Orthopedic Health

Tailbone Pain (Coccydynia)

Written by Dr. Mohan Krishna and medically reviewed by iCliniq medical review team.

 
Image: Tailbone Pain (Coccydynia)

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. Any irritation (inflammation) of the bony area (tailbone) situated between the folds of the buttocks is referred to as coccydynia.

The usual complaint is a pain at the bottom region of the back on sitting. 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.

Coccydynia is usually diagnosed based on the typical complaints and sometimes by an X-ray. A clinician can diagnose the condition by examination and eliciting tenderness in the local region. It is necessary to directly visualize the tailbone region to rule out other causes and any infection. Sometimes, infection of the hair follicles in the tailbone region can mimic coccydynia.

This condition usually frustrates patients and impairs the quality of life. Sometimes, patients feel embarrassed to get the treatment done. Treatment is usually by activity modification, anti-inflammatory medications, and local injections. Surgery is rarely indicated in non-responsive cases.

Prevention

  • 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.
  • Use of stool softeners and laxatives in cases of constipated patients could help relieve pain.
  • Sitz bath by sitting in a tub of hot water may provide pain relief.

Oral anti-inflammatory medications and local application of pain gels may relieve the symptoms. Local trigger injections with low-dose steroid preparations will aid in complete relief in a majority of cases. These local injections can be given by the doctor in the outpatient department. In rare cases, surgical treatment by removal of coccyx may be required in those cases not responding to conservative methods.

 
Last reviewed at: 15.May.2019

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