Tailbone Pain (Coccygodynia)

Overview

Tailbone pain, also known as coccygodynia, is discomfort in the region of the coccyx, the small bone at the bottom of the spine. This pain can vary from a dull ache to sharp, intense discomfort and can significantly impact daily activities, especially those involving sitting or sudden movements.

Causes

  1. Trauma: Injury from a fall or impact can bruise, dislocate, or fracture the coccyx.

  2. Repetitive Strain: Activities such as cycling or prolonged sitting on hard surfaces can strain the tailbone.

  3. Childbirth: During childbirth, the coccyx can become bruised or strained.

  4. Degenerative Joint Changes: Aging can lead to wear and tear on the coccygeal joints.

  5. Infections and Tumours: Rarely, infections or tumours can affect the coccyx, leading to pain.

Symptoms

  • Localised pain in the tailbone area, especially when sitting or standing up from a seated position.

  • Tenderness in the coccyx region.

  • Pain during bowel movements or sexual intercourse.

  • Radiating pain into the hips, thighs, or buttocks.

Diagnosis

Diagnosis of tailbone pain involves:

  1. Medical History: Discussing recent injuries, activities, and childbirth history.

  2. Physical Examination: Palpation of the tailbone area to check for tenderness and mobility.

  3. Imaging Tests: X-rays, MRI, or CT scans may be used to identify fractures, dislocations, or other abnormalities.

Treatment

  1. Self-care Measures:

    • Rest: Avoid activities that exacerbate the pain.

    • Ice/Heat Therapy: Applying ice packs or warm compresses to reduce inflammation and pain.

    • Cushions: Using a doughnut-shaped or wedge cushion to relieve pressure when sitting.

  2. Medications:

    • Pain Relievers: Over-the-counter pain medications like ibuprofen or acetaminophen.

    • Steroid Injections: Corticosteroid injections to reduce inflammation.

  3. Physical Therapy:

    • Exercises: Tailored exercises to strengthen the muscles around the coccyx and improve posture.

    • Manual Manipulation: Techniques to improve mobility and reduce pain.

  4. Medical Procedures:

    • Nerve Blocks: Injections to block pain signals from the coccyx.

    • Surgical Intervention: In severe cases, surgical removal of the coccyx (coccygectomy) may be considered.

Prevention

  • Proper Posture: Maintain good posture to reduce strain on the tailbone.

  • Ergonomic Seating: Use chairs that support the lower back and coccyx.

  • Safe Physical Activities: Use proper techniques and protective gear during activities to avoid injuries.

When to See a Doctor

Consult a healthcare provider if:

  • Pain is severe or persistent despite self-care measures.

  • There are signs of infection, such as redness, swelling, or fever.

  • Pain is associated with unexplained weight loss or other systemic symptoms.