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Coccydynia

What is Coccydynia?

Coccydynia is a pain in the region of the coccyx, a triangular bone present at the bottom of the spine. Coccydynia is also known as tailbone pain. The pain is usually caused by some kind of trauma, which also causes inflammation of the surrounding tissue that worsens the pain. The condition can make it difficult to sit down on a chair comfortably.

Causes of Coccydynia

Causes of Coccydynia include:

  • Local trauma
  • Abnormal, excessive mobility of the tailbone
  • Tumor or infection of the tailbone
  • Pressure and strain on the tailbone which sometimes occurs during childbirth
  • Repetitive stress from activities like cycling, motorbike riding, and horse riding

Symptoms of Coccydynia

Symptoms of Coccydynia include:

  • Localized pain in the tailbone region
  • Sharp pain when sitting on a chair
  • Worsening of pain when standing up from a sitting position
  • Pain during bowel movements
  • Pain during sexual intercourse

Diagnosis of Coccydynia

The doctor will discuss your symptoms, check your medical history, and conduct a physical examination including palpation of the lower spine region to check for local tenderness or swelling. This can help in identifying cysts, tumors, or bone spurs in this region.

Diagnostic tests that may be ordered include:

  • Dynamic X-rays: X-rays are taken in the sitting and standing position to check for bony abnormalities.
  • CT or MRI scans: This is done to check for soft tissue abnormalities.
  • SPECT scans: This is an advanced imaging study that can help diagnose hidden fractures.

Treatment for Coccydynia

Treatments for Coccydynia include:

  • Physical therapy: This includes a wide range of techniques such as breathing exercises and pelvic floor relaxation exercises to help you relax your pelvic region completely while urinating and defecating.
  • Cold and Heat Therapy: Cold therapy reduces the swelling and inflammation that occurs after an injury. The ice pack can be applied to the area over a towel for 10-15 minutes at a time 3-4 times a day for the first 48 hours after the injury. Thereafter, warm compresses can be applied to the tail bone to help sore muscles relax.
  • Manipulation: This method involves a spinal adjustment to reduce the pain associated with the condition.
  • Massage: The muscles surrounding the tail bone may be massaged through the rectum to help relieve the pain.
  • Medication: Non-steroidal anti-inflammatory drugs (NSAIDs) and injections of a local anesthetic into the tailbone can relieve pain for a few weeks while healing takes place.
  • Surgery: This involves the removal of the coccyx by a procedure called a coccygectomy. Surgery is used only in rare cases, as a last resort, when all other treatment methods fail to have any effect.