Understanding Coccydynia (Tailbone Pain)


A painful condition called coccydynia is truly difficult to tolerate. It actually is prompted by inflammation situated in your tailbone. Despite all the guessing about it, the most frequent reason for it is plain trauma a fracture, a heavy fall.
This non-stop aching in the bottom of your spine reminds you of itself whenever you wish to sit or lay down – basically very time when soft tissue around it gets compressed. The signals of radiating pain going into your buttocks or lower back are letting you know you need a specialist taking a look. If you choose to leave this issue unattended, you risk getting the matter much worse: your routines will grow to be intolerable because of the growing pain. Get ready to coccyx pain interference with your daily life.

Anatomy of Coccyx

Spinal column ends with coccyx. It has a triangle shape, the bones in it are closely fused.
Traditional medicine considers coccyx to be the remainder of a tail, thus the name for it. EVen though fused tightly, coccyx bones are connected by fibrous tissue.
The allow for slight forward and backward movement that coordinates with movement of the pelvis, hips, and legs. Gluteus maximus muscle attaches to the posterior coccyx’ side, playing an important role in its position.

Coccyx Function

When sitting or standing, your coccyx, along with every other pelvic basin bone, adjusts position. It literally helps to balance your body and provide balance. This role coccyx plays in human vestibular system is one of the main reasons why removal surgery is so rarely recommended.
In the seated position your body dispenses the overall weight among ischium bones for stability maintenance. The tail bone also acts as a site of attachment for other minor body structures in the area. It is also an insertion point for some of your pelvic floor muscles.

Diagnosing Coccydynia

Pain in this condition 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 try to relieve the pain in coccyx by shifting their weight to one buttock, or moving buttocks towards the front of a chair.
A heavy fall backwards or a complicated delivery of a child can cause Coccydynia. However, about one-third of cases are idiopathic in nature, meaning they arise without a specific identifiable cause. Obesity is also a major factor. Females have an increased risk of developing the condition. It is associated with post childbirth consequences in many cases.
Increase in symptoms is reported when the area is condensed or put pressure onto. Sitting on something really hard may impact and worsen Coccydynia. If the inflammation is long while neglected – having a bowel movement or a sexual intercourse may induce the heavy pain in the area.

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 surgery is rarely recommended. Being a simple kind of operative intervention, coccygectomy implies a long-lasting and often rather painful recuperative period. It also happens that the pain persists even after the rehabilitation. Healing time varies in every patient, but it is recommended to take from three to twelve months. Sitting is going to be difficult during the period.

Uninvasive Coccydynia Treatment

Conservative multifaceted non-invasive treatment for inflammation in tailbone area is common for medical science. Treatments will include 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 the extreme pain sensation. Coccygectomy is an operation where a part or the entire 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. The operation itself is fairly straightforward procedure. Recuperation from the surgery is known to be lasting and painful. And it 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 the coccydynia condition. At NYDNRehab, we’re dedicated to finding the root cause besides treating the symptoms. Suffering from tailbone pain? Do not waste your time or 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.



In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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