What is a ganglion impar block injection?

A ganglion impar block injection is an injection around a group of nerves located in the sacrum/coccyx joint at the base of the spine (tailbone). Similarly, a coccyx injection is into the coccyx/sacrococcygeal joint area.

Why do I need to have the injection?

This is to help improve your coccyx (tailbone) pain.

Who does the procedure?

The injection is usually carried out by a Pain Specialist Doctor in the Injection Suite in the Outpatients Department (OPD). They may use an ultrasound machine or x-ray to guide the injection.

What is injected?

The injection consists of an anti-inflammatory drug (corticosteroid) and sometimes may also include a local anaesthetic.                                                

Important information

Before your injection you must inform the Outpatient Injection Suite staff if you are:

• pregnant or may be pregnant,
• diabetic,
• feel unwell,
• have an infection, cold or persistent cough,
• have any allergies,
• taking any of the following medication: Antibiotics, Aspirin, Warfarin or Clopidogrel or other tablets taken to thin the blood (some of these may need to be stopped some days before).

Failure to do so may result in your procedure being cancelled on the day.

How effective is the injection?

For many people the injection can produce noticeable improvements in symptoms. However, their effectiveness cannot be guaranteed or predicted. The effects can last for weeks, months or even years and the injection can be repeated if symptoms return.    

What are the risks of the procedure?

• Infection.
• Damage to small veins when the needle is inserted.  
• Bleeding causing local bruising or bleeding around the nerve.
• Nerve damage.
• Adverse reaction to injection which may be mild or life threatening (anaphylaxis).
• If you are diabetic, then the injection may raise your glucose levels. Glucose levels should be monitored for up to 1 month after your injection. If there are any changes in diabetic symptoms, then patients should consult their GP.
• Facial flushing for a few days.
• Temporary discomfort for a few days after your injection.
• For females - temporary alteration of your menstrual cycle.

The risk of complications with this procedure are small. Please discuss any concerns with the clinician looking after you.

On the day of your procedure  

• Please arrive at the Outpatients Department no more than 10 minutes before your appointment time as the waiting area is limited.  
• Take any medication as normal unless advised otherwise. Bring a list of your tablets with you.
• You can eat and drink normally before arriving. Food and drink will not be offered before the procedure, this is to aid your comfort during the procedure and is an additional safety measure in case of complications.
• You will be assessed by a nurse. This is to make sure you are fit and ready for the injection. You will have the opportunity to ask any questions at this stage.
• The Doctor carrying out your injection will also see you before you have the procedure.

As your ganglion impar block injection is being carried out as a day case you will normally be admitted for half a day. You may be asked to stay overnight but this is unusual.

What will happen after the ganglion impar block injection?

You will be asked to rest in the chair after the procedure during this time you will be monitored by the nursing staff who will check your:

• Blood pressure
• Injection site
• Once you have passed urine you will be able to make arrangements for going home.

You must not drive yourself home or use public transport. For your own wellbeing we advise that you are collected by a relative or friend. Hospital transport can only be booked if there is a medical need and you meet the set criteria.

Back at home

• It is important that you take things easy for the rest of the day.
• Do not do any excessive exercise or heavy work for the first few days.
• If a dressing is in place, remove the dressing the morning following your procedure.
• Continue to take your pain relief tablets until you notice an improvement in your symptoms.

Who do I contact if I have any problems following the procedure?

From 9am – 4pm you can either speak to a nurse in the Outpatients Injection Suite on 0121 685 4000 extension 55814 or you can contact the Secretary for the clinician you are under. Outside these hours contact the bleep holder through switchboard at the ROH (0121 685 4000).

Follow up appointment

Need for a follow up appointment will be discussed before you are discharged.

Can’t make your appointment?

If for any reason you cannot make your appointment you must let the Scheduled Care Coordinators know as soon as possible. You can contact the department on 0121 827 3835, Mon - Fri 8:30am to 4pm. Your appointment will not be automatically re-booked unless you call to tell us you are not coming.

Useful contact numbers
PALS - 0121 685 4128
Scheduled Care Coordinator - 0121 827 3835