Coccydynia (Tailbone Pain): Symptoms, Diagnosis and Treatment

Coccydynia

 

The coccyx or the tailbone is a small bone situated at the bottom of the spinal column and is made up of 3 to 5 fused coccygeal vertebrae. The coccyx is connected to multiple tendons, muscles, and ligaments and helps in bearing the weight of the body while sitting. 

Coccydynia is a painful condition in which the coccyx can become damaged resulting in pain and discomfort. Tailbone pain in mild cases is manageable but in severe cases can be disabling and interfere with the day-to-day tasks. The pain is worse during sitting, prolonged standing, and getting up from a sitting position. Defecation also might become painful.

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Causes

Coccydynia is caused when the tailbone (coccyx) suffers damage or injury due to external or internal factors. The tailbone is prone to fracture and injury due to fall or other accidents and such incidents can severely damage it. A repetitive motion injury which is usually a characteristic of sports activities, prolonged sitting on hard surfaces can damage the tissues surrounding the coccyx and cause pain.

Sometimes pregnancy and childbirth can also lead to Coccydynia as the body undergoes drastic changes and bears so much pressure. During pregnancy the area between the coccyx and sacrum becomes soft, allowing the coccyx mobility. Sometimes this stretching can cause tearing of the muscles of the coccyx resulting in severe pain. Other than these infections or tumors of the coccyx can also cause pain and discomfort. 

Obesity is also a contributing factor in this condition as the tailbone has to bear extra weight while sitting. Being underweight has its own set of disadvantages such as a deficit of fat in the body. This results in friction between the tailbone and the adjoining muscles, ligaments, and tendons causing inflammation. 

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Symptoms

The symptoms of Coccydynia are:

  • Pain and tenderness in the tailbone
  • Pain aggravated by prolonged sitting
  • Pain during defecation
  • Pain in the buttocks

Depression, insomnia, and anxiety are additional symptoms of Coccydynia. Tailbone pain is also experienced during pregnancy and menstruation. 

Diagnosis

Your physician will have a look at your medical record and enquire about any recent traumas to the lower back or body. Traumatic childbirth can also cause pain in the tailbone. 

Imaging tests such as X-ray and CT scan help in determining if the tailbone has suffered a fracture or not. Other tests such as bone scan and MRI help in determining if the coccyx has suffered inflammation due to some internal reason. This also helps in detecting any tumor in the spine.

Treatment

The treatment involves taking over-the-counter anti-inflammatory drugs and making lifestyle changes to reduce pressure on the coccyx. 

  • NSAIDs help in reducing swelling and relieving pain. 
  • Reducing the sitting period to prevent putting undue pressure on the tailbone
  • Taking a hot shower to help the body (muscles) in relaxing
  • Wearing comfortable shoes and clothing
  • Taking laxatives for allowing easy bowel motion.
  • Local corticosteroid injection along with local anesthetic into & around the area of the tailbone can reduce inflammation and pain. If the pain does not reduce after conservative treatment, your doctor might give ganglion impar block with local anesthesia. Ganglion impar is situated at the level of the sacrococcygeal junction. This injection blocks the nociceptive as well as sympathetic fibers resulting in pain relief.
  • Physical therapy helps a lot in speeding up the recovery process. It involves performing stretching and strengthening exercises to improve posture to reduce pain.
  • Lifestyle changes such as sitting on doughnut-shaped pillows, application of ice on affected areas, leaning a little forward while sitting down are recommended. 

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