FAQ’s on Coccydynia

When the area located between the buttocks (called the Coccyx or tailbone) is painfully inflamed, it is called Coccydynia. Less than 1% of patients of low back pain are found to have this condition of pain and tenderness at the tailbones tip. The curved Coccyx is the last bone of the spine and it is made of three small bones, or vertebrae. Its main function is as a weight-bearing structure when sitting on a hard surface.

Common causes of Coccydynia

If a spontaneous case, coccydynia (idiopathic) injury is the most common cause. Children can be afflicted with this condition but senior adults are the more prone group as to the erosion with organic aging.

Natural trauma: and childbirth the muscles, ligaments and tendons attached to the coccyx can be affected. Women naturally have a broader coccyx in a more pronounced position, making them more susceptible to this condition. During childbirth the bones are displaced to make the passage for the baby. Due to the association of this factor, women can be up to five times more susceptible in developing coccydynia over men.

Acute injury:  trauma to the area of the coccyx usually from a fall or automobile collision.

Position migration: over a period of time the coccyx may shift from its normal (anatomical) position; by poor posture when sitting, or by activities involving repetitive motions when sitting for the coccyx acts as a pivot, such as cycling or rowing.

Rare causes: Infections or pressure placed upon the coccyx by an abnormality such as a tumor.

Symptoms of Coccydynia

The classic symptom is pronounced pain while sitting on a hard chair (or surface) due to the additional pressure to the tailbone and it adds further stress on the area when leaning backwards. Pain may be relieved when the person stands and walks. Pain intensity ranges from mild to severe. Sometimes the patient can’t sit comfortably in the same posture for long periods of time, and needs to continually re-distribute the weight by shifting from one position to another to relieve the symptoms of pain.

  • Pain may limit everyday activities such as sitting for periods of time over a half hour, forward bending, or driving. Intense pain may occur when the patient goes from a sitting to standing position. Sitting on a soft surface may be more painful, as most of the weight comes onto the coccyx rather than the hip joints.
  • Pain may also be felt during sex, or normal activities that are needed such as passing stool.
  • Shooting pain down the legs.
  • Patients often experience disturbed sleep as they have to keep on changing position while lying on the bed.

How do you diagnose Coccydynia?

The physician starts with a work-up of the medical history of the patient and full clinical exam. Prolonged labor during childbirth or any trauma (whether recent or past) should be noted. A Clinical evaluation including thorough inspection and physical palpation of the lower lumbar area to detect any deformities such as an abnormal mass, due to a tumor or a collection of pus (abscess), following infection or sickness.
X-ray of coccyx (lateral view) is taken to detect fracture etc.
Sophisticated imaging tests (CT scan or magnetic resonance imaging (MRI)) will be used to help identify and determine a diagnosis. Tests such as these detect the exact pathology in real time, such as shifting of the coccyx in position, stretching of muscles, muscle rupture or herniation, etc.

How do you treat Coccydynia?

In treating coccydynia , traditional treatment includes non-steroidal anti-inflammatory drugs (NSAID), such as Ibuprofen or Naproxen, which will reduce inflammation and symptoms of pain. Patients sensitive to NSAIDs can be treated with paracetamol. Therapeutic cushions may be provided for more comfortable periods when sitting at my health relieve the pressure on the tailbone. Significant relief of pain may vary in time with conservative treatments before they become effective.

If a more advanced case, corticosteroid injections are recommended. Short time relief, or with acute cases, the physician may recommend Spinal manipulation or physiotherapy and chiropractic alternative therapies.

In very severe cases surgical removal of the coccyx (coccygectomy) is formed. The risks associated with surgery are infection, tenderness at the surgery site, and improper wound healing.

Most of the cases of coccydynia are successfully treated with conservative methods; rarely do the cases need chronic pain rehabilitation methods or surgical intervention.