Tailbone pain begins in the coccyx,  which is located at the bottom of the spine’s sacrum.

Coccydynia (kŏk′sĭ-dĭn′ē-ə)  is the term for pain in the coccyx, or tailbone.

Sitting and leaning back could be very uncomfortable.

However, pretty much everybody responds well to conservative treatment.

Spinal Anatomy of the Coccyx

The coccyx, or tailbone, is the lowest area of the spine. It sits right below the sacrum.

The tailbone is made up of 3 to 5 small bones fused together by around age 30.

The coccyx helps support our weight while sitting.

 

 

Risk Factors

The prevalence of coccydynia is still unknown, but medical research has found that the condition affects:

• Adolescents
• Adults
• Women
• People that are overweight

However, women and those that are overweight are the two highest risk factors.

Women are affected five times more than men, which is likely due to injuries from childbirth.

Also, a woman’s coccyx is farther back than the male counterpart. This makes it more vulnerable to trauma.

Obesity causes coccydynia because of the extra weight/pressure on the coccyx, which alters how a person sits.

 

Causes

There are several causes, the most common are:

Trauma from:

• Falling
• Getting bumped/hit

Repetitive/Extensive: 

• Bike riding
• Rowing

and Childbirth

Activities like these can bruise, break, and even dislocate the tailbone.

If this happens there could be painful inflammation and muscle spasms in the tailbone area.

 

 

Other possible causes:

Bone spurs: A small bone spur on the lowest part of the coccyx can pinch the surrounding area, and cause pain and discomfort while sitting.

Joint instability: Sacrococcygeal joint (which connects the coccyx and sacrum) allows too much or too little movement.

• Osteoarthritis

Rare causes are:

• Infection
• Metastatic cancer
• Chordomas
• Arachnoiditis

Coccydynia pain can mimic:

• Lower back pain
• Sciatica
• Infection
• Pilonidal cysts (skin infection)
• Fractured bone

A doctor will rule out these causes to make a proper diagnosis.

 

Diagnosing

A doctor utilizes medical history and physical exam to diagnose coccydynia.

Imaging scans are usually not necessary, but a doctor may order:

• Computed tomography (CT) scan
• Magnetic resonance imaging (MRI) scan

If they believe a separate:

• Bone
• Nerve
• Tissue

Problem to be the cause of tailbone pain.

Medical history is important, a doctor wants to know if a

• Fall
• Accident
• Recent trauma

Might have caused the pain.

A physical exam is next in line along with symptoms.

The pain is usually localized in the tailbone, making it straightforward to diagnose.

A doctor will want to know if the pain strikes when sitting or leaning back and which is worse.

A doctor might ask the patient to point to where they’re feeling the pain.

Pointing could be enough for the doctor to tell if the pain is coccydynia when compared to other low back pain conditions.

The doctor will want to palpate the tailbone area for signs of inflammation.

 

Non-surgical Treatment

Conservative treatment is extremely effective for coccydynia.

Ninety percent of people experience pain reduction using non-surgical means or any medical intervention.

It is first treated with noninvasive methods:

• Ice or heating pad can help provide immediate, short-term relief.
• Donut/Wedge cushion provides extra padding taking the pressure off the coccyx when sitting. These cushions are available at pharmacies.
• Avoid sitting for long times, like a long flight will help prevent additional pain and injury.
• Rest is very important to help avoid further injury during recovery.

If there is still pain after these therapies, a doctor may recommend over-the-counter or prescription-strength non-steroidal anti-inflammatory drugs (NSAIDs) or other pain medications.

If the medication doesn’t work then a doctor may try cortisone injection or local spine blocker to send strong medicine directly to the tailbone area.

 

Surgical Procedure

If none of the conservative treatments work then surgery could be the next step.

The procedure is called a coccygectomy, which means the removal of the tailbone.

A surgeon will discuss the procedure in great detail before it is performed.

These risks include:

• Infection
• Hematoma (abnormal collection of blood outside an artery or vein)
• Perineal hernia (weakened pelvic muscles)

 

Chronic Coccydynia

A small portion of people can develop chronic coccydynia, which means the pain lasts for more than 2 months.

Chronic coccydynia can take a major toll on the quality of life. Talk to a doctor if symptoms are not resolving.

They may refer you to a doctor that specializes in coccydynia management.

 

Protecting the Tailbone

There is no exact way or method to prevent coccydynia,

However, reducing the risk of tailbone pain can be achieved by using caution when participating in sports like:

• Skating – Ice, Inline, and Roller
• Biking
• Horseback riding

And take extra care when walking on icy/slippery/hazardous conditions so nobody falls.

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NCBI Resources

Before you run screaming in horror to the medicine cabinet, one of the best reasons to participate in chiropractic treatment is that it helps reduce the chance of a recurrence. By working on the total body and getting it in the best shape possible, the patient is stronger and more balanced to handle their workload and other strenuous activities. Chiropractors also impart advice on how to minimize the chances of re-aggravating the lower back.

Millions of people suffer from back pain each year, and some never visit a chiropractor. Those who do choose chiropractic treatment are privy to treatment that reduces their pain, increases healing, shortens their downtime and lessens their chances of a recurrence. If over the counter medication and ice packs haven’t worked within a few days, it’s time to make an appointment for a consultation with a licensed chiropractor. You will be happy you did.