Causes of Tailbone Bone
Tailbone pain can be caused by various factors, including:
Trauma: Direct injury to the tailbone or ligaments surrounding the coccyx. Examples include slipping on ice or falling from the stairs and landing in a seated position.
Anatomical Changes: Conditions that result in changes to the positioning of your tailbone including sports such as bicycling that require repetitive leaning forward and back resulting in strain. Pregnancy hormones, particularly in the 3rd trimester, increase the ligamentous laxity of the tailbone in preparation for childbirth.
Pathologic: Space occupying lesions such as localized or metastatic tumors including chordoma or prostate cancer. Degenerative arthritis resulting in bone spurs near the tailbone.
Symptoms of Tailbone Bone
You may not have any symptoms. However, if you do, the symptoms may gradually develop and worsen over time. The common symptoms of tailbone pain are mild to intense pain that is aggravated while sitting. Other symptoms include:
- Pain in the tailbone area while reclining, due to the increased weight placed on the tailbone
- Pain when transitioning from a seated to a standing position
- Discomfort while defecating or during sexual intercourse
Impact of Tailbone Pain
Tailbone pain can lead to several conditions:
- Chronic Pain Syndrome: A condition in which pain persists beyond the expected time of healing or resolution of the underlying injury; typically 3-6 months despite appropriate medical therapy.
- Pelvic Floor Dysfunction: A condition where the muscles and ligaments which make up the pelvic floor do not function properly, leading to symptoms such as pelvic pain, urinary or fecal incontinence, and discomfort during sexual activity.
Diagnosis of Tailbone Bone
Diagnosing tailbone pain typically involves:
Medical History: Discussion of symptoms, past medical conditions, and any history of trauma to the tailbone area.
Physical Examination: Assessment of reflexes, muscle strength, and sensation.
Diagnostic Imaging: X-rays to assess for possible fractures, CT scans, MRI scans, or bone scans to visualize coccygeal structures and detect inflammation or tumors resulting in tailbone pain.
Prognosis of Tailbone Pain
The prognosis of coccydynia, is generally favorable with conservative treatments such as avoiding prolonged sitting, using cushions, and physical therapy. Most cases improve over time without the need for invasive interventions, although some individuals may experience chronic or recurring symptoms requiring ongoing management.1
Treatment of Tailbone Pain
Treatment options include:
Conservative Treatments: Non-surgical approaches include:
Medications: Such as nonsteroidal anti-inflammatory drugs (NSAIDs) or muscle relaxants for pain management. Stool softeners if you are having pain with defecation.
Physical Therapy: Exercises to strengthen pelvic and lumbar muscles and improve range of motion.
Off-Loading Pillows: Utilization of “donut pillow” or “wedge-shaped gel cushion” to decrease pressure off of the tailbone.
Nerve Block Procedure (Ganglion Impar Nerve Block): Targeted nerve block procedure to the coccygeal nerve that helps to relieve chronic pain.
Acupuncture or Chiropractic Care: Some patients find relief through alternative therapies.
Surgical Intervention: When conservative measures are ineffective or symptoms worsen, surgery may be considered in extremely rare circumstances:
Partial or Total Coccygectomy: Surgical removal of either part of or complete removal of the coccyx.
Procedure Videos
Caudal Epidural Steroid Injection
Ganglion Impar Block
References
- Lirette, L. S., Chaiban, G., Tolba, R., & Eissa, H. (2014). Coccydynia: an overview of the anatomy, etiology, and treatment of coccyx pain. Ochsner journal, 14(1), 84–87.
- Foye P. Coccydynia. In: UpToDate, Connor RF (Ed), Wolters Kluwer. (Accessed on July 20, 2024.)