This article is a simple patient education material on tailbone pain, its causes, symptoms, ways to avoid it, and cure. Read this article and get to know about tailbone pain.
The pelvis comprises of two bones, namely the coccyx and ischial tuberosity. The term coccyx was given because it resembles the beak of a cuckoo. The bone is located below the sacrum at the base of the spine. It is made up of fused vertebrae, three to five in number. These bones are responsible for bearing your weight. In general, the coccyx bone should be pointed straight; however, it can be curved in some cases. The coccyx is termed abnormal when it is too curved and causes pain.
Any irritation (inflammation) of the bony area (tailbone) situated between the folds of the buttocks is referred to as coccydynia. Coccydynia comes from two words, 'coccyx' and 'dynia.' 'Coccyx' is a Greek word for the cuckoo and 'dynia' means pain.
Pain in the tailbone can frustrate, irritate, and embarrass many patients while getting the treatment. This condition can be cured and is preventable if proper care is taken.
Tailbone pain or coccydynia is a quite commonly occurring phenomenon. It is much more common in people who are obese or were obese and have drastically lost their weight. Adults are most commonly affected, and it is comparatively rare in young children. Also, women have around five times more chances of getting coccydynia than men.
It is usually caused by injury, pregnancy, or chronic pressure on the tailbone due to sitting long hours, for example, in the case of cab drivers. Sometimes, tailbone pain occurs in patients with chronic constipation as well. In one-third of the cases, the cause is not known.
The following are the causes of coccydynia:
Trauma From External Forces:
Falling on your back can cause the coccyx to bruise, fracture, or dislocate.
Repeated activities like rowing a boat or bicycling can strain the surrounding tissues of the coccyx.
2. Trauma From Internal Forces:
Labor - Of the changes in a woman's body during pregnancy, softening of the area between the coccyx and sacrum is one. This is caused by the hormonal changes occurring in the third trimester of pregnancy. It leads to tissue stretching and produces strain, thereby resulting in pain.
Prolonged sitting on hard, narrow surfaces.
When you are obese, the coccyx naturally tends to lean backward, which might bring about pain in the tailbone.
Being very lean also does not help because when there is not enough fat to protect the rubbing of coccyx against the ligaments, tendons, and muscles, soft tissue inflammation can occur.
4. Tumors - Coccydyniacan also be a sign of underlying cancer, but it is infrequent.
6. Menstruation increases the intensity of tailbone pain and makes it too bad.
The usual complaint is pain at the bottom region of the back when sitting.
In addition, the following are the symptoms of coccydynia:
Piercing pain in the tailbone.
Pain aggravates on prolonged sitting.
Even standing up after sitting for quite some time produces intense pain.
Bowel movements produce pain.
Pain during intercourse.
Disturbance in sleep.
Pain in the buttocks.
Coccydynia is usually diagnosed based on the typical complaints and sometimes by an X-ray. The doctor asks for the patient's medical history to know about any recent trauma, fall, or labor. A clinician can diagnose the condition by examining and eliciting local region tenderness. It is necessary to visualize the tailbone region directly to rule out other causes and any infection. Sometimes, infection of the hair follicles in the tailbone region can mimic coccydynia.
The following tests are done to look for fractures in the coccyx:
Magnetic resonance imaging (MRI) and bone scan help diagnose inflammation in the coccyx and a rare tumor of the spine called chordoma.
This condition usually frustrates patients and impairs their quality of life. Sometimes, patients feel embarrassed to get the treatment done. Treatment is generally by activity modification, anti-inflammatory medications, and local injections. Surgery is rarely indicated in non-responsive cases.
The following are the available treatment modalities:
Physical Therapy: Pelvic floor relaxation techniques can be helpful. Your physiotherapist will help you in doing these exercises. During this exercise, you will be asked to keep your pelvic floor muscles as relaxed as possible as you would do while peeing or defecating.
Massaging: Pain can also be relieved by rubbing the muscles attached to the tailbone or coccyx.
Medications: Certain medications like antiepileptics and antidepressants can help relieve the pain associated with the tailbone. Also, a local anesthetic is administered into the tailbone in some cases. It helps relieve pain for a few weeks. Oral anti-inflammatory medications and the local application of pain gels may alleviate the symptoms. Local trigger injections with low-dose steroid preparations will aid in complete relief in most cases. The doctor can give these local injections in the outpatient department.
Surgery: When all other treatment modalities fail, surgery is indicated. Surgical treatment for coccydynia involves removing the coccyx or tailbone, and this procedure is called coccygectomy. It can be either partial or complete. In partial coccygectomy, [part of the coccyx is removed, and in incomplete coccygectomy, the entire coccyx is removed.
Treatment with a chiropractor can also help relieve the pain associated with coccydynia when it occurs due to forward or backward leaning of the coccyx.
Since long hours of sitting may aggravate the condition, a modified padded cushion with a cut-out at the back could relieve the pressure on the coccyx (doughnut cushion).
Pelvic floor exercises could help to get relief from pain.
While sitting, make sure you lean in a forward position.
The use of stool softeners and laxatives in constipated patients could help relieve pain.
Use hot water bags or ice packs on the area to relieve pain.
Sitz bath by sitting in a tub of hot water may provide pain relief.
It is normal to have tailbone pain during pregnancy. At those times, try sleeping on your side and use a cushion for your back to lessen the pain.
Tailbone pain produces a lot of discomfort and frustration. But by following the management strategies can help lessen the pain and prevent the condition from becoming severe. When you experience any pain in the tailbone area, do not blindly take pain medications that are available over-the-counter. Instead, reach out to a healthcare provider and get the best possible treatment.
Apart from an injury, the other causes of tailbone pain are:
- Infection from childbirth.
- Sitting for a prolonged period.
- Bone cancer.
- Being underweight.
You can get rid of tailbone pain by:
- Using NSAIDs (nonsteroidal anti-inflammatory drugs) to reduce swelling and pain.
- Decreasing sitting time.
- Sitting on a donut pillow or coccygeal cushion.
- Taking stool softeners to relieve pain due to constipation.
- Taking hot water to ease pain and relax the muscles.
- Applying cold and hot packs to your lower back region.
- Wearing loosely fitting clothes.
- Strengthening and stretching the muscles in your pelvis and lower back area.
Tailbone pain is not usually serious, but if there is severe pain and for a more extended period, it has to be treated by the physician because it can be a sign of an injury, or in rare cases, a sign of cancer.
You can consider sleeping on a firm mattress if you have tailbone pain. Keeping a pillow between your knees while sleeping on your side, and keeping a pillow under your knees while sleeping on your back will also help.
The following symptoms indicate a possible tailbone fracture:
- Constant dull pain in the lower back region above the buttocks.
- Pain that worsens while sitting and getting up from a sitting position.
- Severe localized pain, tenderness, and swelling felt around the tailbone area.
- Irregular bowel movements.
- Pain that increases during bowel movements.
- Pain that increases during sexual intercourse.
- Tingling or numbness in the leg.
- If the tailbone pain is due to injury, you can notice the bruise.
A small triangular bone that is present at the bottom of the spinal column is called coccyx bone. When this coccyx bone gets bruised or fractured, it will cause pain while sitting, and it gets relieved on walking. Standing and walking will help to reduce pressure on the tailbone and ease discomfort.
Chordoma is a bone cancer often formed in the bones of the spine and the skull that can spread to the coccyx bone through metastasis. It is most often seen near the tailbone called a sacral tumor. Regular radiation and chemotherapy will not be sufficient. Therefore, it can be cured by surgery. Surgery on the tailbone is quite difficult because it is present close to the spinal cord. The surgery of tailbone cancer includes excision of the tumor. It also requires the excision of the affected sacral nerve roots, which can result in sexual dysfunction, motor weakness, and permanent incontinence.
Tailbone pain can range from mild to extreme. There will be severe pain while sitting down, getting up from a sitting position, and leaning backward on the tailbone while sitting. The pain may also get worse during bowel movements, during sex, or during menstruation for women.
Sunbird pose is a simple and powerful way to strengthen your tailbone muscles, which will also stabilize the tailbone and the spine.
During childbirth, the pressure from the baby's head can cause a fracture of the coccyx or the tailbone. The pain from the fractured coccyx can be quite severe, which can last for a few months. Many women get relief within two months by physical therapy, applying ice packs, or taking painkillers.
Tailbone pain is commonly seen in women during pregnancy and after delivery. This can be due to the production of relaxin and other hormones by the ovaries and placenta, which stretches and relaxes the pelvic floor muscles and results in the movement of coccyx bone.
Coccydynia is a pain that ranges from mild to severe discomfort. It usually goes away on its own, or it may take a few weeks to months to recover from pain. Behavior changes and home remedies are helpful to recover from coccydynia.
Tailbone is a small triangular bony structure that is present at the bottom of the spine. The pain which is present in and around the tailbone is called tailbone pain or coccydynia. In this region, sudden pain can be caused due to trauma caused by falls, sitting for a prolonged period on a hard or narrow surface, vaginal childbirth, or degenerative joint changes.
Coccydynia will usually resolve within a few weeks to months with or without any conservative treatment. Some people may present for a prolonged period, and the pain can become debilitating and chronic if not controlled.
Last reviewed at:
11 Jan 2022 - 5 min read
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