Coccydynia is Tailbone Pain

Tailbone pain originates in the coccyx located at the bottom of the spine's sacrum.

Written by Stewart G. Eidelson, MD

Coccydynia is the medical term for tailbone pain. The tailbone, the coccyx is made up of 5 small bones below the spine's sacrum that are tail-like in appearance.

Causes of Coccydynia

There is no definitive cause for coccydynia. However, trauma from falling or being bumped, repetitive action (extensive bike riding or rowing), or childbirth can cause tailbone pain. Aside from an injury, coccydynia can appear to be spontaneous.

Tailbone pain and lower back pain can mimic coccydynia in sciatica, infection, pilonidal cysts, and fractured bone. Your doctor will rule out these causes to make a coccydynia diagnosis.

Exams and Tests

The symptoms and examination findings of localized pain is typically all the doctor needs to diagnose coccydynia. If there is any question about the condition, the doctor can order a CT scan or MRI. Those tests are used to exclude bone or tissue disorders, such as a tumor.

Non-Surgical Treatment

Coccydynia usually is initially treated with non-invasive methods.

If pain is persistent, anti-inflammatory and pain medications can help reduce the lower back and coccyx pain. Should the medication be insufficient, the doctor can administer a local cortisone injection. Local nerve blocks also can be beneficial, especially when fluoroscopic guidance (similar to real time x-ray) is used. For patients with recurrent, persistently troublesome tailbone pain, the injection can provide quick, thorough, and sometimes lasting relief; for some patients, the injection completely resolves the symptoms.

Surgical Treatment

In rare cases, the surgeon can perform a coccygectomy, or removal of the tailbone. The surgery can increase the risk of a perineal hernia (weakened pelvic muscles supporting the rectum) later in life, but otherwise is considered effective and relatively low risk.

Protect Your Tailbone

There is no definitive way to prevent coccydynia, but general caution while taking part in certain sports (eg, skating [ice, inline, and roller], biking, and horseback riding) and careful footing in icy conditions can help minimize your risk for tailbone pain.

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