“…3 When the pain is refractory to conservative medical therapy, including neuromodulators, localized nerve injections may be offered. Traditionally, anesthesia pain clinics may perform this procedure through an anococcygeal approach using a bent needle, 4 a lateral paramedian coccygeal approach under fluoroscopic guidance, 5 or transdiscal through the sacroccygeal disc, 6 typically using a combination of local anesthetic (bupivacaine or lidocaine), normal saline solution, and steroid (triamcinolone or methylprednisolone). Improvement in pain as determined through symptom surveys occurs in 41% to 100% of cases at 1 to 2 months 5,7 ; however, potential risks include bleeding, pain (particularly when using a bent needle or corkscrew approach), discitis, and injury to the surrounding pelvic organs.…”