ganglion impar nerves due to overactivity can cause chronic pain. Typically, this pain is felt in the perineum and may be associated with nerve, organ, or tissue damage. It is experienced as a vague or widely diffused burning or discomfort in this area that is usually controlled by the ganglion impar.

        Ganglion impar block is an outpatient non-invasive treatment procedure performed under fluoroscopy. In the procedure, after the location of the tailbone and ganglion is determined by fluoroscopy, a small amount of local anesthetic is injected into the entry point of the needle to numb the skin. The procedural needle is directed towards the ganglion impar just in front of the tailbone using fluoroscopy. Once the impar ganglion has been reached, contrast is injected to confirm the location. After confirmation, a local anesthetic solution alone or mixed with steroids is injected through the same needle. The process usually takes less than 10 minutes.

         Usually the painful area is numbed immediately after the procedure and provides complete relief of coccyx or rectal pain. Sometimes it may be necessary to repeat the injection several times for complete relief. With the procedure, long-term relief is provided for patients. However, sometimes even if the relief is short-lived, this process provides your doctor with diagnostic information that he or she can use for future treatments.

         Ganglion impar block is a very low-risk procedure that is typically followed by mild pain at the site for the first 24 hours. Risks include increased pain, bleeding or hematomas, and perforation of the bowel. However, using safe techniques that include direct visualization with fluoroscopy makes a potential complication extremely rare. A ganglion impar block may benefit you if you have chronic pelvic or rectal tailbone pain.