FAQ’s on Coccydynia: Causes, Symptoms, Diagnosis, Treatment
Coccydynia, or “tailbone pain,” is a type of Lower Back Pain. This variety is uncommon, 1 out of 100 patients of low back pain is found to have tailbone disease. Coccyx is the last bone of the spine located just above the buttocks and it is made of three small bones, or vertebrae. It curves towards the front and its main function is to bear the weight while sitting.
Common causes of Coccydynia
Most often no obvious cause is found in case of coccydynia (idiopathic). Age related “wear and tear” is believed to play a role in some cases. Coccydynia is not specific to any ethnicity or race. Older adults are more prone but the condition may affect all age groups including younger children.
Childbirth: various muscles, ligaments and tendons are attached to the coccyx. Women naturally have a broader coccyx in a more pronounced position, making them more susceptible to this condition. During childbirth the bones are displaced to make the passage for the baby. Due to the association of this factor, women are five times prone to develop coccydynia than men.
Trauma: sudden injury to coccyx resulting from fall or road traffic accident
Shifting of coccyx: over a period of time the coccyx may shift from its normal (anatomical) position; by poor posture when sitting, or by activities involving repetitive motions when sitting for the coccyx acts as a pivot, such as cycling or rowing.
Rare causes: Infections or pressure placed upon the coccyx by an abnormality such as a tumor.
Symptoms of Coccydynia
The classic symptom is pronounced pain while sitting on a hard chair (or surface) due to the additional pressure to the tailbone and it adds further stress on the area when leaning backwards. Pain may be relieved when the person stands and walks. Pain intensity ranges from mild to severe. Sometimes the patient can’t sit comfortably in the same posture for long periods of time, and needs to continually re-distribute the weight by shifting from one position to another to relieve the symptoms of pain.
- Pain may limit everyday activities such as sitting for periods of time over a half hour, forward bending, or driving. Intense pain may occur when the patient goes from a sitting to standing position. Sitting on a soft surface may be more painful, as most of the weight comes onto the coccyx rather than the hip joints.
- Pain may also be felt during sex, or normal activities that are needed such as passing stool.
- Shooting pain down the legs.
- Patients often experience disturbed sleep as they have to keep on changing position while lying on the bed.
How do you diagnose Coccydynia?
A thorough medical history of the patient and full clinical examination leads to the diagnosis. A history of prolonged labor during childbirth or any trauma (whether recent or past) should be noted. Clinical examination includes inspection/palpation of the lower lumbar area to detect any deformities such as an abnormal mass, due to a tumor or a collection of pus (abscess), following infection or sickness.
X-ray of coccyx (lateral view) is taken to detect fracture etc.
More sophisticated diagnostic tests such as a CT scan or magnetic resonance imaging (MRI) are useful. Tests such as these detect the exact pathology in real time, such as shifting of the coccyx from a normal position, stretching of muscles, muscle rupture, etc.
How do you treat Coccydynia?
The first step to treat coccydynia is conservative treatment that includes non-steroidal anti-inflammatory drugs (NSAID), such as Ibuprofen or Naproxen, which reduce inflammation and pain. Patients allergic to NSAIDs are given paracetamol. Therapeutic cushions may be provided for more comfortable periods when sitting at my health relieve the pressure on the tailbone. Significant relief of pain may take weeks or months with conservative treatment.
If a more advanced case, corticosteroid injections are recommended. Spinal manipulation by physiotherapy and chiropractic therapy may provide short-term relief.
In very severe cases surgical removal of the coccyx ( coccygectomy) is formed. The risks associated with surgery are infection, tenderness at the surgery site, and improper wound healing.
Most of the cases of coccydynia are successfully treated with conservative methods.