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Coccydynia by Mary Cresse

Definition

Coccydynia is pain in the area of the coccyx, or tailbone. The coccyx is a small, curved, V-shaped bone at the bottom of the spine.

The Coccyx

Causes

This condition is caused by an injury or stress that affects the tailbone, as well as the muscles and nerves surrounding it. Examples include:

Fall or trauma
Pressure and strain, as during childbirth
Prolonged sitting on hard surfaces
Spinal cyst or tumor
Dislocation from injury or obesity , which can cause bones to shift
Repeated stress (eg, horseback riding, bicycling, motorcycle riding)

Risk Factors

These factors increase your chance of developing coccydynia:

Gender: female
Brittle bones (eg, osteoporosis , arthritis )
Low back pain
Participation in contact sports or certain activities (eg, horseback riding)
Infections (eg, tuberculosis , osteomyelitis )
Obesity

Tell your doctor if you have any of these risk factors.

Symptoms

If you have any of these symptoms, do not assume it is due to coccydynia. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:

Pain when:
- Sitting down
- Changing position from sitting to standing
- Moving bowels
- Having sex
Tenderness directly over tailbone
All-over backache
Pain or spasm of pelvic muscles

Diagnosis

Your doctor will ask about your symptoms and medical history. He will do a physical exam, looking to see if the tailbone area is swollen, red, or warm. Tests may include:

CT scan —a type of x-ray that uses a computer to make pictures of structures inside the body
X-ray —a test that uses radiation to take a picture of structures inside the body, especially bones

These tests can show if there is a fracture or dislocation.

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include the following:

Bed rest
Use of special pillows to sit on
Sitz baths (which involves soaking hips and buttocks)
Medication, including steroid injections, pain medications, stool softeners
Manual realignment of spine
Relief of pain by massage of surrounding nerves
Physical therapy, involving:
- Strengthening of muscles in pelvic area
- Relief and stimulation with heat therapy and ultrasound therapy

Prevention

To help reduce your chance of getting coccydynia, take the following steps:

Learn proper sitting posture.
If you have to sit for long periods at work, ask for an ergonomics consultation.

RESOURCES:

American Academy of Orthopedic Surgeons http://www.aaos.org/
Orthopedic Trauma Association http://www.ota.org/

CANADIAN RESOURCES:

Canadian Orthopaedic Association http://coa-aco.org/
Health Canada http://www.hc-sc.gc.ca/index_e.html/

References:

Acetaminophen. EBSCO Publishing Patient Education Reference Center website. Available at: http://www.ebscohost.com/pointOfCare/perc-about . Updated February 2008. Accessed November 7, 2008.
Coccydynia (tailbone pain). Cleveland Clinic website. Available at: http://my.clevelandclinic.org/disorders/Coccydynia/hic_Coccydynia_Tailbone_Pain.aspx . Accessed November 7, 2008.
Coccydynia. EBSCO Publishing DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated April 2008. Accessed November 20, 2008.
Dressendorfer R. Coccydynia. EBSCO Publishing Rehabilitation Reference Center website. Available at: http://www.ebscohost.com/pointOfCare/nrc-about . Updated August 2008. Accessed November 20, 2008.
Ibuprofen. EBSCO Publishing Patient Education Reference Center website. Available at: http://www.ebscohost.com/pointOfCare/perc-about . Updated February 2008. Accessed November 2, 2008.
Naproxen. EBSCO Publishing Patient Education Reference Center website. Available at: http://www.ebscohost.com/pointOfCare/perc-about . Updated February 2008. Accessed November 7, 2008.
Stedman’s Medical Dictionary . 28th ed. Baltimore, MD: Lippincott Williams & Wilkins; 2005;403.

Last reviewed [Under Medical Review] by Rosalyn Carson-DeWitt, MD

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