[slideshow]Painful Tailbone! OUCH! What Treatment Options are Available for Coccydynia?
I have a patient who fell on her buttock while walking down the stairs. Immediately, she felt a sharp and bruising pain in the buttock. The next day she went to her family doctor who explained that her tailbone was inflamed – he called this condition coccydynia NOT tax pain (for those that have seen the H&R block commercials). She asked me what treatment methods would help her coccydynia. She explained that she wanted to not only decrease pain, but also fix the problem.
Before we discuss treatment options for coccydynia, let us discuss the anatomy/location of the tailbone.
Where is the Tailbone Located Anatomically?
The tailbone is located in the lower buttock. Follow your spine all the way down and it is the final segment in the vertebral column. Interestingly, the coccyx is a remnant tail! The coccyx is usually formed of four rudimentary vertebrae (sometimes five or three). It articulates above with the sacrum. Here is a picture of the coccyx attached to the sacrum above.
What is Coccydynia?
Coccydynia is associated with pain and tenderness at the tip of the tailbone – between the buttocks. The pain is often worsened by sitting on a hard surface. Symptoms include:
- Pain that is worse when sitting
- Local pain in the tailbone area that is worse when touched or when any pressure is placed on it
- Pain that is worse when moving from a sitting to standing position
- Pain that is worse with constipation and feels better after a bowel movement
What causes Coccydynia?
Coccydynia can be caused by various factors. For instance, coccydynia is often caused by an injury (fall on ice or on a hard surface), but it may occur seemingly spontaneously. Conditions which mimic coccydynia, include sciatica, infection, cysts, and fractured bones. When the tailbone does break due to trauma such as a fall, it usually protrudes forward towards the front of the body – thus causing much discomfort.
How is Coccydynia Treated?
Patients with coccydynia are advised to use a well-padded seat when sitting and avoid long periods of sitting.
Furthermore, the following treatment methods can help. Rest, avoiding re-injury to the affected area, using an anti-inflammation cream and/or pain medications can help to relieve symptoms. Some patients with persistent coccydynia are treated with local cortisone injection. Rarely, when patients have unrelenting pain, a surgical resection of the coccyx can be performed to remove the irritated bony prominence.
Now let’s get back to my patient…
Amazingly, acupuncture helped my patient! Four treatments of acupuncture and the pain was completely resolved. The treatments were provided every other day and lasted approximately 30 minutes each. The acupuncture needles were inserted around the sacrum on both sides. Electrical stimulation was added to the surrounding area. Furthermore, ice therapy also helps to reduce pain, swelling and inflammation in the area. Laser therapy is also a treatment modality in which I have had success with. Laser therapy has been known to assist in soft tissue healing.
All in all, coccydynia is poorly understand. It is not too common, however, does occur. Over the last few years, I have seen about eight to ten patients with this particular condition. 100% of these individuals fell on their buttock and immediately felt the buttock pain. If you are unsure if you have this condition, make sure you go see your health practitioner.
MEDICAL DISCLAIMER: The following information is my personal notes about this subject matter. It is intended for informational purposes only. Consult a health practitioner to help you diagnose and treat injuries of any kind.
Dr. Luciano Di Loreto, HBSc., DC
Chiropractor in Woodbridge, Ontario