Tailbone pain occurs at the very bottom of your spine(coccyx), right above your buttocks. Tailbone pain induced by trauma to the coccyx during a fall, extended sitting on a hard or narrow surface, degenerative joint changes, or vaginal childbirth. The tailbone is small, but it does have a few important functions. It helps stabilize you when you sit. Additionally, many tendons, muscles, and ligaments run through the area.
We call pain in your coccyx coccydynia or coccygodynia. Pain from a bruised tailbone can range from mild to intense. Tailbone pain can feel dull and achy but typically becomes sharp during specific activities, such as when you sit down or stand up from a chair or when you lean back while sitting. You can likewise feel soreness when you use the bathroom or have sex.
Sometimes the pain can shoot all the way underneath your legs. Standing or walking should reduce the pressure on your tailbone and ease the pain. Women may feel pain in that area during their period.
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Tailbone Pain Symptoms
Tailbone pain is normally followed by other, more specific symptoms that can sometimes designate how pain is occurring. Coccydynia may be further described by one or a combination of the following symptoms:
Pain is usually confined to the tailbone and does not spread through the pelvis or to the lower extremities. Pain is normally described as an aching soreness and can fluctuate from mild to severe. Tightness or common discomfort around the tailbone may be permanent, or pain may come and go with movement or pressure.
Coccydynia is usually more intense when weight is distributed on the tailbone, as in when a person leans backward in a sitting position. Furthermore, sitting on hard surfaces without a cushion or leaning back against a wall puts added stress on the tailbone, making pain worsen.
During moving from a seated posture to standing or vice versa, the turn of the pelvic bones may be painful. It may be painful to stand or sit, requiring one to lean against something to provide better stability.
Some patients struggle with heightened pain throughout defecation or sexual intercourse, due to the proximity of the coccyx to the anus and genitals.
Tailbone Pain Causes
Coccydynia is typically caused by the following :
Hypermobility of the coccyx puts added stress on the joint within the sacrum and coccyx and on the coccyx itself. Too much movement can further pull the pelvic floor muscles that connect to the coccyx, causing tailbone and pelvic pain.
The poor mobility of the coccyx causes the tailbone to just outward during sitting and can put extended pressure on the bones and the sacrococcygeal joint. Poor coccyx movement may further result in pelvic floor muscle tension, adding to the discomfort.
In rare instances, part of the sacrococcygeal joint may become separated at the front or back of the tailbone, producing coccyx pain.
Tailbone Pain Diagnosis
Following a medical history, a physician will begin a physical exam. A careful physical examination for coccyx pain may include:
A physician will feel by hand to identify swelling and tenderness nearby the coccyx. Palpation may additionally be used to identify potential coccygeal spurs, cysts, or tumors.
In some instances, a physician may choose to manipulate the coccyx manually throughout the rectum, in order to estimate the limited or excessive mobility of the sacrococcygeal joint. Intrarectal manipulation may further be used to assess any muscle tension in the pelvis attaching to the coccyx.
While there is some debate over the effectiveness of imaging tests for diagnosing coccydynia, it is usually agreed that dynamic X-ray imaging is helpful. A dynamic X-ray provides two images—one of the patient sitting and another of the patient standing. A physician will compare the images and mark the angle of pelvic rotation as well as the coccyx’s change in position from sitting to standing. If these determinations are outside of the normal range (between 5 and 25 degrees), too much or too little coccygeal movement can be identified as the cause of pain.
A static image of the coccyx obtained by MRI or CT scan may be practiced if the suspected cause of pain is a fracture, tumor, or unusual mobility of the sacrococcygeal joint. Static images, though, are usually not helpful for diagnosing coccydynia and are employed sparingly when a source of coccydynia cannot be definitely identified using other means.
Tailbone Pain Treatment
Many studies find that non-surgical procedures are successful in roughly 90% of coccydynia cases. Treatments for coccydynia are normally noninvasive and include activity modification. The first line of approach typically includes self-care that can be done without the support of a medical professional, such, it might help to:
- Lean forward while sitting down
- Sit on a round-shaped pillow or wedge (V-shaped) cushion
- Apply ice or heat to the affected area
If your tailbone pain doesn’t improve, consult your physician. Your physician might recommend using magnetic resonance imaging (MRI) to find out if you possess a fracture, degenerative changes or, in rare instances, a tumor. Possible treatments for chronic tailbone pain might include:
A physical therapist might teach you how to do pelvic floor relaxation procedures, such as breathing deeply and completely relaxing your pelvic floor.
Massaging the muscles connected to the tailbone might assist ease the pain. Manipulation is typically done throughout the rectum.
Tail Bone Pain Medication.
An injection of a local anesthetic within the tailbone can reduce pain for a few weeks. Certain antidepressants medications might relieve tailbone pain as well. Take over-the-counter pain relievers, such as acetaminophen, ibuprofen or aspirin.
Tail Bone Pain Surgery
During a procedure known as a coccygectomy, the coccyx is surgically eliminated. This option is particularly recommended when all other treatments fail.