Journal of pain research
Coccydynia as a Multimechanistic Pain Syndrome: A Narrative Synthesis and Proposal of the Coccyx Pain Phenotype Score (CPPS) for Mechanism-Based Clinical Phenotyping
By Khalfallah M, Savalli L, Khalfallah I and 1 others.
Abstract
Objective
To introduce the Coccyx Pain Phenotype Score (CPPS), a conceptual clinical phenotyping framework intended to characterize the proposed contribution of four pain mechanisms in coccydynia and to provide a basis for individualized, mechanism-based assessment and management.
Methods
A narrative synthesis of the literature was conducted to identify clinical and pathophysiological features relevant to four proposed pain mechanisms in coccydynia: mechanical, myofascial, peripheral neural sensitization, and central sensitization. PubMed and Embase were searched without date restriction using terms related to coccydynia, chronic pelvic pain syndromes, pelvic floor dysfunction, neuropathic pain, peripheral sensitization, central sensitization, and nociplastic pain. Findings were organized across the four proposed domains and combined with recurrent clinical observations to construct a hypothesis-generating CPPS framework. No quantitative evidence synthesis or formal assessment of evidence quality was performed.