What is coccydynia (tailbone pain)?
Coccydynia is pain in or around the area of the coccyx, also called the tailbone.
What causes coccydynia (tailbone pain)?
Most often, the cause of coccydynia is unknown (idiopathic). Other causes include:
- Trauma (for example, from falls and childbirth)
- Abnormal, excessive mobility of the tailbone
- Infection, tumor, or fracture (very rare)
What are the symptoms of coccydynia (tailbone pain)?
The classic symptom is pain when pressure is applied to the tailbone, such as when sitting on a hard chair. Symptoms usually improve when pressure is relieved when standing or walking.
Other symptoms include:
- Immediate and severe pain when moving from sitting to standing position
- Pain during bowel movements
- Pain during sex
- Deep ache in the region of the tailbone
You might also be suffering from depression and anxiety, especially if you have had the pain for a long period of time.
Diagnosis and Tests
How is coccydynia (tailbone pain) diagnosed?
A thorough medical history and physical exam are very important. The doctor will want to know if you have had any particular injury, whether recent or in the remote past, or if you’ve ever had prolonged labor or an injury while giving birth.
The doctor will also inspect and feel this area to find any unusual masses or abscesses (infections). A lateral X-ray of the coccyx is taken to help find any significant coccygeal problem, such as a fracture.
Your health care provider might order more sophisticated tests such as CT scan, magnetic resonance imaging (MRI), or a bone scan of this area if he or she feels that it is necessary.
Management and Treatment
How is coccydynia (tailbone pain) treated?
Treatment usually consists of non-steroidal anti-inflammatory drugs (NSAIDs) -- such as ibuprofen and naproxen -- to reduce inflammation (swelling), and the use of a therapeutic sitting cushion to take the pressure off the tailbone when sitting. It might take many weeks or months of conservative treatment before there is major pain relief.
Other possible treatments for coccydynia include the following:
- Your doctor might refer you to a biomedical engineer to be measured for a customized seating cushion. This cushion provides an "open area" in the surface that shifts the weight off the tailbone to promote healing.
- Your health care provider might also consider physical therapy. This could include exercise to stretch the ligaments -- the tissue that connects bone to bone in a joint -- and strengthen the supporting muscles.
- Treatments such as heat, massage, and ultrasound might also be used.
- Coccygeal manipulation is used to move the coccyx back into its proper position and relieve pain.
- Coccygectomy (surgery to remove the coccyx) is considered in rare and very severe cases only, when extensive conservative management does not control the pain. The main risks of surgery are infection and wound-healing problems. There is also a significant risk that the surgery will not bring pain relief.
- Depression and anxiety should be aggressively treated.
- A multidisciplinary chronic pain rehabilitation program might be offered in some instances.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition.
This document was last reviewed on: 07/22/2014