- Coccygodynia refers to the pain in or around the coccyx
- It is also known as tailbone pain
- It is more common in women than in men (5:1)
- Etiology: it can be post-traumatic or idiopathic.
- Discogenic disease (herniation)
- Degenerative spondylolysis or spondylolisthesis
- Lumbar spinal stenosis
- Sacroiliac joint dysfunction
- Anal fissures
- Inflammatory cysts
- Thrombosed hemorrhoids
- Chordoma (neoplasm)
- Plonidal cysts
- Trauma (fall, childbirth, anal intercourse)
- Nonunion fracture (sacrum, coccyx)
- Coccygeal disc injury (rare)
signs and symptoms
- Pain in the coccyx and adjacent regions (sacrum, gluteus, anorectum, perineum and urogenital system)
- What makes the pain worse?
- Passing gas
- Standing for long
- Bending or lifting
- Sexual intercourse
- Bowel movement
- Can be associated with defecation disorder (painful or incomplete defecation, constipation)
- A thorough patient history regarding trauma to the coccyx
- Pain reproduction during digital transrectal palpation and movement of the coccyx
- Radiographs of the coccyx in the standing and sitting positions
- Differential diagnosis should be done for the levator ani syndrome
- Conservative treatment is best for initial treatment. It includes analgesics and protection from painful sitting positions by sitting on a doughnut-shaped pillow to reduce pressure.
- Hot baths
- Physical therapy: Pelvic floor muscles relaxation exercises and pelvic massage
- If coccygodynia is persistent or chronic, removal of the coccyx can be performed
- Goodman CC, Snyder TK. Differential Diagnosis for Physical Therapists: Screening for Referral. 4th ed: Saunders Elsevier, St. Louis, MO; 2007.
- Nikolaos P. et al. Chronic Perineal pain: current pathophysiological aspects, diagnostic approaches and treatment. Europen Jounral of Gastroenterology & Hepatology. 2011, 23:2-7.
- Mazza et al. Anorectal and perineal pain: new pathophysiological hypothesis. Tech Protocol. 2004, 8:77-83.