Tailbone pain, technically called coccygodynia, can result from a fall or other trauma onto the very bottom part of your spine. Such trauma can bruise the periosteum (connective tissue that surrounds the bone), causing pain. Falls onto the tail bone can also fracture the bone, dislocate it (at the sacrococcygeal joint, which is the place where the coccyx and the sacrum come together,) or both. Whatever the outcome of the trauma, getting pain relief for an injured tail bone can be difficult.
In fact, because sitting — a staple activity for most of us, and one that directly impacts the coccyx — can be very uncomfortable when you have coccygodynia, this condition is notorious for interrupting quality of life.
While some of the time coccygodynia results from trauma to the tail bone, there are other causes, as well.
Problems with your coccyx bone that can result in coccygodynia may include injuries (including but not limited to falls, as discussed above), disc degeneration at your sacrococcygeal (defined above) and/or intercoccygeal joints (joints between the tiny bone pieces that together comprise the coccyx), bone spurs at the coccyx (called coccygeal spicule), infection in the bone (called osteomyelitis) or a tumor on the bone.
Childbirth is another possible cause of coccygodynia (in the mother).
Symtpoms that mimic occygodynia may be the result of referred pain, i.e. pain arising from organs in which disorders are present. Examples may include conditions or problems in the sigmoid colon, urogenital system, and/or the rectum.
Not only that, pain in the tail bone region can sometimes be traced to problems occurring at, on or in nearby structures. Examples include problems in the lumbosacral area of your spine, sacrum and sacroiliac joint issues, piriformis syndrome, diseases of the pelvic organs, hemorrhoids, and more.
Finally, your coccygodynia maybe be a case of "cause unknown." A 2012 review of studies states that 30% of coccygodynia is idiopathic; in other words, the reason for the tail bone pain could not be found.
Hypermobile Tail Bone
With that said, hypermobility of the coccyx (hypermobility refers to the tendency of the bone to subluxate) is the most common medical finding associated with tail bone pain. Grgić asserts that 70% of patients with coccygodynia showed signs of excess motion of this bone when dynamic X-rays were taken.
Along with injury (as mentioned above), overloading the coccyx during movement as well as when stationary can cause a hypermobile (and painful) coccyx. Activities and states of being that might predispose you to overload your coccyx include being obese and/or sitting for long periods of time (static overloading), and bicycling, rowing or riding (dynamic overload).
In their 2014 study published in the Ochsner Journal, researchers assert thatobesity and being female are two risk factors for tailbone pain.
Symptoms of Coccygodynia
Symptoms of coccygodynia include discomfort and pain at the base of your spine (this is where the coccyx bone is located, particularly when sitting. It can also include pain in your lower back and/or hips. You may find you get a shooting pain down your legs, too.
Coccygodynia intensity varies from person to person. In some cases, the severity of your coccygodynia pain may worsen over time, but in many cases may resolve on its own.
As I mentioned earlier, coccygodynia can be very disruptive to your lifestyle. It can ruin a good night's sleep and interrupt your ability to carry out activities in which sitting and/or bending is necessary.
This means that things you normally do — and perhaps take for granted — such as working at your computer or driving may become too painful. The fact is that when you put weight on your coccyx bone, even if the surface underneath you is a soft pillow or chair, your pain may increase. You may also find that getting up from a sitting position is difficult.
Healthcare providers typically diagnose coccygodynia by taking a medical history, doing a physical exam (which involves palpation of the area) and taking standard and dynamic x-rays. Most likely, your healthcare provider will ask you to sit and/or to do some cycling, to try to reproduce your pain and symptoms.
A coccygodynia diagnosis can sometimes be confirmed by means of an injection. In this case, a local anesthetic is injected into the specific place or places in the tail bone region from which, based on what you say about your symptoms and the results of your physical exam, as well as the x-rays and possibly an MRI (see below for more information), your healthcare provider suspects the pain originates.
Research on MRIs
Most of the time an MRI is not used in the diagnosis process. But in 2012, French researchers found that MRIs may provide details that can be used to determine the cause of a painful tail bone. Their study revealed that when the relative state of the mobility of the coccyx is known, an MRI may help further paint a picture of what's going on. For example, in the study, out of 172 cases being tested, 105 showed a mobile coccyx. Of these, most showed abnormal discs; in the 67 patients with a rigid (immobile) coccyx, abnormal features were found at the bottom part of the bone, called the tip.
Treatment and Pain Relief
As with most spine problems, treatment is divided up into two main types: Conservative (non-invasive) and surgical (also called invasive). The surgery for tail bone pain is called a coccygectomy. It can be either partial or total removal of the tailbone; this surgery is usually reserved for times when everything else has been tried without success. Generally speaking, results tend to be moderate at best, and by having surgery, you run the risk of experiencing complications.
Conservative treatment for tail bone pain include rest, medication, such as NSAIDs (especially at first), sitting on a cushion with a hole cut out of the middle (often jokingly called a "whoopie cushion"), and physical therapy. Once you're in the chronic phase of the injury, physical therapy treatment may include hands-on techniques to increase the flexibility of the pelvic floor - specifically the levator ani muscle, which in turn may release the coccyx bone if it is stuck.
The researchers mentioned above whose 2014 study was published in the Ochsner Journal say that a multidisciplinary approach to treatment tends to work best.They also say that non-surgical treatment works about 90% of the time.
Your healthcare provider may suggest getting a steroid injection, or an injection of a local anesthetic, to help with the pain. Sometimes a pain control procedure known as radiofrequency ablation is used for coccygodynia, but this is not generally recommended.
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Patijn J, Janssen M, Hayek S, Mekhail N, Van zundert J, Van kleef M. 14. Coccygodynia. Pain Pract. 2010;10(6):554-9. doi:10.1111/j.1533-2500.2010.00404.x
Grgić V. [Coccygodynia: etiology, pathogenesis, clinical characteristics, diagnosis and therapy]. Lijec Vjesn. 2012;134(1-2):49-55.(Video) Tailbone Pain Coccydynia | Causes, Symptoms, Treatments | Pelvic Rehabilitation Medicine
Lirette LS, Chaiban G, Tolba R, Eissa H. Coccydynia: an overview of the anatomy, etiology, and treatment of coccyx pain. Ochsner J. 2014;14(1):84-7.
Maigne JY, Pigeau I, Roger B. Magnetic resonance imaging findings in the painful adult coccyx. Eur Spine J. 2012;21(10):2097-104. doi:10.1007/s00586-012-2202-6
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By Anne Asher, CPT
Anne Asher, ACE-certified personal trainer, health coach, and orthopedic exercise specialist, is a back and neck pain expert.
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What causes coccygodynia? ›
Causes. Most of the time, coccydynia is caused by an injury or other trauma to the tailbone, which causes inflammation. In rare cases, there may be no real injury or trauma to the tailbone, and this condition may seem to appear on its own, without any real cause.What is the treatment for coccyalgia? ›
Manual manipulation and massage can help relieve associated muscle spasms or ligament pain. In a handful of cases, COCCYX OR TAILBONE INJECTION (a combination of coccygeal nerve block and ganglion of impar block) has been shown to an extremely successful treatment option to resolve pain.Can coccydynia be cured? ›
Many studies find that non-surgical treatments are successful in approximately 90% of coccydynia cases.What exercises fix an inflamed coccyx? ›
Lying flat on the back, bring your left ankle over the right leg. Keeping your left knee out to the side, gently pull your right leg up to your chest. For an extension – hold the front of your thigh or shin and apply gentle pressure forwards your chest. Lower your legs and repeat the stretch on the other side.How long does a coccyx take to heal? ›
Healing time for an injured tailbone depends on the severity of the injury. If you have a fracture, healing can take between 8 to 12 weeks. If your tailbone injury is a bruise, healing takes about 4 weeks.Can coccyx be healed? ›
A tailbone injury can be very painful and slow to heal. Healing time for an injured tailbone depends on the severity of the injury. If you have a fracture, healing can take between 8 to 12 weeks. If your tailbone injury is a bruise, healing takes about 4 weeks.Can coccydynia be permanent? ›
Coccydynia is often reported following a fall or after childbirth. In some cases, persistent pressure from activities like bicycling may cause the onset of coccyx pain. Coccydynia due to these causes usually is not permanent, but it may become very persistent and chronic if not controlled.Is coccydynia serious? ›
In some cases, the pain may be the result of sitting posture changes brought on by obesity or aging. Rarely, the cause of tailbone pain is something more serious, such as an infection, benign tumor or cancer. Medical treatment typically is not needed for tailbone pain.What are the side effects of coccygeal nerve block? ›
Coccygeal nerve blocks are considered minimally invasive procedures; however, as with all procedures, there is some risk of complications, which include nerve damage, bleeding, numbness in the extremities, and infection.Can physical therapy help coccyx pain? ›
Possible treatments for chronic tailbone pain might include: Physical therapy. A physical therapist might show you how to do pelvic floor relaxation techniques, such as breathing deeply and completely relaxing your pelvic floor — as you would while urinating or defecating.
Does coccydynia show up on MRI? ›
In a case of suspected coccydynia where initial imaging is inconclusive but clinical suspicion is very high, higher level imaging such as MRI or CT can reveal radiographic findings of coccydynia. MRI and CT can play a role in the diagnosis and treatment of coccydynia in the absence of x-ray evidence.Can chiropractor fix coccydynia? ›
Coccydynia and related injuries have been treated using chiropractic care for decades. Many people find that manual adjustments, instrument-guided treatments, stretches, and massage therapy can all help with the rehabilitation of an injured or inflamed tailbone.Can coccydynia be caused by stress? ›
When the tailbone sustains an injury or damage, it causes inflammation that leads to pain and tenderness. Common causes of coccydynia include: Direct trauma from a fall. Repetitive stress and soft tissue strain from prolonged sitting on hard surfaces, horseback riding, bicycle riding, etc.What exercises should I avoid with coccyx pain? ›
Repetitive movements: Activities such as cycling, riding, and rowing can put stress on the tailbone, as well as the surrounding muscles and ligaments, and can cause injury.What is the success rate of coccyx surgery? ›
Once the tailbone is removed, 95% of our patients are pain free in 90 days or less. Overall, we are #1 in the country with a 99% success rate for coccygectomy procedures used to reduce and eliminate tailbone pain.What does a damaged coccyx feel like? ›
The main symptom of tailbone (coccyx) pain is pain and tenderness at the base of your spine, near the top of your bottom. It may feel dull and achy most of the time, with occasional sharp pains. The pain may be worse: while you're sitting down.What happens if a broken tailbone goes untreated? ›
Without treatment, these areas might pull the coccyx back out of alignment over time. The same concept applies to areas such as the lower back and the neck. Once the pressure of the malaligned tailbone is resolved, it's important to also treat the rest of the spine as it may have become tight or weak over time.Does a broken coccyx need surgery? ›
A broken or bruised coccyx will usually heal on its own. Physical therapy, exercises, and a special cushion can all help ease the pain and speed recovery. See your doctor if pain is severe, or if you have trouble with bowel movements or urination. Surgery is needed in fewer than 10 percent of cases.What kind of doctor do you see for tailbone pain? ›
When Should I See a Doctor for Tailbone Pain? If your tailbone pain doesn't subside, you should consult with a hip surgeon. Your orthopedist may do an exam to rule out other conditions, including checking for a fracture, degenerative conditions, or even a tumor in the tailbone area.How is coccydynia diagnosed? ›
Coccydynia is typically diagnosed by gathering a thorough medical history and completing a physical exam. These two standard diagnostic practices are usually sufficient in obtaining a diagnosis and evaluating treatment options, but in some cases, diagnostic tests such as scans or injections may be used.
How common is coccydynia? ›
Coccygodynia accounts for fewer than 1% of all back pain conditions. It is five times more prevalent in women than in men, presumably because the bone is more prominent in women than in men. Although coccygodynia can occur over a wide age range, the mean age of onset is around 40 years.Can you massage your coccyx? ›
Massage the muscles attached to the tailbone to help ease pain. Physical therapy can be beneficial in teaching pelvic floor relaxation techniques (reverse Kegels) which help get the coccyx into better alignment and can relieve the pain experienced when urinating or defecating.Can coccydynia be seen in xray? ›
Commonly, coccydynia (coccygodynia) occurs after trauma and appears with normal imaging features at static neutral radiography, but dynamic imaging with standing and seated lateral radiography may reveal pathologic coccygeal motion that is predictive of pain.How long does a coccyx nerve block last? ›
How long can I expect the relief to last? Every patient is different, some patients get a day of relief. Sometimes these injections can provide more than 6 months of relief.How painful is a coccyx injection? ›
Coccyx Injection Side Effects
But you should expect to have some soreness at the injection site, just as you would with any injection. Some patients do notice a little facial flushing, nausea, or mild abdominal cramps for a few days following the injection.
Defecation pain is a symptom known to be caused by chronic coccydynia; especially before defecating or when constipated.Is heat or ice better for coccyx pain? ›
Hot or cold compresses may be used soon after having a coccyx injury. Heat or cold is also used to help decrease pain and swelling after having surgery. Heat: Use heat 15 to 20 minutes every hour as long as you need it. Heat brings blood to the injured area and may help it heal faster.What aggravates tailbone pain? ›
Tailbone pain usually becomes sharp during certain activities, such as sitting, rising from a seated to a standing position, or prolonged standing. This pain is often aggravated by sitting or by activities that put pressure on the bottom of the spine.What are the symptoms of coccydynia tumor? ›
Symptoms of tailbone cancer include pain, noticeable mass, and weakness or numbness in the lower back and legs. Cancer in the tailbone, also known as the coccyx, may be a chordoma or a cancer that has spread from elsewhere in the body.Should I get an xray or MRI for tailbone pain? ›
We recommend MRI of the painful coccyx when dynamic radiography fails to reveal clearly a pathological lesion (i.e., normal or slightly increased mobility of the coccyx or a rigid coccyx lacking a spicule).
How long does an MRI of the coccyx take? ›
The study takes from 30-45 minutes. The body part being studied will be located in the center of the MRI machine.What conditions mimic coccydynia? ›
Several medical problems may mimic coccydynia, including pilonidal cysts, sciatica, and shingles. On rare occasions, coccydynia may result from an infection or a tumor. When a patient presents with coccydynia, it is important to rule out other causes of the pain, including a fracture of the coccyx.Is coccydynia a fracture? ›
A coccyx injury results in pain and discomfort in the tailbone area (the condition is called coccydynia). These injuries may result in a bruise, dislocation, or fracture (break) of the coccyx. Although they may be slow to heal, the majority of coccyx injuries can be managed with cautious treatment.Can arthritis cause coccydynia? ›
The most common autoimmune cause of coccydynia is ankylosing spondylitis, an inflammatory disease that causes the fusion of bones in the body over time. Tailbone pain may also be associated with other conditions, such as osteoarthritis of the spine, psoriatic arthritis, and systemic lupus.Does coccydynia require surgery? ›
It is done in the cases of pain in the tailbone region (coccydynia) when conservative treatment options, such as rest, painkillers, physiotherapy, and steroid injections, have failed. The surgery is not commonly done, but it can be efficiently performed by experienced orthopedic or spinal surgeons.What doctor treats coccyx pain? ›
When Should I See a Doctor for Tailbone Pain? If your tailbone pain doesn't subside, you should consult with a hip surgeon. Your orthopedist may do an exam to rule out other conditions, including checking for a fracture, degenerative conditions, or even a tumor in the tailbone area.Can a chiropractor help with coccydynia? ›
Coccydynia and related injuries have been treated using chiropractic care for decades. Many people find that manual adjustments, instrument-guided treatments, stretches, and massage therapy can all help with the rehabilitation of an injured or inflamed tailbone.What does coccydynia feel like? ›
Tailbone pain, or coccydynia, can be a dull ache or a sharp pain at the bottom of your spine. It might hurt when you stand up, have sex, or go to the bathroom. It usually goes away on its own in a few weeks or months.Is tailbone surgery risky? ›
Potential Risks and Complications of Coccyx Surgery
A possible but uncommon risk of coccygectomy is injury to the rectum as the coccyx is being removed. While it is unlikely, it is possible that if this were to happen, a diverting colostomy would be necessary to allow the rectum to heal.
The surgeon makes an incision over the sacrum. Fluoroscopy, or live x-ray, is used during the procedure. The coccyx is dissected and removed from the sacrum. Surgery takes approximately 1 hour.