Ganglion Impar Block in ChennaiImage-Guided · Day-Care · For Chronic Tailbone & Pelvic Pain
When chronic tailbone, perineal or lower pelvic pain refuses to settle, a Ganglion Impar Block can interrupt the pain at its relay point. Performed under image guidance as a day-care procedure by Dr. Soma Sundar S — one of the few pain specialists in Chennai offering this block, with neurolysis and radiofrequency options for longer-lasting relief when needed.
Dr. Soma Sundar S
MBBS · MS (Ortho) · DNB · FRCS (Tr & Orth) UK · FISS · FESS (Germany) · FMISS (Switzerland)AO Spine fellowship (UK), Gold medalist, Pain Management Specialist, Minimally Invasive Surgeon – Spine and Ortho.
Dr. Soma Sundar is among the few pain specialists in Chennai performing the Ganglion Impar Block, done under image guidance for accuracy and safety. The approach is staged and honest: a precise diagnostic-therapeutic block first, with neurolysis or radiofrequency for durable relief only when it is clearly the right next step.
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Kauvery Hospital, Alwarpet
Mon – Sat · 8:30 AM – 5:00 PM
Get Directions →
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Shens Hospital, Ashok Nagar
Mon – Sat · 5:30 PM – 8:00 PM
Get Directions →
Quick Answer: What Is a Ganglion Impar Block?
The ganglion impar (ganglion of Walther) is a small nerve cluster in front of the sacrococcygeal junction that relays pain from the tailbone, perineum and lower pelvis. A Ganglion Impar Block places medicine around it under image guidance to interrupt those pain signals. It is a day-care procedure for chronic coccydynia and perineal or pelvic pain that has not settled with cushions, physiotherapy or a simple tailbone injection — and Dr. Soma Sundar is among the few pain specialists in Chennai who perform it.
Blocking the Pain at Its Relay Point
The ganglion impar is a single, small bundle of sympathetic nerves that sits right in front of the joint between the sacrum and the coccyx. It acts as a relay station, carrying pain from the tailbone, the perineum and the lower pelvic region.
When pain from this area becomes chronic and does not respond to cushions, physiotherapy or a simple tailbone injection, calming this relay can interrupt the pain cycle. A Ganglion Impar Block places a small amount of local anaesthetic — usually with a little steroid — precisely around the ganglion.
Because the target sits very close to important structures, the block is always done under image guidance. That precision is what makes it both effective and safe, and it is why this procedure belongs in experienced, specialist hands.
🦴Tailbone Pain Guide
💉Tail Bone Injection
🖐️Coccyx Manipulation
The ganglion impar sits in front of the sacrococcygeal junction — a relay point for tailbone, perineal and lower pelvic pain.
Who Benefits Most From a Ganglion Impar Block
This block is usually considered when pain is chronic and has not settled with simpler steps, or when pain sits in the tailbone, perineal or lower pelvic region. You may be a good candidate if any of these sound like you.
Chronic Tailbone Pain
Coccydynia that has lasted months and has not settled with cushions, physiotherapy or a simple tailbone injection.
Perineal Pain
Pain in the area between the tailbone and the genitals or anus that is hard to localise and slow to settle.
Lower Pelvic Pain
Deep, hard-to-pinpoint pain low in the pelvis that may be relayed through the ganglion impar.
Pain After Surgery or Radiation
Persistent perineal or pelvic pain following pelvic surgery or radiation that needs a targeted pain option.
Other Treatments Not Enough
You have tried cushions, medicines, physiotherapy and injections, and the pain keeps coming back.
Selected Cancer-Related Pain
For certain cancer-related pelvic or perineal pain, the block can be part of a palliative pain plan.
How the Ganglion Impar Block Is Done
Knowing exactly what happens removes most of the worry. Here is the full journey, from arrival to going home — usually all on the same day.
1
Assessment & consent
Your symptoms, examination and any X-ray or MRI are reviewed. The procedure, benefits and what to expect are explained, and your questions are answered before you agree.
2
Comfortable positioning
You lie face down comfortably. The skin over the tailbone is cleaned and a local anaesthetic is used so the area is numb.
3
Image-guided targeting
Using C-arm fluoroscopy or ultrasound — most often through a trans-sacrococcygeal route — a fine needle is guided to the front of the sacrococcygeal junction. A little contrast confirms correct spread.
4
The block
A small volume of local anaesthetic, usually with a little steroid, is placed around the ganglion impar. The active part takes only a few minutes.
5
Short observation
You rest briefly while we make sure you are comfortable. Many patients already notice early relief from the local anaesthetic.
6
Home the same day
You go home with clear aftercare advice. Most people resume light routine the same or next day, and relief is reviewed at follow-up.
Done under image guidance in a sterile day-care setting — position is confirmed with contrast before any medicine is given.
What a Ganglion Impar Block Can Do for You
The goal is to settle chronic, hard-to-treat pain at its relay point — precisely, with the least intervention needed, and with a clear path to longer relief if required.
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Targets the Pain Relay
Calms the exact nerve cluster carrying tailbone, perineal and pelvic pain — not just the symptom on the surface.
Image-guided
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Test and Treatment
Good relief confirms the ganglion impar is the source while treating it — valuable information for planning next steps.
Diagnostic + therapeutic
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Quick & Day-Care
A short procedure under local anaesthesia with same-day discharge. Minimal disruption to your week.
Same day home
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Breaks Chronic Pain Cycles
Interrupting the pain relay can settle long-standing pain enough for physiotherapy and recovery to take hold.
For chronic pain
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A Path to Durable Relief
If relief is good but temporary, neurolysis or radiofrequency can offer much longer-lasting effect in selected cases.
Step-up option
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Can Be Combined
When suitable, it pairs with a tailbone injection and coccyx manipulation in one sitting for a stronger effect.
3-in-1 option
Start Precise, Step Up Only If Needed
The Ganglion Impar Block is not a one-size-fits-all injection. It follows a logical, staged path — starting with the least intervention, and stepping up to longer-lasting options only when the first step has clearly shown it helps you. This is how lasting relief is achieved without over-treating.
Diagnostic-Therapeutic Block
A precise image-guided block of local anaesthetic, usually with a little steroid. It treats the pain and confirms the ganglion impar is the source.
Neurolysis / Radiofrequency
If relief is good but temporary, neurolysis (alcohol or phenol) or radiofrequency ablation can give much longer-lasting relief in selected chronic cases.
Combined in One Sitting
For chronic coccydynia, the block can be combined with a tailbone injection and gentle coccyx manipulation in the same sitting.
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Why this matters: A diagnostic block tells us whether the ganglion impar is truly your pain source before committing to any longer-lasting procedure. You only step up if the block has already proven it helps you — precise, evidence-led, and tailored to your response.
Why Choose Dr Soma Sundar
A Specialist Procedure in Experienced Hands
The ganglion impar sits close to important structures, so this block belongs with a specialist who does it under image guidance and recommends it only when it genuinely helps.
14+Years Experience
InternationallyTrained
Image-GuidedPrecision
Impar BlockSpecialist
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Image-guided accuracy: Needle position confirmed with contrast before any medicine is given — precise and safe.
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Honest, staged plan: A diagnostic block first; durable procedures only if the block has shown it works for you.
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Full range of options: Block, neurolysis, radiofrequency, plus tailbone injection and manipulation when needed.
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Clear, calm guidance: Every step explained in simple terms, so you feel informed and at ease.
A short rest, then home — most patients are back to light routine the same or next day.
Safe & Straightforward
Safety, Recovery & What to Expect
Performed under image guidance by an experienced specialist, the Ganglion Impar Block is a low-risk, well-tolerated procedure. It is done under local anaesthesia, takes only a few minutes of active time, and you usually go home the same day.
You may notice early relief from the local anaesthetic, then a short settling period before the steroid effect builds over the following days. Mild soreness at the site for a day or two is normal and usually eases with simple measures.
As with any injection there are small, uncommon risks, which are minimised by careful assessment, sterile technique and confirming needle position with contrast before injecting. Everything is explained clearly beforehand.
📞Discuss Your Case
🦴About Tailbone Pain
Tell us beforehand if any of these apply
Active infection or skin problem near the tailbone, blood-thinning medication, uncontrolled diabetes, pregnancy, or a known allergy to local anaesthetic or steroid. These don’t always prevent the procedure, but they help us plan it safely for you.
Aftercare: Do’s and Don’ts
A few simple habits in the first days help the block settle the pain and keep the relief lasting.
✅Do
- Use a wedge or coccyx cut-out cushion whenever you sit.
- Take short standing or walking breaks instead of long unbroken sitting.
- Keep the injection site clean and dry for the first day.
- Resume light routine gradually as comfort allows.
- Continue any prescribed physiotherapy and posture work.
- Note how your pain changes — it guides whether to step up.
⛔Don’t
- Don’t sit for long hours on hard surfaces in the first few days.
- Don’t do heavy lifting or strenuous exercise immediately.
- Don’t soak the site in pools or tubs until advised.
- Don’t ignore increasing pain, redness, swelling or fever — call the clinic.
- Don’t expect full effect on day one; the steroid action builds up.
- Don’t stop your physiotherapy once the pain eases.
Ganglion Impar Block — FAQs
Clear answers to the questions patients ask most before booking the procedure.
The ganglion impar (ganglion of Walther) is a small nerve cluster in front of the sacrococcygeal junction that relays pain from the tailbone, perineum and lower pelvis. The block places local anaesthetic, often with a little steroid, around it under image guidance to interrupt those pain signals. It is a day-care interventional pain procedure.
It is most often used for chronic tailbone pain (coccydynia) that has not settled with cushions, physiotherapy and simple injections, as well as perineal pain, lower pelvic pain, and certain pain after pelvic or perineal surgery or radiation. In selected cases it helps cancer-related pelvic or perineal pain.
You lie face down and the skin is numbed. Using C-arm fluoroscopy or ultrasound, a fine needle is guided to the front of the sacrococcygeal junction, most often through a trans-sacrococcygeal approach. Correct position is confirmed before a small volume of medicine is placed around the ganglion impar.
It is done under local anaesthesia with image guidance, so it is generally well tolerated. You may feel brief pressure during the block and mild soreness at the site for a day or two, which usually settles quickly.
Yes. In most cases it is a short day-care procedure. After a brief observation you can usually go home the same day and resume light routine.
It varies. Many patients get useful relief lasting weeks to several months. When relief is good but wears off, the block can be repeated, or neurolysis or radiofrequency ablation may be offered for longer-lasting effect in selected chronic cases.
Yes. Dr. Soma Sundar performs it under image guidance (C-arm fluoroscopy or ultrasound), often with contrast to confirm correct spread. This is essential for accuracy and safety, as the target sits very close to important structures.
Yes. Good relief after a well-placed block confirms the ganglion impar is relaying your pain while also treating it. This helps decide whether a longer-lasting neurolysis or radiofrequency procedure is worthwhile.
If a diagnostic block gives clear but temporary relief, the next step in selected chronic cases is a neurolysis (alcohol or phenol) or radiofrequency ablation of the ganglion impar, which can provide much longer-lasting relief. This is discussed only after the block has shown it helps you.
When performed under image guidance by an experienced specialist, it is a low-risk procedure. Minor effects like temporary soreness or a short-lived flare of pain can occur. Serious complications are uncommon and are minimised by careful assessment, sterile technique and image confirmation before injecting.
Yes. In selected patients with chronic coccydynia, Dr. Soma Sundar combines the block with a tailbone injection and gentle coccyx manipulation in the same sitting. Together under image guidance, they can have a useful added effect while reducing visits and anaesthetic exposures.
A clinical assessment and review of any X-ray or MRI is done first. Most patients can eat normally and continue routine before the procedure. Please mention any blood thinners, allergies, diabetes, pregnancy or active infection near the tailbone so it can be planned safely.
Yes. Share your symptoms and any X-ray or MRI reports and a video consultation can clarify whether the block suits you and what to expect. An in-person examination is needed to plan and perform the procedure.
What Patients Say After Their Procedure
Real-world relief, in patients’ own words. Individual results vary, and your plan is always tailored to you.
Years of tailbone pain that nothing touched. The block finally gave me real relief, and it was explained so clearly that I wasn’t anxious at all.
★★★★★VVenkatChronic coccydynia · Chennai
I had perineal pain after pelvic surgery and had almost given up. The Ganglion Impar Block made daily life bearable again. Grateful for the calm, honest guidance.
★★★★★LLakshmiPost-surgical pain · Alwarpet
The diagnostic block worked but wore off, so we did the radiofrequency step. Much longer relief now. I appreciated that nothing was rushed.
★★★★★AArunStep-up to RFA · Ashok Nagar
Combined the block with a tailbone injection in one sitting. Fewer visits, and my sitting pain has hugely improved. Highly recommend Dr. Soma.
★★★★★DDeepaCombined sitting · Chennai
Video Consultation Before the Procedure
If you are outside Chennai, finding it hard to travel because sitting is painful, or simply want to understand your options first, a video consultation is an easy way to begin.
📄Share reports before the call
X-ray, MRI, prescriptions and previous treatment details can be reviewed in context.
🎯Know if the block suits you
Understand whether a Ganglion Impar Block, tailbone injection or coccyx manipulation is right for your pain.
🗓️Plan the visit efficiently
If the procedure is suitable, your in-person visit can be planned so assessment and treatment flow smoothly.
💬Book Video Consultation
📞Call Clinic
Dr. Soma Sundar S
Spine, Orthopaedic & Pain Specialist
Online consultation available
1
Send your pain details and reports
2
Get a review and learn if the block suits you
3
Receive a clear plan and book the procedure
ℹ️ Fever, swelling, a lump near the tailbone, unexplained weight loss or bladder/bowel changes need direct hospital evaluation, not only video consultation.
Dr. Soma Sundar S
MBBS · MS (Ortho) · DNB · FRCS (Tr & Orth) UK · FISS · FESS (Germany) · FMISS (Switzerland)AO Spine fellowship (UK), Gold medalist, Pain Management Specialist, Minimally Invasive Surgeon – Spine and Ortho.
If chronic tailbone, perineal or pelvic pain is not settling, a precise image-guided Ganglion Impar Block can interrupt it at the source — often in a single day-care visit, with neurolysis or radiofrequency options for durable relief when needed.
Book a consultation to find out whether the block is right for you, and get a clear, honest, staged plan with no pressure.
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Kauvery Hospital, Alwarpet
Mon – Sat · 8:30 AM – 5:00 PM · By appointment
Shens Hospital, Ashok Nagar
21/40 Mettupalayam, 11th Avenue, Ashok Nagar, Chennai 600083 · 5:30 PM – 8:00 PM
