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Tailbone Pain or Coccydynia

Tailbone Pain or Coccydynia | Spire Orthopaedic

What is Coccydynia?

Inflammation of the tailbone (coccyx or bony area located deep between the buttocks above the anus) is referred to as coccydynia. Coccydynia is associated with pain and tenderness at the tip of the tailbone between the buttocks. Sitting often worsens coccyx pain. Coccydynia can also be referred pain from the lower back.

What are the symptoms of coccydynia?

The symptoms of coccydynia include:

  • Achy or piercing pain in the tailbone.
  • More severe pain when changing from sitting to standing up.
  • More severe pain when sitting for long periods of time.
  • Pain during bowel movements.
  • Pain during sex.

Other related symptoms that may occur with coccydynia include:

  • Depression.
  • Anxiety.
  • Poor sleep.
  • Painful buttocks.
  • Back pain.

What are the treatments for coccydynia?

  1. Anti-Inflammatory Medication

Common anti-inflammatory medications can help to reduce all of the inflammation surrounding the coccyx, which is often the cause of the pain. Talk to your doctor first. As anti-inflammatories are sometimes not specific when taken orally, you could consider an anti-inflammatory rub or gel.

2. Ice

Apply ice to the area multiple times per day for the first few days following the onset of pain. Simply sit on an ice bag or lay on your front with the ice over your tailbone. Make sure the ice is wrapped in a tea towel so it is not too cold. Ice reduces inflammation and it’s one of the best ways to treat coccydynia. The ice needs to be used regularly for a 4-8 weeks so be persistent with it.

3. Heat

As well as using ice to treat the pain, heat can also be used. Alternate between the two alternatives to achieve optimal relief. Try 5-10 minutes of ice, followed by up to 20 minutes of heat. Be careful with skin burns from the ice or heat if applied directly to the skin.

4. Avoid Pressure

Avoid sitting in one position for an extended period of time. Placing pressure on the area will increase inflammation and pain, so you need to make sure you are getting up and moving every once in a while to alleviate pressure and inflammation.

5. Customized Pillow

Using a customized pillow, you can help take some of the pressure off the coccyx whenever you are sitting down. For some individuals, a donut-shaped pillow will work perfectly. Others find that it is not the right shape for them and still places pressure on the coccyx. Some individuals find that a foam pillow in a U-shape or a V-shape is ideal. Having the back of the pillow open helps to avoid anything touching the coccyx, which works well for a number of people. Any type of sitting arrangement or pillow that helps to alleviate pressure from the coccyx is perfect.

6. Tool Softeners​

For those who are having pain in the tailbone from constipation or an increase in bowel movements, stool softeners, water and an increase in fiber all work to help alleviate some of the pressure on the coccyx.

7. Manipulation

Massaging of a loose bone attached to the tailbone might help ease pain. Manipulation is typically done through the rectum under an anaesthetic block. This treatment is only for patients who meet specific criteria. Not all are candidates for this technicque

8. Medication

An injection of a local anesthetic into the tailbone can relieve pain for a few weeks. Certain antidepressants or anti-epileptic medications might relieve tailbone pain as well.

9. Surgery

During a procedure known as a coccygectomy, the coccyx is surgically removed. This option is typically only recommended when all other treatments fail.

What are the risk factors for coccydynia?

  1. The major risk factor for coccydynia is injury to the coccyx or pelvic bones. 

    It seldom affects any nerve as most would have exited higher above.

How do Doctors diagnose coccydynia?

  1. Doctor may diagnose coccyx inflammation based solely on the symptoms and the examination findings of local pain.

    Doctor may advise for further investigations such as MRI or CT scans to exclude bone or tissue disorders

    In a case of suspected coccydynia where initial imaging is inconclusive but clinical suspicion is very high, higher level imaging such as MRI or CT can reveal radiographic findings of coccydynia. MRI and CT can play a role in the diagnosis and treatment of coccydynia in the absence of x-ray evidence.

How common is coccydynia?

  1. Tailbone pain is common.

    Women are five times more likely than men to develop coccydynia. Adults and adolescents get it more often than children. Obese persons are three times more susceptible than those at the ideal weight according to the BMI (Bone Mass Index) scale. You’re also more vulnerable if you lose weight too quickly.

What are the causes of tailbone pain (coccydynia)?

Falling

Who hasn’t fallen backwards onto their behind? Maybe your feet slipped out from under you on the ice. Maybe you fell off a ladder. Or, maybe you were leaning too far back in your office chair and took a tumble. If you take a really bad fall you can bruise, break (fracture) or dislocate (knock out of place) your tailbone (coccyx).

Repetitive Strain Injury (RSI)

Sports like bicycling and rowing require you to lean back and forth and stretch your spine. Too much of that repeated motion can strain the tissues around your coccyx.

Pregnancy/Childbirth

During the third trimester of pregnancy, a woman’s body secretes hormones that soften the area between the sacrum and the coccyx. This enables the coccyx to move as necessary during childbirth. This is a natural process but, unfortunately, such movement may stretch the muscles and ligaments around the coccyx too far, causing additional pain. Such a strain on those soft tissues keeps them from supporting your coccyx at the correct angle.

Obesity

Extra weight applies additional pressure to the coccyx. This can cause the coccyx to lean backward. Your tailbone will hurt if it is out of position.

Underweight

If you don’t have enough fat in your buttocks to prevent your coccyx from rubbing against the muscles, ligaments and tendons, that can cause. The rubbing inflames the soft tissues.

Sitting

Just this simple act can increase coccyx pain, especially if you’re sitting on a hard or narrow surface. Do your best to get up often, stretch and take a short walk. Better yet, find yourself a softer, more comfortable place to sit or use a cushioned seat.

Cancer

Only in rare cases is tailbone pain a sign of cancer. It is extremely unlikely.

How long does it take for coccydynia to heal?

There are a number of treatments that can help reduce the pain of coccydynia. The duration for recovery is highly variable. Simple measures you can try at home are usually recommended first. Coccydynia often improves over a few weeks or months. However, if pain persist, further investigations maybe warded.

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