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Coccydynia (Tailbone Pain)

What are the causes of coccydynia?

Coccydynia is most commonly known as tailbone pain. Most often the causes of coccydynia are unknown, however tailbone pain may be due to trauma, accident, fall, prolonged labor, or another type of injury. Another cause of tailbone pain is excessive mobility of the tailbone, or in some rare cases a tumor, infection, or fracture.

coccyx

How do I know if I have coccydynia?

The most typical symptom of coccydynia is pain when pressure is applied to the tailbone area. This may occur when sitting in a chair, getting in and out of the car or bed, or when changing from sitting to standing position. The pain usually improves when pressure is removed from the area.
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Other symptoms include:

  • Immediate and severe pain when moving from sitting to standing position
  • Pain during bowel movements
  • Deep ache in the region of the tailbone

Dr. Mohemani diagnoses coccydynia with a thorough history and physical examination, asking questions to discover the origin of the tailbone injury. If there is no history of injury to the area, Dr. Mohemani will feel the area for any unusual masses or infections. In some cases, an x-ray is taken of the area to rule out the possibility of fracture.

How is coccydynia treated? 

Treatment usually consists of non steroidal anti inflammatory drugs– such as ibuprofen and naproxen — to reduce inflammation (swelling), and the use of a therapeutic sitting cushion to take the pressure off the tailbone when sitting. It might take many weeks or months of conservative treatment before there is major pain relief.

According to spine-health possible treatments for coccydynia include the following:

  • Your doctor might refer you to a biomedical engineer to be measured for a customized seating cushion. This cushion provides an “open area” in the surface that shifts the weight off the tailbone to promote healing.
  • Your health care provider might also consider physical therapy. This could include exercise to stretch the ligaments — the tissue that connects bone to bone in a joint — and strengthen the supporting muscles.
  • Treatments such as heat, massage, and ultrasound might also be used.
  • Coccygeal injections of corticosteriods or PRP are administered directly to the area. 79948w
  • Coccygeal manipulation is used to move the coccyx back into its proper position and relieve pain.
  • Coccygectomy (surgery to remove the coccyx) is considered in rare and very severe cases only, when extensive conservative management does not control the pain. The main risks of surgery are infection and wound-healing problems. There is also a significant risk that the surgery will not bring pain relief.
  • Depression and anxiety should be aggressively treated.
  • A multidisciplinary chronic pain rehabilitation program might be offered in some instances.

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