Coccydynia

Coccydynia is the term for pain in the tailbone area, or coccyx. The coccyx is a small triangular bone which sits at the bottom of the spine.

WHAT CAUSES COCCYDYNIA?

Coccydynia can be caused by a variety of injuries or other conditions affecting the tailbone, or the muscles and nerves around it. These include:

  • Trauma to the coccyx from a fall, causing a fracture or dislocation
  • Pressure and strain (sometimes occurs during childbirth)
  • Spinal tumours or cysts
  • Infection
  • Repetitive stress (eg, cycling, motorbike riding, horseriding)

WHAT ARE THE RISK FACTORS FOR COCCYDYNIA?

Coccydynia occurs more frequently in women.

Other risk factors include:

  • Osteoporosis
  • Sitting for long periods on hard surfaces
  • Obesity

SYMPTOMS OF COCCYDYNIA

Typical symptoms of coccydynia are pain on:

  • Sitting
  • Going from sitting to standing
  • Opening bowels
  • Sex
  • Tenderness directly over tailbone

HOW IS THE DIAGNOSIS MADE?

Your symptoms and physical examination are important in making the diagnosis.

Imaging studies may include:

  • CT or MRI scan
  • X-ray
  • SPECT scans (nuclear medicine)

HOW IS COCCYDYNIA TREATED?

Treatment of coccydynia frequently targets the symptoms, and sometimes the actual cause too. Options may include:

  • Modification of physical activity
  • Special cushions to sit on
  • Medications pain medications and stool softeners
  • Steroid (cortisone) injections
  • Massage
  • Physiotherapy
  • Neuromodulation procedures
  • Very occasionally surgical removal of the coccyx (coccygectomy)