Coccydynia: Causes, Symptoms, Diagnosis, Treatment, and Prevention
Coccydynia involves pain in the tailbone area. The tailbone, also called the coccyx, is a small triangular bone that supports your weight when you sit down and serves as an attachment point for several muscles and ligaments.
We will discuss the possible causes, symptoms, diagnosis, treatment, and prevention of coccydynia in this blog post. It can interfere with your daily activities and quality of life. It can make sitting, standing, moving, and even pooping painful.
Causes of Coccydynia
There are many possible causes of coccydynia, but the most common ones are:
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Injury: A fall, a blow, or a fracture can damage the tailbone or the surrounding tissues. This can cause inflammation, swelling, and pain in the area.
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Birth: Pregnancy and childbirth can negatively affect the pelvic floor muscles and the tailbone, resulting in bruising, dislocation, or fractures. After childbirth, some women experience coccydynia.
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Sitting: Sitting for a long time, especially on hard or uneven surfaces, can put excessive pressure on the tailbone. This can irritate the nerves and the tissues around the tailbone and cause pain.
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Posture: Having a poor posture, such as slouching or leaning forward, can alter the angle of the tailbone and strain the muscles and ligaments that support it. This can lead to coccydynia over time.
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Weight: Being overweight or underweight can affect the distribution of body weight and the cushioning of the tailbone. This can increase the risk of coccydynia.
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Other conditions: Some medical conditions, such as arthritis, infection, tumor, or cyst, can affect the tailbone or the nearby structures and cause coccydynia.
Symptoms of Coccydynia
The main symptom of coccydynia is pain in the tailbone area. The pain can be dull, sharp, or throbbing, and it can vary in intensity and duration. The pain can be triggered or worsened by:
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Sitting, especially on hard or narrow surfaces
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Standing up from a sitting position
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Moving from sitting to lying down or vice versa
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Bending, twisting, or lifting
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Having a bowel movement
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Having sex
Some people with coccydynia may also experience:
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Swelling or bruising in the tailbone area
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Difficulty sitting or standing for a long time
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Reduced range of motion in the lower back and hips
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Back pain or sciatica
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Sleep problems
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Depression or anxiety
Diagnosis of Coccydynia
To diagnose coccydynia, your doctor will ask you about your medical history, your symptoms, and your possible risk factors. Your doctor will also perform a physical examination, which may include:
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Inspecting the tailbone area for any signs of injury, infection, or abnormality
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Palpating the tailbone and the surrounding tissues to check for any tenderness, swelling, or movement
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Performing a rectal exam to assess the pelvic floor muscles and the internal structures of the tailbone
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Performing a pelvic exam to evaluate the reproductive organs and the pelvic floor muscles
Your doctor may also order some tests, such as:
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X-rays to look for any fractures, dislocations, or deformities of the tailbone
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MRI or CT scan to get a detailed image of the tailbone and the nearby structures
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Bone scan to detect any inflammation, infection, or tumor in the tailbone
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Nerve conduction studies to measure the electrical activity of the nerves in the tailbone area
Treatment of Coccydynia
The main goals of treatment for coccydynia are to reduce the pain, to promote healing, and to prevent complications. Treatment options include:
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Home remedies: You can try some self-care measures at home to ease the pain, such as:
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Taking over-the-counter pain relievers, such as ibuprofen or acetaminophen
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Applying ice packs or heat pads to the tailbone area
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Sitting on a cushion, a pillow, or a donut-shaped device to reduce the pressure on the tailbone
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Avoiding sitting for a long time or sitting on hard or uneven surfaces
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Changing your posture and adjusting your work station to support your spine
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Doing gentle exercises and stretches to strengthen the muscles that support the tailbone
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Losing weight or gaining weight if needed to achieve a healthy body mass index (BMI)
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Medications: Your doctor may prescribe some medications to help with the pain and inflammation, such as:
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Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen
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Corticosteroids, such as prednisone or methylprednisolone
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Muscle relaxants, such as cyclobenzaprine or baclofen
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Antidepressants, such as amitriptyline or duloxetine
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Anticonvulsants, such as gabapentin or pregabalin
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Injections: Your doctor may recommend some injections to deliver medication directly to the tailbone area, such as:
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Local anesthetics, such as lidocaine or bupivacaine, to numb the pain
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Corticosteroids, such as triamcinolone or dexamethasone, to reduce the inflammation
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Botulinum toxin (Botox), to relax the muscles and nerves around the tailbone
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Nerve blocks, to interrupt the pain signals from the tailbone to the brain
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Physical therapy: Your doctor may refer you to a physical therapist, who can help you with:
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Exercises and stretches to improve the flexibility, strength, and stability of the tailbone and the surrounding muscles
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Massage and manipulation to release the tension and improve the blood flow in the tailbone area
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Ultrasound, electrical stimulation, or laser therapy to stimulate the healing and reduce the pain in the tailbone area
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Biofeedback, relaxation techniques, or cognitive behavioral therapy to cope with the pain and stress
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A doctor may suggest surgery as a last resort if your pain is severe and does not respond to other treatments. During surgery, part or all of the tailbone is removed (coccygectomy). Although the surgery relieves pain in most cases, there are risks associated with it, such as:
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Infection
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Bleeding
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Nerve damage
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Wound healing problems
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Recurrence of pain
Prevention of Coccydynia
You may not be able to prevent coccydynia completely, but you can take some steps to reduce your risk of developing it, such as:
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Avoiding falls or injuries to the tailbone area
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Wearing protective gear when playing sports or doing activities that may cause trauma to the tailbone
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Sitting properly and using a cushion, a pillow, or a donut-shaped device to support your tailbone
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Taking breaks and changing positions frequently when sitting for a long time
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Maintaining a good posture and a healthy spine alignment
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Doing exercises and stretches to keep the tailbone and the surrounding muscles strong and flexible
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Eating a balanced diet and staying hydrated to nourish the bones and the tissues
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Seeking medical attention promptly if you have any symptoms or signs of coccydynia
Conclusion
An individual with coccydynia experiences pain in the tailbone area. It can affect anyone, but it is more prevalent in women and people assigned female at birth (AFAB) than in men and people assigned male at birth (AMAB). There can be a number of causes for coccydynia, including injuries, childbirth, sitting, posture, weight, or other factors. A doctor can diagnose coccydynia based on your history, physical examination, and some tests. Home remedies, medications, injections, physical therapy, and surgery can all be used to treat coccydynia. You can prevent coccydynia by avoiding falls or injuries, sitting properly, maintaining a good posture, exercising and stretching, eating a balanced diet, and getting medical attention as soon as possible.
