What is Coccyx pain?
If the last region of the spine becomes paining, then it is termed as coccyx pain or tailbone pain (1).
Symptoms of Coccyx pain:
The following are the symptoms of coccyx pain:
- Dull and achy pain
- But prolonged sitting or standing or sudden postural change like from sitting position to standing posture can cause a sharp pain sensation.
- Painful defecation
- Pain during sexual activities
- Pain worsen during sexual activities
- Pain raises during menstrual cycle
- Localized tenderness and swelling
- Difficulty in sitting (2,5)
The following are the possible cause of generation of coccyx pain:
Any injury which directly hit on the coccyx can cause pain.
During childbirth, pressure is generated in the coccyx during the passage of the head of the baby. Sometimes the force of the pressure is too much, which cause injury in the coccyx head and pain occurs.
Some activities like horse riding or prolonged sitting on the hard seat or traveling on the bad road can cause pain in the coccyx.
Infection and tumor
Any infection and tumor can cause pain in the coccyx, but this is rare cause. Usually the spine tumor which mainly affect the coccyx is a malignant type.
With increasing of age degenerative changes in spine health can also cause coccyx pain.
Females are more susceptible to have coccyx pain, as due childbirth or degenerative diseases are more common in women. (1,4)
The diagnosis is initiated with the thorough knowledge of medical history and sign and symptoms . The evaluation of medical history can help to judge the presence of accidental trauma, childbirth or occupational hazard are the reason of coccyx pain. The symptomatic analysis is very important to evaluate the cause and treatment.
Tenderness, swelling, nature of pain are evaluated during the physical examination of the site.
Other than physical examinations, some imaging tests may conducted like:
- CAT scan (3, 4)
It is advisable to treat coccyx pain, avoid following activities:
- Prolonged sitting on the hard surface
- Any activities, which create pressure on the coccyx
Always prefer to sit on padded or cushioned place which supports the buttock.
The following are the medical treatment available for treating the coccyx pain:
- Physiological therapy: Physical therapy and breathing management can reduce the discomfort and pain.
- Some stretching are help to relax the spine.
- Physical therapy along with ultrasound can provide better result.
- Ice compression can help to relief from pain.
- Application of hot compression for few days can help to release the pressure.
- Massaging in the associated muscles in the coccyx area can help to relaxing the pain. Rectum muscle manipulations can help to ease the pain during defecation or urination.
- Local anesthetic injection can cause relieving of pain.
- Cortisone injection is also prescribed for controlling severe pain and inflammation.
- In rare cases, opoid analgesics are prescribed with high precautionary measures, as this are habit forming medications.
- Non steroidal-anti-inflammatory drugs are prescribed for pain relief.
- Some anti-depressant or anti-epileptic pain also cause relaxation of pain in coccyx.
- Laxative are prescribed for easy defecation.
- If nonsurgical therapy become unsuccessful, then coccygectomy is the only option. In this surgical process, the affected part of the coccyx is surgically removed. In this technique, incision of skin and subcutaneous fat present in the upper part of the coccyx is conducted. No muscle tissues are removed, but, the periosteum (the outer covering of the bone) is carefully incised and permit the coccyx to dissect for separate out from the sacrum. Then with caution coccyx is removed. (1, 2,5)
- Richard A. Staehler, MD (2010); Tailbone Pain Causes; Retrieve from: http://www.spine-health.com/conditions/lower-back-pain/tailbone-pain-causes
- Margaret Moutvic (2015); Tailbone pain: How can I relieve it?; Retrieve from: http://www.mayoclinic.org/tailbone-pain/expert-answers/faq-20058211
- William C. Shiel; Coccydynia(Tailbone Pain) (2015); Retrieve from: http://www.medicinenet.com/coccydynia/article.htm
- Patrick M Foye (2015); Coccyx Pain, Retrieve from: http://emedicine.medscape.com/article/309486-overview#a5
- Steven Doerr, (2015), Tailbone Pain Overview; Retrieve from: http://www.emedicinehealth.com/tailbone_coccyx_injury/article_em.htm