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Coccydynia

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

Definition

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

The tailbone can be found at the end of the spinal column. It supports the body in a sitting position and helps transfer body weight during changes in sitting positions. It is also an area where muscles, nerves, ligaments, and tendons from other locations in the body come together. Excess pressure can affect these structures.
In most cases, the specific cause of coccydynia is not known. Other times, it may be caused by:
Pain can come from bones, muscles, nerves, or supporting structures.

Risk Factors

Coccydynia is more common in females. Other factors that may increase your chance of coccydynia include:

Symptoms

Pain may occur when:
Coccydynia may cause:

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. This will include an evaluation of the tailbone to see if the area is swollen, red, or warm.
Imaging tests to look for fractures, dislocation, or other damage in the tailbone may include:

Treatment

In most cases, coccydynia will resolve on its own with conservative treatment. This includes using a special seating cushion to relieve pressure on the tailbone.
If the coccyx is misaligned, it may be manually manipulated into place. Other treatments include:

Medications

Inflammation and/or pain may be relieved by:
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
  • Steroid injections
  • Nerve blocks
  • Antidepressants
Stool softeners can help reduce strain during bowel movements.

Physical Therapy

Physical therapy may include:
  • Exercises to strengthen muscles and supporting structures, such as ligaments
  • Relief and stimulation with heat therapy and ultrasound therapy

Other Treatments

Some people find relief with:
  • Massage
  • Transcutaneous electrical nerve stimulation (TENS)
Your doctor may also refer you to counseling.

Surgery

Coccygectomy is the surgical removal of the tailbone. This surgery is not generally recommended and may be considered if all other treatment methods fail.

Prevention

To help reduce your chance of coccydynia:

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 (tailbone pain). Cleveland Clinic website. Available at: http://my.clevelandclinic.org/health/diseases%5Fconditions/hic%5FCoccydynia%5FTailbone%5FPain. Updated March 8, 2010. Accessed December 15, 2015.

Howard PD, Dolan AN, Falco AN, et al. A comparison of conservative interventions and their effectiveness for coccydynia: a systematic review. J Man Manipulative Ther. 2013;21(4):213-219.

Lirette LS, Chaiban G, et al. Coccydynia: An overview of the anatomy, etiology, and treatment of coccyx pain. Oschsner J. 2014;14(1):84-87.

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