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Medically reviewed by Dr Diana Chan Xin Hui, Anaesthesiologist & Pain Specialist (MBBS, MMED (Anaesthesia), MCI, FAMS, GDA, EDRA, FIPP).  Last Updated: July 14, 2026

Treatments

Ganglion Impar Block & Radiofrequency Ablation (RFA) for Tailbone & Pelvic Pain in Singapore

Persistent tailbone, rectal, or pelvic pain can make sitting, driving, or even simple daily activities uncomfortable. When conservative treatments haven't provided enough relief, image-guided procedures targeting the ganglion impar may help. Depending on the cause of your pain and how you respond to treatment, Dr Diana Chan may recommend a ganglion impar block to diagnose and relieve pain, or radiofrequency ablation (RFA) for longer-lasting relief in suitable patients.
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Dr Diana Chan: Ganglion Impar Block Pain Specialist in Singapore

Dr Diana Chan is a Pain Medicine Specialist with over 20 years of experience and more than 2,000 pain procedures performed. She is the former Head of the Department of Pain Medicine at Singapore General Hospital and founder of the SingHealth Duke-NUS Pain Centre, with experience in image-guided nerve block procedures, including ganglion impar block for tailbone and pelvic pain.

  • Over 20 years in pain medicine
  • Performed over 2,000+ basic and advanced pain procedures
  • Expertise in minimally invasive, comprehensive and holistic pain management and interventions in Singapore
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Understanding Tailbone Pain (Coccydynia)

Coccydynia is the medical term for pain in and around the tailbone (coccyx), the small triangular bone at the very base of the spine. It’s a common and often frustrating condition, since the tailbone bears weight directly when sitting, making everyday activities like sitting at a desk, driving, or sitting down and standing up genuinely painful.

  • Pain localised directly over the tailbone, often described as sharp, aching, or throbbing
  • Pain that’s worse when sitting, particularly on hard surfaces, and often eased by standing or leaning forward
  • Pain when moving from sitting to standing, or vice versa
  • In some cases, pain extending into the rectal or perineal area
  • Tenderness when the area is directly touched or pressed
  • Direct injury — a fall onto the tailbone, or trauma from childbirth, is one of the most common causes
  • Prolonged sitting, particularly on hard or unsupportive surfaces, which can lead to repetitive strain
  • Childbirth — tailbone pain can develop or worsen during pregnancy and delivery, due to the pressure and positioning involved
  • Degenerative changes in the small joints of the coccyx, similar to arthritis elsewhere in the spine
  • In some cases, no clear single cause is identified, and pain develops gradually without an obvious triggering event

Most tailbone pain is not dangerous and is related to injury, prolonged sitting, or joint-related changes rather than a serious underlying condition. That said, persistent pelvic or tailbone pain can occasionally be associated with other conditions, which is why it’s worth having pain that is severe, worsening, or accompanied by other symptoms (such as unexplained weight loss, bleeding, or changes in bowel habit) properly assessed rather than assumed to be purely mechanical.

When Home Remedies Aren't Enough

Many people manage early tailbone pain with cushions, stretches, and activity modification, and for some, this is genuinely sufficient. It’s worth knowing what these measures can and can’t do:

  • Donut or wedge cushions can reduce direct pressure on the tailbone when sitting, and are a reasonable first step for mild, recent-onset pain.
  • Gentle stretches targeting the lower back, hips, and glutes can help for pain linked to muscle tension around the coccyx, though they don’t address pain coming directly from the tailbone joint or surrounding nerves.
  • Adjusting sleep position — avoiding lying directly on the back for extended periods can ease discomfort for some people, though it doesn’t treat the underlying cause.

If pain has persisted for several weeks despite these measures, or continues to significantly limit sitting and daily activity, it’s a reasonable point to seek a proper assessment rather than continuing to manage around the pain indefinitely.

What Is a Ganglion Impar Block?

The ganglion impar is a small cluster of nerves located at the very base of the spine, just in front of the tailbone (coccyx). It carries pain signals from the tailbone, rectum, perineum, and parts of the pelvic region.

A ganglion impar block is a minimally invasive, image-guided injection that delivers local anaesthetic, sometimes combined with anti-inflammatory medication, around this nerve cluster. By interrupting pain signals from the affected area, it can help relieve chronic tailbone, pelvic, rectal, and perineal pain.

Who Is a Candidate for a Ganglion Impar Block?

A ganglion impar block may be recommended if you have:

  • Persistent tailbone pain (coccydynia) that hasn’t improved with cushions, activity modification, medication, or physiotherapy
  • Chronic rectal, perineal, or pelvic pain without a structural condition requiring surgery
  • Pain suspected to arise from the sympathetic nerves supplying the tailbone or pelvic floor
  • Ongoing pain after childbirth, pelvic surgery, or injury affecting the coccyx or perineal region

Before recommending treatment, Dr Diana Chan performs a thorough assessment to ensure your symptoms are consistent with ganglion impar-related pain and to exclude other conditions that may require different treatment.

How Dr Diana Chan Performs the Ganglion Impar Block

Your consultation includes a detailed medical history, physical examination, and review of any previous imaging or treatments. This helps confirm that a ganglion impar block is appropriate for your condition.

The procedure is performed under fluoroscopy or ultrasound guidance to accurately position the needle in front of the tailbone. Once the correct position is confirmed, local anaesthetic, with or without additional medication, is injected around the ganglion impar. The procedure is usually performed under local anaesthetic, with light sedation if appropriate, and typically takes around 15 to 30 minutes.

Most patients return home on the same day. Mild soreness around the injection site may occur for a day or two. Some patients experience pain relief soon after the procedure, while for others improvement develops over several days. The duration of relief varies, and your response helps determine whether repeat treatment or longer-lasting options may be appropriate.

What Is Ganglion Impar Radiofrequency Ablation (RFA)?

Ganglion impar radiofrequency ablation (RFA) is a minimally invasive, image-guided procedure that provides longer-lasting pain relief by targeting the same nerve cluster. Instead of injecting medication, controlled radiofrequency energy is used to interrupt the nerve’s ability to transmit pain signals.

Because the ganglion impar is responsible for carrying pain from the tailbone and pelvic region, RFA can provide longer-term relief for selected patients whose pain returns after a successful ganglion impar block.

Who Is a Candidate for Ganglion Impar RFA?

Ganglion impar RFA may be suitable for patients who:

  • Experienced significant but temporary relief after a ganglion impar block
  • Have chronic tailbone, pelvic, rectal, or perineal pain that continues to affect daily activities
  • Want longer-lasting pain relief without major surgery
  • Have been assessed as suitable following clinical examination and imaging where required

A successful diagnostic block is often one of the strongest indicators that ganglion impar RFA is likely to be beneficial.

How Dr Diana Chan Performs Ganglion Impar RFA

Dr Diana Chan reviews your symptoms, previous treatments, and response to any earlier ganglion impar block. Imaging and clinical findings are assessed to confirm that radiofrequency ablation is an appropriate next step.

Using fluoroscopic guidance, a specialised needle is carefully positioned beside the ganglion impar. After confirming accurate placement, radiofrequency energy is delivered through the needle to create a controlled heat lesion that interrupts pain transmission while preserving surrounding structures. The procedure is performed under local anaesthetic, with light sedation if needed, and usually takes 30 to 60 minutes.

Patients usually return home the same day. Mild soreness at the treatment site is common for a few days. Pain relief may not be immediate and often develops gradually over several weeks as the treated nerve stops transmitting pain signals. If symptoms return over time as the nerve regenerates, the procedure can be repeated following reassessment where appropriate.

Are Ganglion Impar Procedures Safe? Risks and What to Expect

Both ganglion impar block and ganglion impar radiofrequency ablation (RFA) are generally safe, minimally invasive, image-guided procedures with a low risk of complications when performed by an experienced pain specialist.

As with any procedure, potential risks include infection, bleeding, temporary soreness or bruising at the treatment site, and, rarely, temporary nerve irritation. Most side effects are mild and settle within a few days.

Why Choose Dr Diana Chan for Ganglion Impar Block & Radiofrequency

Specialist in Pelvic, Tailbone & Nerve-Related Pain

More Than 20 Years of Pain Medicine Experience

Precision, Image-Guided Nerve Procedures

Focus on Non-Surgical, Minimally Invasive Pain Relief

Singapore's Only Female Private Pain Specialist

Frequently Asked Questions

Here are answers to some of the most frequently asked questions about ganglion impar procedures.

A ganglion impar block uses local anaesthetic, sometimes with additional medication, to relieve pain and help confirm whether the ganglion impar is the source of your symptoms. Ganglion impar RFA uses controlled heat to interrupt pain signals and may provide longer-lasting relief. RFA is often considered if you experience good but temporary relief from a ganglion impar block.

Relief varies depending on the individual and the procedure performed. A ganglion impar block may provide relief for weeks to months, while ganglion impar RFA may provide longer-lasting relief for several months or more in suitable patients.

In many cases, yes. A successful ganglion impar block helps confirm that the ganglion impar is the source of your pain and can indicate whether you are likely to benefit from RFA.

Both procedures are performed under local anaesthesia, with light sedation if appropriate. Most patients experience only mild discomfort during the procedure and temporary soreness at the treatment site afterwards.

Yes. If pain returns over time, either a repeat ganglion impar block or RFA may be considered, depending on your previous response and clinical assessment.

Because local anaesthetic or sedation may be used, you may be advised not to drive after the procedure. It’s best to arrange for someone to accompany you home.

Coverage depends on your insurer, policy, and where your procedure is performed. Our team can help verify your benefits and assist with insurance claims before your treatment.