Coccydynia
Pain in the Tailbone
Coccydynia is a condition commonly known as tailbone pain. It results from
trauma or irritation of the
coccyx (tailbone), a boney structure found at the bottom of the spine. Tailbone pain may start after a backward fall, prolonged sitting on hard
surfaces, joint degeneration, pregnancy, and vaginal childbirth.
While tailbone pain usually improves on its own, sometimes it may go undiagnosed
and persist for several months or longer. A pain specialist can diagnose
tailbone pain and provide treatments that bring you much needed relief.
What is the Tailbone?
The coccyx (tailbone) is the ending of the spinal column. It contains several
bone segments that are fused and it attaches, through a joint, to the
large sacral bone above.
Because it corresponds to the location of an animal’s tail, the coccyx is called the “tailbone."
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The coccyx is an important attachment site for tendons, ligaments, and
muscles in the pelvis. It
bears the body’s weight and acts as a shock absorber when a person sits.
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Its position under the skin, leveled with the cleft of the buttocks, makes
the tailbone
likely to get bruised or fractured.
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Some people have a coccyx that curves too far instead of pointing straight down, predisposing them to injuries and pain.
What Causes Tailbone Pain?
In most cases, tailbone pain starts after a trauma and is not a sign of
a threatening condition.
Tailbone pain is caused by:
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Falls. Tailbone pain may start with a fall where a person lands on the buttocks,
bruising, breaking, or dislocating (shifting out of place) the tailbone.
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Repetitive Strain. Sports like bicycling and rowing require back and forth movements that
stretch the ligaments and tendons attached to the tailbone.
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Pregnancy and childbirth. Pregnancy hormones soften the pelvic tissues, causing the tailbone to shift.
Constipation, the weight of the growing baby, and vaginal birth can push
against the tailbone, causing pain.
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Obesity or excessive weight loss. Excess weight puts pressure on the coccyx, changing its position. Conversely,
an underweight person, does not have enough fat in their buttocks to prevent
the tailbone from rubbing against surrounding tissues. This creates inflammation and pain.
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Sitting too much. Sitting on a hard and narrow surface puts pressure on the tailbone.
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Cancer. In rare cases, the tailbone may develop cancer.
Symptoms in people with tailbone problems
Most people have
tailbone pain only in the buttocks. Other people may feel that their
pain radiates (moves) to the pelvis and legs. Radiating pain can start if the tail bone presses on a nearby nerve grouping,
called the Ganglion Impar.
Most people with tailbone pain have:
- An achy or stabbing pain in the buttocks
- Pain when standing up from a seated position
- Increased pain when sitting for long periods
- Pain during bowel movements
- Pain during sexual intercourse
Finding a diagnosis for tailbone pain
Your pain specialist will start by asking about your medical history and
conducting a thorough physical exam that checks for
tenderness around the tailbone area.
The following tests are useful:
Treatments for tailbone pain
Tailbone injuries heal slowly and may cause long-term pain if a person
does not receive adequate care.
Initial tailbone pain treatments include:
- Over-the-counter pain relievers
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Special pillows to cushion the tailbone
- Stretching and improved posture
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Physical therapy and massage to reduce muscle tension and ligament strain
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Manual manipulation to realign the coccyx into the correct position
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Corticosteroid injections to decrease inflammation around the tailbone
For additional pain relief, a pain specialist provides the following treatments: