What is Coccydynia?
Coccydynia (also called Coccygodynia) is inflammation of the tailbone or coccyx. Coccydynia is associated with pain and tenderness at the tip of the tailbone between the buttocks. The pain is often worsened by sitting. Tailbone pain can be caused by trauma to the coccyx during a fall, prolonged sitting on a hard or narrow surface, degenerative joint changes, or vaginal childbirth.
Potential Causes of Tailbone Pain
Coccydynia is typically caused by the following underlying anatomical issues:
- Hypermobility or too much movement of the coccyx puts added stress on the joint between the sacrum and coccyx and on the coccyx itself. Too much mobility can also pull the pelvic floor muscles that attach to the coccyx, resulting in tailbone and pelvic pain.
- Limited mobility of the coccyx causes the tailbone to just outward when sitting and can put increased pressure on the bones and the sacrococcygeal joint. Limited coccyx movement may also result in pelvic floor muscle tension, adding to the discomfort.
- In rare cases, part of the sacrococcygeal joint may become dislocated at the front or back of the tailbone, causing coccyx pain.
- Childbirth causes immense pressure around the pelvic area causing pain in the coccyx
Coccydynia/Tailbone Pain Signs and Symptoms
The classic symptom for tailbone pain is a pain with sitting and transitional movements such as sit to stand.
Tailbone Pain Risk Factors
Risk factors include history prior surgery in the area of the tailbone, history of pregnancy and vaginal birth, history of a fall on your coccyx, history activities that traditionally can cause mechanical microtrauma with time to the coccyx such as horseback riding, biking, snowboarding, etc.
Coccydynia Preventative Steps
Preventative steps include protecting your coccyx during “high risk” activities such as protective tailbone padding for snowboarding, proper fitting bike seats, and saddles, proper cushion for sitting to relieve pressure around coccyx. If you have a propensity for tailbone pain, a proper physical therapy program can optimize posture, sitting technique as well as evaluate and treat any underlying pelvic floor muscle dysfunction what could predispose patients to coccyx pain.
Coccydynia, usually goes away on its own within a few weeks or months. However, for some the pain can become chronic. If traditional conservative methods of treatment are not helping, such as leaning forward while sitting down, using a doughnut-shaped pillow or wedge (V-shaped) cushion to sit on, or apply heat or ice to the affected area, do not minimize your pain, contact our office for a thorough evaluation for your chronic coccydynia.
Shrikhande A, Ahmed T, Shrikhande G, Hill C. A Novel, Non-Opiod Based Treatment Approach to Men with Urologic Chronic Pelvic Pain Syndrome (UCPPS) Using Ultrasound Guided Nerve Hydrodissection and Pelvic Floor Musculature Trigger Point Injections. The International Continence Society. 2018 Aug. Link to Article.