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Coccydynia (tailbone pain)


Coccydynia is a pain felt in your coccyx (tailbone). This is the last bone at the bottom of the spine (tailbone). You can get it if you injure or strain your coccyx or the surrounding muscles and ligaments.


Despite its small size, the coccyx has several important functions. Along with being the insertion site for multiple muscles, ligaments, and tendons, it also serves as one leg of the tripod—along with the ischial tuberosities—that provides weight-bearing support to a person in the seated position. The incidence of coccydynia (pain in the region of the coccyx) has not been reported, but factors associated with increased risk of developing coccydynia include obesity and female gender.


In most cases, the pain will improve over a few weeks or months, but occasionally it can last much longer and severely affect your ability to carry out everyday activities.



Common causes of coccydynia

  • Childbirth

  • An injury or accident, such as a fall

  • The repeated or prolonged strain on the coccyx

  • Poor posture

  • Being overweight or underweight


Less common causes can include a bony growth on the coccyx, the coccyx being too flexible or too rigid, and arthritis. Rare but serious causes include infection and cancer.


In many cases, no obvious cause can be found. Age-related "wear and tear" may play a part.


Symptoms of coccydynia


The main symptom is pain and tenderness in the area just above the buttocks.


The pain may:

be dull and achy most of the time, with occasional sharp pains

be worse when sitting down, moving from sitting to standing, standing for long periods, having sex, and going for a poo

make it very difficult to sleep and carry out everyday activities, such as driving or bending over


Some people also have back pain, shooting leg pains (sciatica), and painful buttocks and hips.


Treatments for coccydynia


Self-care measures


  • The following advice may help reduce pain and allow you to get on with your everyday activities.

  • Use a specially designed coccyx cushion – these can be bought online and from some shops; they help reduce the pressure on your tailbone while you're sitting down

  • Avoid prolonged sitting whenever possible – try to stand up and walk around regularly; leaning forward while seated may also help

  • Wear loose-fitting clothes – avoid clothing such as tight jeans or trousers that may put pressure on your tailbone

  • Apply warm and cold packs to your tailbone – warm packs include hot water bottles and microwaveable heating pads; cold packs are available as freezable gel-filled pads from pharmacies, or you can use a bag of frozen vegetables wrapped in a towel

  • try laxatives (medicines to treat constipation)

  • If the pain is worse when you are having a poo – many laxatives are available to buy from pharmacies and supermarkets without a prescription

  • Take over-the-counter painkillers


Physiotherapy


If your pain has not started to improve after a few weeks, your GP may be able to refer you to a physiotherapist.


A physiotherapist can:

give you advice about posture and movement to help reduce your pain

teach you some simple exercises to help relax the muscles around your tailbone

try techniques such as manipulation and stretches.

References


Lirette, L.S., Chaiban, G., Tolba, R. and Eissa, H., 2014. Coccydynia: an overview of the anatomy, etiology, and treatment of coccyx pain. Ochsner Journal, 14(1), pp.84-87.


https://www.spine-health.com/conditions/lower-back-pain/coccydynia-tailbone-pain


Amal Adithya

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