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Coccydynia

(Coccyalgia; Coccygeal Pain; Coccygodynia; Pain, Tailbone; Pain, Coccygeal; Tailbone Pain)

Pronounced: KOK-sih-DIE-nee-ah

Definition

Coccydynia is pain in the area of the coccyx (tailbone). It is a small, curved, V-shaped bone at the bottom of the spine.

The Coccyx

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Causes    TOP

The tailbone can be found at the end of the spinal column. It supports the body in a sitting position and helps transfer body weight during changes in sitting positions. It is also an area where muscles, nerves, ligaments, and tendons from other locations in the body come together. Excess pressure can affect these structures.

In most cases, the specific cause of coccydynia is not known. Other times, it may be caused by:

  • Trauma or injury from falls
  • Tailbone shift during childbirth
  • Other stress that affects that tailbone

Pain can come from bones, muscles, nerves, or supporting structures.

Risk Factors    TOP

Coccydynia is more common in females. Other factors that may increase your chance of coccydynia include:

  • Brittle bones, which can occur with osteoporosis
  • Joint inflammation or changes in bone structure, which can occur with arthritis
  • Participation in contact sports or certain activities, such as horseback riding
  • Dislocation from injury or obesity, which can cause bones to shift
  • Prolonged sitting on hard surfaces
  • Low back pain
  • Infections, such as osteomyelitis
  • Spinal cyst or tumor

Symptoms    TOP

Pain may occur when:

  • Sitting down
  • Changing position from sitting to standing
  • Having a bowel movement
  • Having sex

Coccydynia may cause:

  • Tenderness directly over tailbone
  • All-over backache
  • Pain or spasm of pelvic or rectal muscles

Diagnosis    TOP

You will be asked about your symptoms and medical history. A physical exam will be done. This will include an evaluation of the tailbone to see if the area is swollen, red, or warm.

Imaging tests to look for fractures, dislocation, or other damage in the tailbone may include:

Treatment    TOP

In most cases, coccydynia will resolve on its own with conservative treatment. This includes using a special seating cushion to relieve pressure on the tailbone.

If the coccyx is misaligned, it may be manually manipulated into place. Other treatments include:

Medications

Inflammation and/or pain may be relieved by:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
  • Steroid injections
  • Nerve blocks
  • Antidepressants

Stool softeners can help reduce strain during bowel movements.

Physical Therapy

Physical therapy may include:

  • Exercises to strengthen muscles and supporting structures, such as ligaments
  • Relief and stimulation with heat therapy and ultrasound therapy

Other Treatments    TOP

Some people find relief with:

  • Massage
  • Transcutaneous electrical nerve stimulation (TENS)

Your doctor may also refer you to counseling.

Surgery    TOP

Coccygectomy is the surgical removal of the tailbone. This surgery is not generally recommended and may be considered if all other treatment methods fail.

Prevention    TOP

To help reduce your chance of coccydynia:

  • Learn proper sitting posture
  • If you have to sit for long periods at work, get up and move around periodically
  • Use proper protection during sports or activities where you may be injured

RESOURCES:

Family Doctor—American Academy of Family Physicians
http://familydoctor.org
Ortho Info—American Academy of Orthopaedic Surgeons
http://orthoinfo.org

CANADIAN RESOURCES:

Canadian Association of General Surgeons
http://www.cags-accg.ca
Canadian Orthopaedic Foundation
http://www.canorth.org

References:

Coccydynia (tailbone pain). Cleveland Clinic website. Available at:
...(Click grey area to select URL)
Updated July 22, 2014. Accessed November 10, 2017.
Howard PD, Dolan AN, Falco AN, et al. A comparison of conservative interventions and their effectiveness for coccydynia: a systematic review. J Man Manipulative Ther. 2013;21(4):213-219.
Lirette LS, Chaiban G, et al. Coccydynia: An overview of the anatomy, etiology, and treatment of coccyx pain. Oschsner J. 2014;14(1):84-87.
Last reviewed November 2017 by EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM
Last Updated: 12/20/2014

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