Ganglion Impar Block
(Non-Surgical Treatment for Tailbone and Pelvic Pain)
Overview
The ganglion impar is a nerve structure located near the coccyx (tailbone) that relays pain signals from the lower pelvis, rectum, perineum, and tailbone. When this nerve becomes irritated or overactive, it can lead to chronic pelvic, rectal, or coccyx pain.
A ganglion impar block is a minimally invasive procedure that involves injecting medication near this nerve to reduce pain and inflammation. It can be both diagnostic (to determine the source of pain) and therapeutic (to relieve pain). If significant relief is achieved with the block, a more long-term option may be considered. This procedure is performed with fluoroscopic (X-ray) guidance at Restore Spine and Pain to ensure precise needle placement and maximum safety.
Conditions Treated
- Chronic tailbone (coccygeal) pain
- Pelvic or rectal pain
- Pain after trauma to the coccyx
- Post-surgical perineal or rectal pain
- Pain from cancer involving the pelvic region
What are the risks and side effects?
Risks and side effects are minimal, and serious complications are rare. We take every precaution to ensure your safety. Potential risks may include but are not limited to:
- Temporary increase in pain
- Bleeding or infection at the injection site (rare)
- Vasovagal reaction (lightheadedness or fainting)
- Allergic reaction to the medication
- Numbness or tingling in the surrounding area
- Elevated blood sugar in diabetic patients
Ask your provider if you have any concerns. Your physician will review the risks in detail before the procedure to ensure you are fully informed.
Pre-Procedure Information
How Should I Prepare?
- Driver Required: We ask that you arrange for a driver to take you home after the procedure.
- Food: You may eat a light meal 1–2 hours prior to the procedure. If sedation is planned, please follow the specific sedation protocol provided by our team.
Medications:
- Continue routine medications unless directed otherwise.
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Blood thinners, Aspirin, NSAIDs, and supplements:
- Inform us in advance if you take blood thinners (e.g., Plavix, Eliquis, Xarelto, Coumadin), NSAIDs (e.g., ibuprofen, naproxen), Aspirin, or supplements that increase bleeding risk.
- Certain medications may need to be stopped for a short period of time before the injection.
- Speak with your prescribing provider to ensure it’s safe to temporarily stop these medications
- Our team will review your medication list and coordinate with your other providers if needed.
Notify us if:
- You have a fever, infection, or are feeling unwell.
- You have started antibiotics or had changes to your medications
Sedation
Most cervical epidural steroid injections can be performed comfortably without sedation. However, if you have anxiety or difficulty lying flat, mild sedation may be offered at the discretion of the physician. Please discuss this with your provider in advance.
Special Instructions for Diabetic Patients:
Steroid injections may raise blood sugar levels for several days.
- Please contact your primary care physician or endocrinologist prior to the procedure for management recommendations.
- Monitor your glucose closely after the injection.
- Report sustained elevations to your managing provider.
What if I am pregnant?
There are serious potential risks to an unborn fetus from imaging used during this procedure (e.g., X-ray/fluoroscopy). If there is any chance you may be pregnant, please notify our team immediately and postpone the injection until pregnancy is ruled out.
Procedure Information
The procedure is performed using sterile technique under real-time X-ray (fluoroscopic) guidance.
- You’ll lie on your stomach on a procedure table
- The area around the tailbone is sterilized and numbed with local anesthetic
- Using fluoroscopic guidance, a needle is advanced to the ganglion impar
- Medication—typically a local anesthetic with or without steroid—is injected
- The procedure usually takes less than 15 minutes
What to Expect:
1. Preparation:
- You will lie face down on a procedure table.
- The area around the tailbone is sterilized and numbed with local anesthetic
2. Injection Process:
- A needle is directed near the affected nerve(s).
- Contrast dye may be used to confirm positioning.
- The medication—typically a local anesthetic with or without steroid—is injected
Monitoring:
- You will be monitored during the procedure to ensure comfort and safety.
- Most procedures last 10-15 minutes, followed by a brief recovery period on-site.
Post-Procedure Information
What to Expect After the Procedure
- Relief Timeline: : : Steroids typically begin to work within 2 to 5 days, but in some cases may take up to 2 weeks.
- Activity:You may resume light activities the next day; avoid strenuous activity for 24 hours. We recommend you return to work the following day.
- Soreness: Temporary soreness at the injection site is common.
- Pain tracking: Keep a log of symptoms over the next 1–2 weeks.
If successful, additional injections may be spaced out over time—typically no more than 3–4 per year in the same region.
Additional Instructions:
- Contact the office for any signs of infection, fever, or worsening pain.
- Attend follow-up as scheduled.
Schedule a Consultation
If you are suffering from persistent tailbone, pelvic, or rectal pain, a ganglion impar block may offer effective non-surgical relief. Contact Restore Spine and Pain today to schedule your consultation and begin your path to recovery.