Tailbone pain, also known as coccydynia, affects millions of people and has numerous causes. Most tailbone pain should be temporary and goes away on its own, but some cases can be chronic. Usually, tailbone pain is the result of any injury, such as a fracture or dislocation. Many treatment and pain management options are available.
Anatomy of the Tailbone
The tailbone lies at the end of the spine, under the pelvis. Three to five vertebrae make up the tailbone. These vertebrae might be fused together. The tailbone serves as the anchor for several important muscles, ligaments and tendons. It is also a main source of support for the spine when seated. Because of its position, the tailbone is susceptible to injury from falls and overuse.
Causes of Tailbone Pain
The most common cause of tailbone pain comes from an injury. Falling backward onto the tailbone is the most common cause. Falling onto the tailbone can result in a fracture, dislocation or bone bruise. Another common cause of tailbone injury is childbirth; the tailbone can become dislocated or compressed when the baby passes through the birth canal. For this reason, and because the shape of the female pelvis leaves the tailbone more exposed, the majority of tailbone pain sufferers tend to be women. Other causes of pain include repeated pressure put on the tailbone, such as from cycling, motorcycle riding, horseback riding or rowing; tumours; infection; bone spurs; compression of nerves; and referred pain from injuries elsewhere in the spine.
Characteristics of Tailbone Pain
Tailbone pain can be considerable. Tailbone pain caused by an injury might be described as grinding, burning or stabbing. Sitting down, especially for prolonged periods, can cause extreme discomfort. Sometimes, even walking can be painful. Tailbone pain sufferers might feel the need to shift a lot while sitting to take the weight off the tailbone. Sometimes, a painful tailbone can make having a bowel movement difficult, and some women experience tailbone pain during sexual intercourse. Most cases of tailbone pain end by themselves after the injury heals. But some people experience chronic pain, which must managed.
Diagnosis of a tailbone injury usually involves an X-ray. This will generally reveal any dislocation or fracture. If an X-ray doesn't work, a doctor might perform a rectal exam to feel for a fracture or dislocation. Bone spurs will be revealed by an X-ray and can be felt through the skin. Occasionally, an injection of local anesthetic might be necessary to see whether the tailbone is causing the pain. In cases where the pain is not caused by traumatic injury, a doctor might perform tests to see whether a tumour is present.
Tailbone pain can be inconvenient and sometimes debilitating. Many people with injured tailbones benefit from special cushions. While doughnut-shaped cushions, with a hole in the centre, are traditionally associated with tailbone injury, many coccydynia sufferers get little relief from these. Instead, cushions with a cutout at the back have been found to be beneficial. These take the pressure off the tailbone when seated. Icing might be effective at relieving tailbone pain, especially if there's swelling. Simply shifting while sitting can help by taking the weight off the tailbone and putting it on one buttock. Some people with tailbones that are prone to dislocation benefit from manual manipulation by chiropractors.
For considerable chronic tailbone pain, medical treatment might be necessary. Local anti-inflammatory injections can be given. In extreme cases, removal of the tailbone, called coccygectomy, might be done. In this procedure, the tailbone is removed in the hopes of ending the pain. Although this isn't considered major surgery and is often performed under local anesthetic, recovery time can be considerable and involves of a good deal of pain when sitting. Because of the pain and inconvenience involved in the healing process, coccygectomy should be a last resort and available only to patients considered good candidates for surgery.