Coccygodynia is a rare condition in that causes pain in and around the coccyx (tailbone).
- A number of different causes have been associated with coccygodynia.
- However, the most common cause is a direct fall and injury to the area of the sacrum and coccyx.
- These types of injuries can occur from various activities, examples include a kick, an injury on a trampoline when one hits the bar or springs that surround the trampoline jumping pad, or from falling from a horse or skis.
- Another common cause, exclusive to women, is childbirth. The other most common cause of the condition is pregnancy.
- During the last three months of pregnancy, certain hormones are released in the women's body causing the area between the sacrum and the coccyx to soften and become more mobile.
- The increased mobility may result in permanent stretching and change and causing inflammation of the tissues surrounding the coccyx.
- In about one third of all cases of coccygodynia, the cause is unknown. Other less common causes include nerve damage, cysts such as Tarlov cysts, obesity, and a bursitis like condition that can arise in slim patients who have little buttocks fat padding.
The classic symptom is pain when pressure is applied to the tailbone, such as when sitting on a hard chair. Symptoms usually improve with relief of pressure when standing or walking.
Other symptoms include:
- Immediate and severe pain when moving from sitting to standing
- Pain during bowel movements
- Pain during sex
- Deep ache in the region of the tailbone
- Physical examination will reveal tenderness over the coccyx.
- Rectal examination allows the coccyx to be grasped between the forefinger and thumb.
- Manipulation will elicit pain and may reveal hypermobility or hypomobility of the sacrococcygeal joint.
- Normal range of motion should be approximately 13 degrees.
- Other causes of coccyx pain, such as infection etiologies (eg, pilonidal cyst), masses, and pelvic floor muscle spasms, should be ruled out.
- Radiographic images can more closely evaluate for the presence of fractures, degenerative changes, or masses. Imaging studies, including dynamic x-ray and magnetic resonance imaging, can help diagnose sacrococcygeal joint hypermobility or hypomobility..
- Treatment for coccygodynia generally falls into conservative management or surgical intervention categories.
- The conservative approach typically includes hot sitz baths, NSAIDs, stool softeners, and/or the use of a donut-shaped pillow or gel cushion to descrease pressure and irritation of the coccyx.
- If these treatment options fails, glucocorticoid injections may be used in an attempt to reduce the pain.
- Massage therapy has also been used to help decrease pain, but most studies have shown that the relief experienced from this form of therapy is temporary.
- The more aggressive and rare approach involves either partial or complete removal of the coccyx (coccygectomy).
- Lirette LS, Chaiban G, Tolba R, Eissa H. Coccydynia: an overview of the anatomy, etiology, and treatment of coccyx pain. Ochsner J. 2014 Spring;14(1):84-7. PMID: 24688338; PMCID: PMC3963058.
NIH genetic and rare disease info
Coccygodynia is a rare disease.