Procedure Description
A ganglion impar nerve block is a minimally invasive procedure used to diagnose and treat chronic pain in the pelvic and perineal region. The ganglion impar is a small nerve cluster located in front of the coccyx (tailbone) and is part of the sympathetic nervous system, which transmits pain signals from the lower pelvic structures.
By injecting a local anesthetic—and sometimes a steroid—near the ganglion impar, this block can interrupt pain transmission from the pelvic floor, rectum, anus, vagina, urethra, or perineum. The procedure can be repeated or followed by neurolytic (destructive) treatment for longer-lasting relief.
What It Treats
Ganglion impar blocks are used to treat chronic, hard-to-manage pain in the following conditions:
Coccydynia (tailbone pain)
Chronic pelvic pain
Perineal pain
Rectal or anal pain
Cancer-related pelvic pain (e.g., from prostate, rectal, or gynecologic cancers)
Post-surgical pelvic pain
Vulvodynia or vaginismus
Urethral pain syndrome
The block may be used for diagnostic purposes (to confirm the source of pain) or as a therapeutic intervention.
How It Is Performed
You will lie on your stomach with a pillow under your hips to expose the sacral/coccygeal region.
The skin over the lower back and tailbone is cleaned and numbed with a local anesthetic.
Using fluoroscopy (X-ray) or CT guidance, the provider advances a thin needle to the anterior aspect of the coccyx, near the ganglion impar.
A small amount of contrast dye may be used to confirm proper needle placement.
A mixture of local anesthetic and corticosteroid is injected. In some cases, a neurolytic agent (e.g., alcohol or phenol) may be used for longer-term relief in cancer-related pain.
The needle is removed and a bandage is applied.
The procedure usually takes 15–30 minutes and is performed in an outpatient setting.
Pre-Procedure Instructions
You may eat and drink normally, unless sedation is planned.
Continue most medications unless otherwise directed. Blood thinners may need to be paused—follow your provider’s instructions.
Inform your provider if you:
Have allergies to contrast dye, anesthetics, or steroids
Are pregnant or breastfeeding
Have an active infection, fever, or recent illness
Arrange for a ride home if sedation is used.
What to Expect After the Procedure
Pain relief may be immediate if the ganglion impar is the source of your symptoms.
Relief may last from several days to several months, depending on whether steroid or neurolytic agents are used.
Mild soreness or bruising at the injection site may occur.
Some patients experience temporary numbness, warmth, or changes in bowel or bladder sensitivity, which typically resolve quickly.
You may resume light activity the same day but avoid heavy exertion for 24 hours.
Call your provider if you experience:
Severe or worsening pain
Fever, chills, or signs of infection
New numbness, weakness, or incontinence
Effective Relief for Deep Pelvic and Tailbone Pain
At Parkview Spine & Pain, we offer advanced, image-guided ganglion impar blocks for patients suffering from chronic pelvic or perineal pain. This safe and effective treatment can provide significant improvement in comfort, mobility, and quality of life.
👉 Schedule a consultation today to learn whether a ganglion impar nerve block is right for you.