What is coccydynia?
Coccydynia or coccygodynia is a type of lower back pain characterised by pain around the last bone of the spine (tailbone or coccyx). The pain can be mild or severe. It usually worsens while sitting, leaning backwards or during movement from a sitting to standing up posture.
Often, the resulting pain will impact the routine activities of an individual, mainly, sitting, bending over or driving. Women are at high risk of developing coccydynia than men due to its association with childbirth.
Many times, the cause is not known (idiopathic). However, the known causes of coccydynia include:
- Damage to the tailbone or the surrounding areas due to an accident.
- Displacement of the tailbone away from its original place due to activities such as rowing or cycling, or due to poor posture.
- Infection or a tumour.
Coccydynia classically manifests with the presence of localised pain over the tailbone, mainly, while sitting on a hard surface. Usually, the symptoms improve when the pressure is relieved by walking or standing.
The other symptoms of coccydynia include:
- Severe and immediate pain when changing from sitting to standing positions
- Pain during sexual intercourse
- Pain during bowel movements
Your physician will ask you about any history of injury in the past such as prolonged delivery or injury during childbirth. He/she will examine you physically for:
- The presence of any abscesses or atypical masses
- Tailbone injuries in a lateral view of X-ray
- Magnetic resonance imaging (MRI), CT scan or a bone scan can be ordered if your doctor deems it necessary
The usual treatment involves the prescription of non-steroidal anti-inflammatory drugs (NSAIDs) to reduce the inflammation, corticosteroid injections and the use of therapeutic sitting cushions which take off the pressure from the tailbone while sitting.
Other approaches for treatment include:
- Ganglion impar nerve block: A cluster of nerves (the ganglion impar) next to the coccyx transmits the pain signal. Blocking these nerves by injecting a local anaesthetic will stop them from transmitting pain signals temporarily
- Sacrococcygeal joint injections: The tailbone and the rest of the spine are held in place by the sacrococcygeal joints. When the inflammation or any damage to these joints cause coccydynia, the joints are injected with a combination of a local anaesthetic and corticosteroids
- Massage, heat or ultrasound therapy
- Physiotherapy exercises for stretching your ligaments and strengthening the supporting muscles
- Ergonomic adaptations
- Coccygeal manipulation is employed to move the tailbone back to its right position and ease the pain
- Rarely, surgical removal of the coccyx might be necessary (coccygectomy)
Many of the cases of coccydynia arise due to accidents and hence they can’t be entirely avoided. Use of protective padding during contact sports can prevent injuries of the tailbone.
- Persistent pain can impact one’s quality of life.
- It can lead to anxiety and depression, especially if one has chronic coccydynia.
If the pain continues to persist even after following all the recommended treatment procedures for coccydynia, then it could be due to some other causes. Visit your doctor immediately in such cases for further evaluation and treatment.
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- Lirette LS, Chaiban G, Tolba R, Eissa H. Coccydynia: An Overview of the Anatomy, Etiology, and Treatment of Coccyx Pain. The Ochsner Journal. 2014;14(1):84-87.
- NHSChoices. http://www.nhs.uk/Conditions/coccydinia/Pages/Introduction.aspx. Accessed 5 Jul. 16.
- Coccydynia (Tailbone Pain). Cleveland Clinic. http://my.clevelandclinic.org/health/diseases_conditions/hic_Coccydynia_Tailbone_Pain. Accessed 5 Jul. 16.