Coccydynia is the term used to describe pain in and around the area of the coccyx, more commonly known as the tailbone. The coccyx represent a “vestigial tail” at the bottom of the vertebral column which is usually made up of 3 – 5 fused vertebrae.
There are a number of different factors that can lead to tailbone pain, but the two most common causes are sudden impact due to fall and the pressure caused by childbirth. Abnormal or excessive mobility of the tailbone can also lead to coccydynia.
Symptoms of Coccydynia
The most common symptom of coccydynia is pain when pressure is applied to the tailbone. This is often felt sharply when sitting on the ground or a hard chair. This pain will typically lessen significantly when pressure is relieved by standing or walking.
Other symptoms of coccydynia can include:
- Severe and immediate pain when moving from sitting to standing
- Pain during bowel movements
- Pain during sex
- Deep ache in the tailbone area
Causes of Coccydynia
Direct injury to the tailbone by falling is one of the most common reasons why coccydynia develops. For women in particular, childbirth is often the leading cause of coccydynia. Typically, during pregnancy, the coccyx will become more flexible towards the end of the third trimester. This is facilitated by the release of hormones in the body which allow the tailbone and the part of the spine above it to bend and give way during childbirth.
However, in some cases, childbirth can cause excessive strain to the muscles and ligaments around the coccyx. This overstretching often means these muscles and ligaments become permanently altered and can no longer hold the coccyx in the correct position. This leads to coccydynia.
In some cases, persistent pressure from activities like bicycling can also cause the onset of coccydynia. Coccyx pain from activities of this nature is not typically permanent, but can become chronic if not properly managed.
Around one third of coccydynia cases have no apparent cause, but it is believed that age-related “wear and tear” may play a part in these scenarios.
Treatment for Coccydynia
Treatment for coccydynia varies from patient-to-patient depending on the cause of the symptoms and the severity of pain. In most cases, anti-inflammatory painkillers (NSAIDs) will be recommended to help control pain and swelling. However, for some patients with more severe coccyx pain, over the counter pain relievers may not be sufficient. For severe or chronic coccydynia, a stronger painkiller known as tramadol may be prescribed for a short period of time to get symptoms under control.
If coccydynia does not improve through the use of oral pain medication, an injection of a steroid medication into the lower back may be recommended for stronger and more immediate pain relief.
Other minimally invasive treatment options for coccydynia include:
- Ganglion impar nerve block
- Sacrococcygeal joint injections
- Spinal manipulation
In rare cases, surgery may be necessary if coccydynia has failed to improve with less invasive treatment methods. The coccyx may be completely or partially removed in a procedure called a coccygectomy. The muscles, tendons and ligaments previously attached to the coccyx are reattached to other parts of the pelvis to preserve function.
Schedule a Pain Management Appointment
If you have been experiencing pain in the tailbone, lower back or elsewhere, please contact the Diagnostic Pain Center today to schedule an evaluation. Call (512) 981-7246 or click on the button below to request an appointment with our providers.