Coccydynia (Tailbone Pain)
Tailbone pain (coccydynia) can make everyday tasks uncomfortable at best, and unbearable at worst. The coccyx, a small triangular bone at the bottom of the spinal column, can get bruised and even fractured. Sitting increases pain while walking relieves it. Using at-home remedies and changing behaviors such as sitting too long make the biggest differences.
Tailbone pain, called “coccydynia,” is pain in and around the small triangular bone at the very bottom of your spinal column, above the cleft of your buttocks. The term “coccyx” comes from the Greek word for “cuckoo” as it resembles a bird’s beak with the tip pointed down. “Dynia” means “pain,” and so “coccydynia” literally means “pain of the coccyx.” And because the bone corresponds to the location of an animal’s tail, it’s called the “tailbone.”
Your coccyx is made up of three to five fused vertebrae (bones). It lies beneath the sacrum, a bone structure at the base of your spine. Several tendons, muscles and ligaments connect to it. Both the coccyx and the ischial tuberosities (two bones that make up the bottom of your pelvis) bear your weight when you sit down. Two-thirds of adults have a coccyx that curves a bit instead of pointing straight down, but one that is curved too far is abnormal and, therefore, painful.
Tailbone pain ranges from a dull ache to a fierce stab. It can last for weeks, months or sometimes longer. There are three types of events that cause tailbone pain:
- External Trauma: A bruised, broken or dislocated coccyx caused by a fall.
- Internal Trauma: Trauma caused by a difficult childbirth or from sitting on a narrow or hard surface for too long.
- Others: Infection, abscess and tumors.
Interestingly, for one-third of those with coccydynia, the cause is unknown while tailbone pain is rarely lifelong although is very common. Women are five times more likely than men to develop coccydynia. Adults and adolescents get it more often than children. Obese persons are three times more susceptible than those at the ideal weight according to the BMI (Body Mass Index) scale. You’re also more vulnerable if you lose weight too quickly.
Causes of tailbone pain (coccydynia)
Tailbone pain can be caused from several things, including but not limited to:
Falling - Who hasn’t fallen backwards onto their behind? Maybe your feet slipped out from under you on the ice. Maybe you fell off a ladder. Or, maybe you were leaning too far back in your office chair and took a tumble. If you take a really bad fall you can bruise, break (fracture) or dislocate (knock out of place) your tailbone (coccyx).
Repetitive Strain Injury (RSI) - Sports like bicycling and rowing require you to lean back and forth and stretch your spine. Too much of that repeated motion can strain the tissues around your coccyx.
Pregnancy/Childbirth - During the third trimester of pregnancy, a woman’s body secretes hormones that soften the area between the sacrum and the coccyx. This enables the coccyx to move as necessary during childbirth. This is a natural process but, unfortunately, such movement may stretch the muscles and ligaments around the coccyx too far, causing additional pain. Such a strain on those soft tissues keeps them from supporting your coccyx at the correct angle.
Obesity - Extra weight applies additional pressure to the coccyx. This can cause the coccyx to lean backward. Your tailbone will hurt if it is out of position.
Underweight - If you don’t have enough fat in your buttocks to prevent your coccyx from rubbing against the muscles, ligaments and tendons, that can cause. The rubbing inflames the soft tissues.
Sitting - Just this simple act can increase coccyx pain, especially if you’re sitting on a hard or narrow surface. Do your best to get up often, stretch and take a short walk. Better yet, find yourself a softer, more comfortable place to sit or use a cushioned seat.
Cancer - Only in rare cases is tailbone pain a sign of cancer. It is extremely unlikely.
Coccydynia Symptoms
Symptoms of coccydynia include: achy or piercing pain in the tailbone, more severe pain when changing from sitting to standing up, more severe pain when sitting for long periods of time, pain during bowel movements, and pain during sex. Other related symptoms that may occur with coccydynia include: depression, anxiety, poor sleep, painful buttocks and back pain.
Coccydynia Diagnosis
First, after getting your general medical history, your healthcare provider will ask you about any recent traumas including a fall or childbirth. Next, he/she will do a visual examination of the area checking for an obvious fracture, deformity, mass or an abscess (infection). To check for a fracture your healthcare provide may order an x-ray or CT scan. To check for inflammation and chordoma (a rare type of cancerous tumor of the spine) your healthcare provider may order an MRI or Bone Scan.
Coccydynia Treatments
Most people recover without undergoing any sort of treatment. Of those who do require treatment, 90% just need to use at-home remedies.
At-home remedies for tailbone pain (coccydynia) include:
Taking a NSAID like ibuprofen to reduce pain and swelling.
Decreasing sitting time. Lean forward if you have to sit.
Taking a hot bath to relax muscles and ease pain.
Using a wedge-shaped gel cushion or coccygeal cushion (a “donut” pillow) when sitting.
Taking stool softeners to reduce pain during bowel movements.
Stretching and strengthening the muscles of your lower back and pelvis.
Applying hot or cold packs to your lower back. Apply for no longer than 20 to 30 minutes, several times a day.
Wearing loose-fitting clothing.
Outpatient treatments for tailbone pain (coccydynia) include:
Blocking the nerve supply of the area — a Coccygeal nerve block — using numbing medications and steroids to decrease the inflammation.
Massage therapy (usually only provides temporary relief).
Stretching exercises and posture improvement guided by a physical therapist.
Acupuncture.
TENS (transcutaneous electrical nerve stimulation).
Recovery time from a coccygectomy can take a few months and possibly up to a year for full recovery in extreme instances. Unfortunately, there’s no guarantee that the pain will go away even if the bone is gone, but again, this procedure is rare.
Other symptoms that could occur along with coccydynia, such as depression, anxiety and sciatica, should also be addressed and treated as well.
Reducing Risk of Coccydynia
You can reduce your risk of tailbone pain by:
Avoiding falling. Keep your floors and pathways free of loose objects, debris and cords. Make sure all stairs are well lit and include rails. Don’t walk while looking at your cellphone.
Avoiding activities that worsen symptoms such as cycling and sitting for long periods of time.
Coccydynia Outlook
Tailbone pain is not something you just have to live with. Follow the at-home remedy recommendations and check with your healthcare provider about outpatient options. Don’t sit for long periods of time without standing up, take a short walk or do a couple quick stretches. If you love to ride your bike, cut back for now. Lie on your side when you sleep. Spend more time on your feet, use the at-home remedies and stay in contact with your healthcare provider. If your severe tailbone pain does not improve within a few weeks you may want to seek additional medical attention.
