The coccyx (KAHK-siks), or tailbone, is the bony structure at the bottom of the spine. In humans, it’s the bud of an undeveloped tail, which we lost the need for long ago. The coccyx comprises three to five separate but fused small bones. The coccyx functions as a kind of hub where muscles, ligaments and tendons of the lower back and pelvic region attach. It plays a part in supporting the body’s weight when standing and sitting.
Coccyx pain, or tailbone pain, is a common complaint. The medical term for coccyx pain is coccydynia (kahks-si-DEYE-nee-ah) or sometimes coccygodynia (kahks-si-go-DEYE-nee-ah). Coccydynia is a general term that describes a range of symptoms from mild tenderness to intense pain. The term also describes a set of conditions from different causes requiring different treatments. Coccyx pain is five times more common in women than in men because of the structure of the female pelvis.
The most common cause of tailbone pain is trauma or injury to the tailbone. Falls resulting in fracture, dislocation or bruising; pregnancy and childbirth; pelvic or back surgery; and extensive sitting on hard or narrow surfaces contribute to tailbone pain. In some cases, an unstable, overly mobile tailbone (a genetic condition) creates pain. Many times the source of tailbone pain is unknown. The pain can appear suddenly and then disappear without treatment. Some conditions-infections, sciatica, fractures in the back-can mimic coccydynia.
Since coccydynia describes coccyx pain, the most common symptom of this disorder is, naturally enough, pain. But coccyx pain has various characteristics and appears at different times and in multiple sites. Coccyx pain can come on suddenly or gradually, be short-lived or chronic and strike the sufferer as mild or excruciating. The pain can appear when a person sits for a long period or when a person moves from sitting to standing. Sitting usually makes coccyx pain worse. It can be felt as a dull ache all around the coccyx or shooting pains down the legs. Sufferers have described coccyx pain as like sitting on a knife or a marble that is rolling around. Coccydynia can also lead to painful bowel movements and painful intercourse.
Coccyx pain can also develop into to secondary symptoms. If the pain is persistent, many patients also suffer from depression, sore feet from too much standing, a sore back from sitting in awkward positions and lack of sleep leading to exhaustion.
A correct diagnosis of tailbone pain is essential for doctors to determine the best treatment. As mentioned earlier, some other conditions mimic tailbone pain. To arrive at a diagnosis, doctors ask for an in-depth medical history to learn of any past trauma to the tailbone. They also conduct a thorough physical exam that includes palpation, that is, feeling the affected area to detect any abnormalities or soreness. In some cases, X-rays or CT scans or even bone scans may be ordered.
Home treatment for tailbone pain includes avoiding prolonged sitting, sitting on cushions and taking nonsteroidal anti-inflammatory medicines such as Advil, Excedrin IB and Motrin. Doctors sometimes prescribe even stronger medications. Clinical treatment includes physical therapy. A small number of physical therapy specialists have developed techniques for working on tight muscles and other structures and for breaking down painful scar tissue in the area of the coccyx. Most doctors recommend surgery for tailbone pain only as a last resort.