Coccydynia

Definition

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

The Coccyx

Copyright © Nucleus Medical Media, Inc.

Causes

This condition is caused by an injury or stress that affects the tailbone, as well as the muscles and nerves surrounding it. Examples include:

• Fall or trauma
• Pressure and strain, as during childbirth
• Prolonged sitting on hard surfaces
• Spinal cyst or tumor
• Dislocation from injury or obesity, which can cause bones to shift
• Repeated stress (eg, horseback riding, bicycling, motorcycle riding)

Risk Factors

These factors increase your chance of developing coccydynia:

• Gender: female
• Brittle bones (eg, osteoporosis, arthritis)
• Low back pain
• Participation in contact sports or certain activities (eg, horseback riding)
• Infections (eg, tuberculosis, osteomyelitis)
• Obesity

Tell your doctor if you have any of these risk factors.

Symptoms

If you have any of these symptoms, do not assume it is due to coccydynia. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:

• Pain when:
  • Sitting down
  • Changing position from sitting to standing
  • Moving bowels
  • Having sex
• Tenderness directly over tailbone
• All-over backache
• Pain or spasm of pelvic muscles

Diagnosis

Your doctor will ask about your symptoms and medical history. He will do a physical exam, looking to see if the tailbone area is swollen, red, or warm. Tests may include:

• CT scan —a type of x-ray that uses a computer to make pictures of structures inside the body
• X-ray —a test that uses radiation to take a picture of structures inside the body, especially bones

These tests can show if there is a fracture or dislocation.

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include the following:

• Bed rest
• Use of special pillows to sit on
• Sitz baths (which involves soaking hips and buttocks)
• Medication, including steroid injections, pain medications, stool softeners
• Manual realignment of spine
• Relief of pain by massage of surrounding nerves
• Physical therapy, involving:
  • Strengthening of muscles in pelvic area
  • Relief and stimulation with heat therapy and ultrasound therapy

Prevention

To help reduce your chance of getting coccydynia, take the following steps:

• Learn proper sitting posture.
• If you have to sit for long periods at work, ask for an ergonomics consultation.