Coccyx Pain

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)

Causes

The following are the possible cause of generation of coccyx pain:

Direct injury

Any injury which directly hit on the coccyx can cause pain.

Childbirth

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.

Continuous friction

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.

Ageing

With increasing of age degenerative changes in spine health can also cause coccyx pain.

Gender specific

Females are more susceptible to have coccyx pain, as due childbirth or degenerative diseases are more common in women. (1,4)

Diagnosis

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.

Physical examinations

Tenderness, swelling, nature of pain are evaluated during the physical examination of the site.

Other than physical examinations, some imaging tests may conducted like:

X-Ray
MRI
CAT scan (3, 4)

Treatment

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)

Exercises

References

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