Back Pain

What is Coccygodynia?

Bifurcated & Crushed Coccyx

Coccygodynia

or

Coccydynia

is the term used to describe pain and discomfort in the tailbone (coccyx), the last bone of the spinal column that consists of 3 to 5 fused vertebrae. It defines a set of symptoms due to which it is often considered as a collection of conditions which may have different causes and treatment options. Bones that make up coccyx are loosely fused, especially in women, to give them flexibility during child birth. It bears the body weight when an individual is in a sitting position and several ligaments, muscles and tendons are attached to it.

Pain in the Coccyx

represents less than 1% of all back pain conditions. Women have 5 times more chances of developing it than men.

Types & Causes of Coccygodynia:

Although the exact cause of this condition is not known, several factors play a key role in its development. Two types of the condition have been identified.

  • Acute Coccygodynia –

    As the name indicates, it is a mild form of the condition which may occur when a person falls on his/her lower back straining their buttocks.

  • Chronic Coccygodynia –

    This type on the other hand, is a more severe one, which occurs when the sacrococcygeal ligaments are damaged. Damage may be a result of several activities including repetitive strain from cycling, rowing or sitting in an improper posture, difficulty during delivery or repeated trauma.

  • Muscle spasms

    in the pelvic floor may cause pain.

  • Pain emanating from the soft tissues around coccyx.

  • Malformation of coccyx

    may also lead to pain.

  • Appearance of

    bony spurs

    on the coccyx.

  • Dislocating or unstable coccyx.

  • In rare cases,

    cancer in any of the spinal column regions

    could be the cause of pain.

  • Coccyx injuries

    which occur during a fall while ice skating or skiing or horse riding may also result in severe pain.

  • Chances of injuring the coccyx during sexual intercourse, especially during anal sex are high.

  • Pain due to

    fractured or dislocated coccyx

    is common due to the movement of the broken bone pieces.

  • Being underweight or overweight

    puts excess pressure on the tailbone in a sitting posture or due to lack of enough fat in the buttocks region, the coccyx may rub against the tissues surrounding it. In either case, it leads to

    pain in the coccyx

    .

Symptoms of Coccygodynia:

The primary symptom is discomfort and pain in the coccyx, at the base of the spine. Pain severity may vary from individual to individual depending on the extent of damage occurred to the tailbone. Symptoms include:

  • Pain in and around coccyx while carrying out daily activities

    such as bending, driving, sitting down, moving from a sitting posture to standing position and leaning backwards while sitting. Sitting on a soft surface could be more painful because coccyx bears the body weight to a large extent.

  • Pain before or during bowel movements (when stools are passed).
  • Pain that shoots down the legs.
  • Painful hips and buttocks.

  • Increased pain levels in women during menses.
  • Pain during sex.

  • Back pain.
  • Feeling uncomfortable while sleeping in the same position.

    The person needs to change his/her sleeping position constantly.

  • Feeling sensitive to the finger pressure when touched on the edges or tip of the coccyx.

Treatment for Coccygodynia:

Treatment strategies may vary depending on the severity of pain and the cause of the pain. These include:

  • Non-Steroidal Anti Inflammatory Drugs (NSAIDs) –

    People suffering from mild to moderate pain may find these drugs as the best option for pain relief. They decrease the pain and inflammation around coccyx. Over the counter NSAIDs such as

    aspirin

    and

    ibuprofen

    can be taken.

  • Corticosteroid injections –

    These can be considered as the next alternative to painkillers for people who do not get pain relief after using OTC drugs. Corticosteroids alone or in combination with a local anesthetic are injected into and/or around the coccyx to ease pain and inflammation.

  • Physiotherapy –

    Physiotherapists, osteopaths, massage therapists and chiropractors help in easing the pain symptoms by guiding the patient in stretching and manipulating the muscles around coccyx. Apart from relieving the pain, the coccyx may return back to its normal position if it has been dislocated.

  • Pillows and Cushions –

    Gel cushion or special donut shaped pillow to sit on, that take the pressure off of the coccyx are suggested by doctors.

  • Surgery –

    If all the above treatments fail to work, surgery is the only alternative to opt for. During surgery if the entire coccyx is removed, the procedure is known as coccygectomy. But, in some cases, only a part of the coccyx is removed through a process called limited or partial coccygectomy. After the patient is given general anesthesia, a small cut/incision is made in the skin that covers coccyx through which it is removed. Although, the process may sound very simple, the recovery period may extend up to 1 year after the patient gets operated.

Some Self Care Tips for Coccygodynia Patients:

Apart from trying out the above mentioned treatment options, self care at home while performing daily activities can ease the pain and reduce future complications. Self care tips include:

  • Wear Loose Clothing –

    People with

    Coccydynia

    should avoid wearing body-hugging trousers or jeans as this may worsen the condition. Flat foot wear is also recommended to avoid pressure on coccyx.

  • Sitting Posture –

    Leaning forward and resting the arms on a flat surface which is at the same height as that of the arms, can take the pressure off the tail bone.

  • Sleeping –

    Sleeping with a cushion or pillow between the knees may ease the pain.

Exercising regularly, having healthy and nutritious food may help in preventing this condition.

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