What is Coccydynia?
Coccydynia is the medical term for tailbone inflammation. And, in the jargony language of doctors, your tailbone is referred to as your coccyx.
The suffix -dynia means pain. Hence, the term coccydynia translates to coccyx pain.
A triangular group of 4 fused bones, your coccyx forms the bottom-most portion of your spine, just beneath your sacrum. A strange little structure, the coccyx appears to have served a now-defunct purpose. Scientists believe that the coccyx may represent the ancient remnants of a tail… something that we lost over many millennia of evolution.
However, the tailbone does serve as the point of attachment for several key muscles, ligaments, and tendons. So, it’s not entirely useless. In particular, your coccyx connects to your gluteus maximus (or butt muscles) and your levator ani (or pelvic floor muscles).
Perhaps because the coccyx supports the pelvic floor muscles, coccydynia is 5 times more likely to occur in women than in men. This could be for several reasons, but the most likely explanation has to do with female pelvic anatomy.
Unlike men, women have a broader pelvis to accommodate childbirth. Although more flexible in a number of ways, the female pelvis actually allows for less rotation. Coupled with manual trauma to the coccyx from childbirth, this can lead to chronic pain.
What Causes Coccydynia?
Because women have a tendency to develop coccydynia 5 times as often as men, coccydynia was once believed to be a form of “female hysteria.” Now, we know that coccygeal pain can result from many causes. The most common of these includes:
- Mobility Defects: Too much movement (hypermobility) in the joint that connects the coccyx to the sacrum can lead to coccyx injuries. However, on the flip side, too little movement (hypomobility) prevents the tailbone from assuming a comfortable position while we are sitting. Over time, this repetitive strain can lead to coccyx pain.
- Injuries: Injuries to the coccyx are by far the most common cause of tailbone pain. These can occur from unexpected falls or a sudden blow during high-impact sports. Tailbone trauma often results in bruising around the coccyx, coccygeal fractures, and/or dislocations.
- Childbirth: Like injuries, childbirth can cause manual trauma to the coccyx. This usually takes place when the fetus’ head passes over the coccyx during the delivery process. If the fetus’ head is larger than normal or positioned awkwardly, then coccygeal injuries can result.
- Strain: Prolonged sitting–whether at a desk, on top of a horse, or while mountain biking over rough terrain–can place extreme pressure on your coccyx. Over time, this repetitive strain can lead to pain flare-ups. Furthermore, if acute inflammation turns chronic, then the coccygeal joint can begin to degenerate from overuse.
- Obesity: Being overweight tends to compound coccydynia, especially during activities that involve sitting for long periods of time. Excess weight places even more strain on the coccyx, encouraging soreness.
- Bone Spurs, Spinal Tumors: Each of these conditions involves a mass or protrusion that can place unwanted pressure on the coccyx. However, as causes of coccydynia, these are comparatively rare.
- Anatomical Changes to the Tailbone: Childbirth is one of the leading causes of tailbone bone pain. The tailbone becomes more flexible to allow the spine above it to bend for birth. This movement is a natural and necessary process for childbirth, but unfortunately, the movements may stretch the muscles and ligaments around the tailbone too far. The stretching of the muscles and ligaments may make the tailbone segments unstable, causing mild or extreme pain.
- Tailbone Infections and Tumors: Although rare, tumors or infections may affect the tailbone. Chondroma is a malignant bone tumor that tends to occur in the tailbone area. A bone infection, osteomyelitis, affects individuals with pre-existing medical conditions such as immunodeficiency and sepsis.
Beating Coccydynia at Home
Fortunately, there are a number of effective ways that you can treat coccydynia at home. Consider trying the following pain relief strategies:
- Over-The-Counter Medications: NSAIDs, like Ibuprofen or Aleve, can be particularly handy for relieving coccygeal pain… and unlike opioid drugs, they aren’t addictive. If you can’t find sufficient relief from NSAIDs, then consider speaking to your doctor about prescription pain relief options like Celebrex. You may also benefit from the use of steroid injections into the coccygeal joint to relieve tenderness.
- Hot & Cold Therapy: For the first few days following your injury, apply ice packs to the base of the spine. The cold will prevent the inflammation from setting in. Around day 3, apply alternating rounds of hot and cold therapy to your coccyx. The use of heating pads will draw blood–rich with white blood cells and healing properties–to the injured area.
- Ergonomic Equipment: If you can, invest in an adjustable desk or computer stand that you can raise and lower throughout your workday. Take frequent breaks where you stand, or if possible, stretch. Use a U-, V-, or donut- shaped pillow to sit on instead of a flat surface. These open pillows support your buttocks, while leaving an opening for your coccyx. This will shift your weight off of your coccyx and onto your buttocks muscles instead.
- Stretches: Relax your pelvic floor and gluteal muscles by engaging in activities that encourage stretching, like yoga or pilates. In particular, Happy Baby, Child’s Pose, Triangle Pose, and Squats are good at relieving tailbone pain.
- Dietary Changes: Eat healthy, well-balanced, and well-portioned meals to maintain an optimal BMI. In addition, if your coccydynia is caused by Levator Ani Syndrome (or pelvic floor dysfunction), make sure to get plenty of fiber and drink water to avoid constipation.
Taking Pain Management to the Next Level
If at home remedies for coccydynia aren’t working for you, then you may need to take things to the next level. The following interventions involve receiving the aid of a licensed medical professional:
- Chiropractic Care: Chiropractic care for coccydynia often involves receiving “manual manipulation,” aka an adjustment. During the adjustment, your chiropractor will use his or her hands to reposition the bones that make up the sacrococcygeal joint: the sacrum and the coccyx.
- Massage Therapy: The goal of massage therapy for coccydynia is to relieve the muscles (such as the gluteus maximus and levator ani) that place strain on the coccyx. Remember that these muscles attach to the coccyx through a network of tendons.
- Physical Therapy: With the aid of a PT, you can develop an exercise regimen that supports strengthening the pelvic floor muscles. Since the levator ani muscle often contributes to coccyx pain, these exercises can be key to your recovery.
- TENS: TENS stands for Transcutaneous Electrical Nerve Stimulator. During TENS, your device delivers a light electrical current that disrupts pain signals from the coccyx to the brain. This solution is ideal for pain management, but tends to wear off several hours after treatment.
When all else fails…
When all else fails, you may need to speak to a board-certified orthopedic surgeon about receiving a coccygectomy. During this minimally invasive procedure, your surgeon will make a tiny incision (< 2 inches) over the coccyx. Then, your doctor will remove the cartilage that wraps around and protects the coccyx (known as the periosteum). Your surgeon will then remove the entire coccyx, effectively silencing pain.
This procedure may be necessary for individuals with persistent pain from coccydynia, or individuals who have an underlying spine condition, such as a spinal tumor. To find out if you qualify for one of our minimally invasive treatments, contact our spine specialists at NJ Spine & Orthopedic today! Our award-winning doctors, like Dr. Douglas Slaughter, specialize coccygectomy and minimally invasive relief options for tailbone pain!