Coccygodynia: The tail bone pain and treatment options.

Coccyx is the bottom most part of the spine. It is a remnant of the tail that vanished during evolution of the humans from the apes. It consists of four or five small pieces of bone forming the lower most tip of the spine and it is attached to sacrum at the sacro-coccygeal joint.

Pain in the coccyx region is called coccygodynia. Coccygodynia can cause significant disturbance of lifestyle because it makes sitting painful. Sometimes it is very painful while getting up after sitting for a while. This pain may get aggravated while travelling, particularly in a two wheeler. Any position that causes pressure on the coccyx region will aggravate the pain. There is usually no pain while walking or bending or in lying down position.

Most common cause of coccygodynia is undue and repeated pressure on the coccyx due to bad sitting posture. The coccyx is not in a weight bearing position when the person is sitting upright but it becomes weight bering when the pelvis tilts backwards as when the person is sitting in a reclined position as seen in the picture.

The second most common cause is a fall in sitting position that leads to a direct impact on the coccyx and may also cause a fracture or dislocation of the coccyx. Coccyx pain is common in pregnancy and after child birth. Repetitive stress during activities like cycling or rowing can strain the coccygeal ligaments and cause pain.

Treatment involves use of a doughnut pillow while sitting, local physiotherapy and medications to control pain. Sitting in good posture is the most important aspect of the treatment. Exercises that involve stretching and relaxing of pelvic floor muscles and ligaments are an important part of the treatment.

Sitz bath with warm water once or twice a day helps alleviate the pain. Most of the times it gets better with these measures.

Local anaesthetic and steroid injections are used in some patients who do not get better with conservative measures. Radio-frequency ablation of the coccygeal ganglion is another effective option in chronic coccygodynia. Very rarely a surgical excision of the coccyx may be required.

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Dr Phani Kiran S

Experience and Professionalism

With years of experience in spine surgery, Dr Phani Kiran S, Senior Consultant Spine Surgeon will assess you and suggest the treatment option that is right for you.

We at Medspine clinics, understand the importance of educating all our patients about the spinal problems and the most effective ways to take care of their spine.