Tailbone pain / Coccygodynia /Coccydynia/ Coccyx Pain

Coccydynia” is a medical term to describe tailbone pain. This bottom is at the very bottom of your spine. Your tailbone plays a vital role in your body. It helps you balance and bear your weight when you sit. It also connects to many tendons, ligaments, and muscles in your body.

Tailbone pain can be a real nuisance — and it can disrupt your everyday activities and well-being. Tailbone pain is common. It is approximately five times more likely in females when compared to males.

What are the symptoms of coccyx pain?

Patient’s may feel 1. A continuous dull (achy) pain or sharp (piercing) tailbone pain while in a seated position. 2. Coccyx pain also worsens when you go from sitting to standing position. 3. Pain while passing stool.

Other related symptoms that may occur in people with tailbone pain include Back pain, Sciatica like feature, sleep disturbances, anxiety, and depression.

What causes tailbone pain?

Your tailbone can hurt for various reasons. Some of the common causes of tailbone pain are:

• Fall. You can injure your tailbone by falling hard and hurting, cracking, or moving it out of place.

• Overuse injury. Some sports, like cycling and rowing, make you move back and forth a lot. Doing this too often can stress the tissues near your tailbone.

• Pregnancy or child birth. In the last three months of pregnancy, your body makes hormones that loosen the area between your tailbone and the sacrum, the bone above your tailbone. This helps your tailbone bend more during delivery. This is normal, but sometimes it can overstretch the muscles and ligaments around your tailbone and cause more pain. The stretched soft tissues cannot hold your tailbone in the right position.

• Obesity. Carrying extra weight puts more pressure on your tailbone. This can tilt your tailbone backwards and cause pain.

• Being underweight. Having less fat means having less padding in your butt. Without this padding, your tailbone can rub against your muscles, ligaments, and tendons and make them swell.

• Sitting for too long everyday. Sitting for a long time can put too much pressure on your tailbone, especially if you sit on hard surface

Can tailbone pain be dangerous?

Tailbone pain can rarely be a sign of cancer that affects your coccyx or the area around it, or cancer (example colorectal or prostate) that has spread to your bones. Though it is very rare but possible.

Diagnosis

A proper medical history is important in this case. History of injury or trauma to the tailbone area like falls or a difficult childbirth are important here. It is of paramount importance to examine the area for fractures, lumps, or abscesses.

Investigations

X-ray, CT scan, MRI and Bone scan may be ordered as per need.

Treatment:

Treatment of coccyx pain depends on the cause and the severity of your discomfort.

Conservative advice

NSAIDs (nonsteroidal anti-inflammatory drugs) are advised to reduce pain and swelling.

Use a donut pillow or wedge-shaped gel cushion to take pressure off your tailbone when you sit.

A hot bath can relax the muscles and ease pain. Hot or even cold packs application locally may ease lower back. It should be applied for about 20 to 30 minutes, several times a day.

Take stool softeners regularly to reduce the pain while passing stool.

Pain Intervention

Ganglion Impar Neurolysis/ Block

This is quiet a successful intervention to get relief from Coccyx Pain. In simple terms, an injection is given at the bottom end of the spine under direct vision of X-ray. This is very low risk daycare procedure.

Surgery

It may be an option only in selective cases if there is a clearly defined fracture.

Dr. Chinmoy Roy is a Senior Pain Physician and Author of multiple medical books who is available at Rajarhat Pain Clinic, Newtown, Kolkata. He is an expert of using radiofrequency, CRYO, chemical neurolytics and other modalities related to the spine related pain interventions. .