Understanding Coccydynia (Tailbone Pain)

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Coccydynia, aka tailbone pain, is difficult to ignore. Every time you sit, you get a painful reminder that your coccyx has been injured. Pain from coccydynia may even extend to your low back and buttocks. If left untreated, coccydynia may gradually become worse, making daily activities a challenge and interfering with your quality of life.

Coccyx Anatomy

The coccyx makes up the bottom portion of your spinal column, below the sacrum. It is a triangle-shaped arrangement of three to five fused bones-depending on individual anatomy-thought to be the remnant of a tail, hence the common name tailbone.

Although fused, the coccyx is not one solid bone. In fact, the bones of the coccyx are held together by fibrous joints and ligaments that allow for slight forward and backward movement that coordinates with movement of the pelvis, hips, and legs.

The gluteus maximus muscle attaches to the posterior side of the coccyx, playing an important role in its position.

Coccyx Function

When you sit or stand, your coccyx, along with other bones that make up the pelvis, adjusts position to help support and balance your body. When sitting, your weight is distributed among the sit-bones, or ischium, and coccyx, to provide balance and stability.

Your coccyx also serves as a site of attachment for a number of tendons, ligaments, and muscles, and as an insertion point for some of your pelvic floor muscles.

Symptoms and Diagnosis of Coccydynia

Coccydynia pain is generally point-tender, not radiating. In addition to pain while sitting, you may feel discomfort while walking, climbing stairs or getting up from sitting. Many patients compensate for coccydynia pain by shifting weight to one buttock, or moving the buttocks to the front edge of a chair.

Coccydynia may be caused by trauma, usually from a backward fall or a stressful childbirth. However, about one-third of cases are idiopathic in nature, meaning they arise without a specific identifiable cause. Obesity increases the risk of Coccydynia.

Women are five times more likely than men to have coccydynia. It is thought that childbirth-related stress may explain the higher incidence in females. Pain usually worsens when sitting or with activities that put pressure on the bottom of the spine, like sitting on hard surfaces, having a bowel movement or during sexual intercourse.

Coccydynia is normally diagnosed through medical history and physical exam. Diagnostic ultrasound may be employed to confirm the condition.

Surgical Remedy for Coccydynia

In extreme cases where conservative treatments do not alleviate pain, coccygectomy surgery is an option, where part or all of the coccyx is removed. However, due to its function as a site of attachment and origin of multiple structural bodies as well as its role in movement dynamics, a coccygectomy is rarely recommended.

Coccygectomy surgery itself is a fairly straightforward operation, but recovery can be long and uncomfortable, and surgery does not guarantee that the patient will be free of pain. Recovery from a coccygectomy can take from three months to a year, and sitting is difficult during the course of healing.

Non-Surgical Treatment for Coccydynia

Treatment for tailbone pain is usually non-invasive and conservative, although surgical interventions are available. Treatment is often multi-modal, and may include a combination of any or all of the following:

  • NSAIDs
  • Ice
  • Heat
  • Modification of activities
  • Use of cushions while sitting
  • Dietary changes to reduce bowel pressure
  • Chiropractic manipulation
  • Stretching
  • Massage
  • Injections to reduce pain and inflammation
  • ESWT (Extracorporeal Shockwave Therapy)

Surgical Remedy for Coccydynia

In extreme cases where conservative treatments do not alleviate pain, coccygectomy surgery is an option, where part or all of the coccyx is removed. However, due to the coccyx’s function as a site of attachment and origin of multiple structural bodies as well as its role in movement dynamics, a coccygectomy is rarely recommended.

Coccygectomy surgery itself is a fairly straightforward operation, but recovery can be long and uncomfortable, and surgery does not guarantee that the patient will be free of pain. Recovery from a coccygectomy can take from three months to a year, and sitting is difficult during the course of healing.

Coccydynia Treatment at NYDNRehab

The sports medicine professionals at NYDNRehab have extensive experience treating tailbone pain. We use cutting edge technology, combining diagnostic ultrasonography and extracorporeal shockwave therapy to treat coccydynia.

At NYDNRehab, we are dedicated to getting to the source of your pain, not just treating the symptoms. If you are suffering from tailbone pain, do not waste your time and money on therapies and treatments that fall short of the mark. Make an appointment with NYDNRehab today, and set yourself on the road to recovery from coccydynia.

 

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