Overview
The ganglion impar is part of the sympathetic nervous system and plays a role in transmitting pain signals from the coccyx, perineum, and lower pelvic region. Pain in this area may follow trauma, prolonged sitting, childbirth, pelvic surgery, or chronic inflammation. Symptoms can be persistent and difficult to treat when nerve sensitivity becomes established.
A ganglion impar block involves injecting local anaesthetic, sometimes with steroid medication, near this nerve centre. The goal is to reduce sensitivity, interrupt pain signals, and help confirm whether this pathway is contributing to symptoms.
Who This Treatment Helps
A ganglion impar block may be suitable for people with:
• Coccyx pain or tailbone pain
• Perineal pain or burning
• Pain after trauma, childbirth, or prolonged sitting
• Pain after pelvic or rectal surgery
• Persistent lower pelvic pain with suspected sympathetic involvement
• Limited improvement from physiotherapy or medication
A consultation is needed to confirm suitability.
What Is a Ganglion Impar Block
A targeted injection delivered near the ganglion impar in front of the coccyx. The injection typically contains:
• Local anaesthetic for temporary numbing
• Steroid medication to reduce inflammation
Imaging guidance such as X ray guidance or CT guidance is used to improve precision and safety. In selected cases, longer lasting procedures may be discussed if diagnostic benefit is clear.
What to Expect During the Procedure
You lie comfortably, usually face down. The skin is cleaned and numbed, then a fine needle is guided into place using imaging. Medication is delivered near the ganglion impar and you are monitored before going home.
After the Procedure
Mild soreness can occur. Some people notice immediate relief from the local anaesthetic, while steroid benefit may build over days.
Your consultant may advise:
• Avoid strenuous activity for 24 to 48 hours
• Use seating cushions if sitting worsens symptoms
• Continue pelvic floor therapy if recommended
• Monitor symptoms and report any concerns
Benefits
• May reduce coccyx and lower pelvic pain
• Can improve sitting tolerance
• Useful for confirming pain pathway involvement
• Minimally invasive with short recovery time
• May reduce reliance on medication
• Can support rehabilitation and daily function
Possible Risks and Side Effects
• Temporary increase in pain
• Local bruising or soreness
• Temporary numbness or pelvic heaviness
• Infection rare
• Bleeding
• Allergic reaction uncommon
• Very rarely irritation of nearby structures
When to Consider Other Options
If symptoms do not improve or involve different nerve pathways, your consultant may discuss pudendal nerve block, hypogastric plexus block, caudal epidural, or multidisciplinary pelvic pain care.
Safety Note
Inform your consultant about blood thinners, allergies, diabetes, pregnancy, and recent infections. Avoid driving if numbness persists.
Arrange a consultation to discuss whether a ganglion impar block may help.