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(Coccyalgia; Coccygeal Pain; Coccygodynia; Pain, Tailbone; Pain, Coccygeal; Tailbone Pain)

Definition

Coccydynia is pain in the tailbone (coccyx). The coccyx is a small, curved, V-shaped bone at the bottom of the spine.

The Coccyx
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Causes

In some people the cause is not known. In others, it may be due to:

  • Trauma, such as:
    • A backwards fall onto the spine (most common)
    • Problems during childbirth
    • Epidural injection
    • Rectal or spinal surgery
    • Repetitive or prolonged sitting that causes trauma over time
  • Bone spurs
  • Changes in the normal structure of the coccyx bones
  • Arthritis
  • Infection
  • Cancer (rare)

Risk Factors

This problem is more common in women and young adults. Other things that may raise the risk are:

  • Trauma, especially a backwards fall onto the back
  • Childbirth
  • Obesity
  • Rapid weight loss
  • Surgery to fuse the sacrococcygeal joint

Symptoms

The main symptom is pain in the tailbone. It may happen when:

  • Sitting down
  • Changing position from sitting to standing
  • Having a bowel movement
  • Having sex

Diagnosis

The doctor will ask about your symptoms and health history. You may also be asked about any recent injuries. A physical exam will be done. It will focus on the tailbone.

Images of the spine may be taken. This can be done with:

Treatment

The goal of treatment is to manage symptoms and allow the area to heal. Rest from physical activities will be needed. Other choices are:

  • Easing pressure on the tailbone with a cushion and cold or warm compresses
  • Medicines, such as:
    • Pain relievers
    • Steroid injections
    • Nerve blocks
  • Physical therapy to improve strength, flexibility, and range of motion
  • Radiofrequency ablation to disrupt pain signals using electrical energy and heat

People who are not helped by these methods may need surgery. Coccygectomy is the full or partial removal of the tailbone. This is rare.

Prevention

There are no known guidelines to prevent this health problem.

RESOURCES

Family Doctor—American Academy of Family Physicians  http://familydoctor.org 

Ortho Info—American Academy of Orthopaedic Surgeons  http://orthoinfo.org 

CANADIAN RESOURCES

Canadian Association of General Surgeons  http://www.cags-accg.ca 

Canadian Orthopaedic Foundation  http://www.canorth.org 

References

Coccydynia. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/coccydynia. Accessed February 18, 2021.

Coccydynia (tailbone pain). Cleveland Clinic website. Available at: http://my.clevelandclinic.org/health/diseases%5Fconditions/hic%5FCoccydynia%5FTailbone%5FPain. Accessed February 18, 2021.

Foye PM. Coccydynia: Tailbone Pain. Phys Med Rehabil Clin N Am. 2017 Aug;28(3):539-549 .

Scott KM, Fisher LW, et al. The treatment of chronic coccydynia and postcoccygectomy pain with pelvic floor physical therapy, Phys Med Rehab. 2017; 9(4):367-376.

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