Coccyx pain

The coccyx is a triangular bone structure located at the bottom of the spinal column. It is made up of three to five bone segments that hold the joints and ligaments in place. Coccyx pain can indicate injury or bone disease, so you should be very careful if this pain occurs and see a doctor if the pain does not go away.

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Reasons

A condition that causes discomfort or pain in the tailbone is called coccydynia. Injuries to the body can cause bruising, dislocation, or rupture (breakdown) of the tailbone. Although they are slow to heal, most tailbone injuries can be managed with conservative treatment.

Most injuries occur in women because the female pelvis is wider and the tailbone is more susceptible to impacts.Tailbone pain during pregnancy is also common.

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Causes of injuries

Most injuries are caused by direct trauma to the coccyx area.

• A blow while sitting on a hard surface is the most common cause of injury.
• A direct blow to the tailbone, such as those that occur during contact sports, can damage the tailbone.
• The coccyx can be damaged or broken during childbirth.
• Repetitive strain or friction on the tailbone (as occurs when cycling or rowing) can damage the tailbone.
• Sometimes the cause of injury is unknown.

Less common causes of coccyx discomfort include bone spurs, compression of nerve roots or damage to other parts of the spine, local infections and tumors.

Symptoms of a Coccyx Injury

• Severe localized pain in the coccyx
• If the injury is too traumatic, bruising may be visible in the area.
• The pain typically becomes more severe when a person sits for long periods of time, or experiences direct pressure on the tailbone area.
• Intestinal strain and constipation, often painful.
• Some women may experience pain during intercourse.

When to seek medical attention?

If a patient has symptoms of injury or unexplained discomfort in the tailbone area, consult a doctor. Then the doctor can decide whether the injury is traumatic or whether the pain is caused by other, more serious problems.

Injuries to the coccyx area rarely require a visit to the emergency room. However, if the patient is unable to move, lie down, or sit, it may be worth visiting the emergency room of the nearest hospital.

Diagnostics

The cause of the injury is largely determined by the medical history and physical examination. Sometimes the following may be done:

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X-ray or other tests

X-rays can be used to determine if the coccyx is fractured or dislocated. However, X-rays sometimes fail to detect these injuries. Some doctors recommend X-rays taken while standing or lying down to better determine if a fracture or dislocation is present.

This may also include an examination of the entire spinal column (spine), a neurological examination, a rectal examination. To perform a rectal examination, the doctor inserts a finger into the rectum to feel the coccyx area and determines if there is a dislocation or fracture, which can be felt by palpation and if direct pressure on the coccyx causes you pain.

Rarely, at the doctor's discretion, an MRI (magnetic resonance imaging) scan is recommended - this is performed at a later stage if x-rays do not reveal the cause of ongoing coccyx discomfort.

Treatment

Home care

Injuries are often extremely painful, so home care is aimed at pain management.

1. Avoid sitting for long periods of time. When sitting on hard surfaces, try to alternate which buttock you rest on. Also, lean forward and direct your weight away from your tailbone.
2. After traumatic injuries, apply ice to the tailbone area for 15 to 20 minutes, four times daily, for the first few days after the injury.
3. Use ibuprofen or similar pain medications to control pain.
4. You can purchase a special soft donut pillow or seat cushion. This pillow has a hole in the middle to protect the tailbone from contact with a flat surface.
5. Eat foods high in fiber to soften your stool and avoid constipation.

Treating tailbone pain with a doctor

In addition to home care, your doctor may be able to provide further pain relief with medications and, less commonly, surgery.

• Strong painkillers may be prescribed at the discretion of the doctor.
• Stool softeners may be prescribed to prevent constipation.
• Injections of local anesthetics and corticosteroids into the coccyx area are sometimes needed to treat long-term pain.
• Rarely, the coccyx may be removed surgically.

What other steps can be taken to treat coccyx?

• Most people do not require follow-up treatment if their tailbone condition improves after treatment.

People with chronic pain that does not respond to medical therapy should seek out other surgical specialists.

Injury prevention

Most injuries are accidental (e.g. due to slipping on ice) and therefore cannot be completely avoided.

Wear appropriate protective clothing if you participate in high-impact sports.

In most cases, tailbone pain goes away within a few weeks after the injury if the patient seeks medical help in time.