Ganglion Impar Block for Chronic Tailbone Pain
A ganglion impar block targets the ganglion of Walther for coccydynia — pain sitting on the tailbone. If cushions and therapy have not lasted, request a consultation with Dr. John Smirniotopoulos to review whether this coccyx pain treatment is a fit.
Typically outpatient, with light sedation rather than general anesthesia
The procedure
Ganglion impar block for coccydynia
A diagnostic block first checks whether the ganglion impar is the pain source. If it helps, ganglion impar neurolysis may be discussed for longer benefit. It is one option among treatments at Full Motion Joint and Spine — not a promised result.
Not a coccyx removal
Not coccygectomy. One-sided buttock pain may be SI joint ablation instead.
MedStar procedures
Done in the MedStar hospital setting. Visit flow is on the Locations page.
Request a consult
Request a consultation so candidacy is decided in person — not from this page.
The tailbone
Pain sitting on the tailbone and selected deep pelvic pain
Coccydynia is tailbone pain, often worse with sitting. Some chronic pelvic pain patterns are discussed here too — only when exam points to this nerve bundle, not from a generic pelvic MRI.
The ganglion
Ganglion of Walther — block, then maybe neurolysis
Guided by imaging, a diagnostic block confirms the target. If it brings relief, neurolysis may quiet that nerve bundle for longer-lasting benefit. The sequence is set at consult.
Candidacy
A consult if sitting is the worst part of the day
People ask about a ganglion impar block after cushions, therapy, and injections have not lasted. Dr. John Smirniotopoulos decides candidacy in person — not from this page.
Often discussed at consult
- Pain sitting on the tailbone (coccydynia) that has lasted
- Selected deep pelvic pain after other causes are considered
- Interest in image-guided test-and-treat care instead of a large operation
Candidacy is confirmed in person — not from this page.
Not every pelvic MRI
SI-pattern buttock pain, hip arthritis, or infection can point elsewhere.
Fever, sudden severe pain after trauma, or new neurologic loss needs urgent care — not this page.
The visit
Your ganglion impar visit, start to finish
Before you arrive
History and exam. Simple prep. See Locations.
The day of treatment
Outpatient image-guided block. Neurolysis only if the plan includes it. Arrange a ride home.
Going home
Typically same-day discharge when the visit goes as planned.
Follow-up
Many people feel relief soon after a helpful block. Lasting benefit depends on the plan. No rate is quoted here.
Afterward
Recovery after a ganglion impar block
This is a short outpatient visit. If it is not the match, options include conservative care, SI ablation, or evaluation with your existing team.
Care led by
Dr. John Smirniotopoulos
A ganglion impar block is performed by a dual board-certified interventional and diagnostic radiologist, Associate Professor of Radiology at MedStar Georgetown University Hospital, fellowship-trained in vascular and interventional radiology (2020). Credentials are on the About page.
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Dual board-certified Interventional & Diagnostic Radiology
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American Board of Radiology
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Associate Professor of Radiology MedStar Georgetown
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Society of Interventional Radiology SIR
Before you book
Tailbone questions we hear at consult
What is a ganglion impar block?
An image-guided injection at the ganglion of Walther for coccydynia and selected deep pelvic pain. Results vary.
What is ganglion impar neurolysis?
If a diagnostic block helps, neurolysis may be discussed for longer benefit. That is a shared decision at consult.
Is it outpatient?
Yes. It is typically outpatient with same-day discharge when the visit proceeds as planned.
Is this the same as SI joint ablation?
No. SI ablation treats the joint where spine meets pelvis. Ganglion impar work is for the tailbone bundle.