Coccydynia (Tailbone Pain)

Coccydynia, commonly called tailbone pain or coccyx pain, is a fairly rare and relatively poorly understood condition that can cause persistent pain at the very bottom of the spine. This part of the spine is the coccyx, or tailbone. Coccydynia is felt as a localized pain and will generally feel worse when sitting or with any activity that puts pressure on the bottom area of the spine.

The condition is much more common in women than men. It is usually caused by local trauma (e.g. a fall) or giving birth. On rare occasions, an infection or tumor can also cause pain in the coccyx.

Coccydynia Terminology: Tailbone Pain, Coccyx Pain...

Coccydynia may be referred to in various terms, such as:

  • Coccygodynia
  • Coccygeal pain
  • Coccyx pain
  • Coccyaglia
  • Tailbone pain

The various terms are all used to describe a set of symptoms in the tailbone that can be caused by various injuries or conditions. Treatment may vary depending on the underlying cause of the symptoms and the severity and duration of the symptoms.

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Coccydynia Symptoms and Treatments

Coccydynia symptoms may consist of one or all of the following:

  • Pain that is markedly 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.

A combination of treatments to reduce the pain and activity modification to keep pressure off the tailbone usually suffices to control or alleviate the pain. In very rare cases, surgery to remove the coccyx may be recommended, but the surgery (a coccygectomy) will typically only be considered if the pain is severe and at least several months of non-surgical treatment and activity modification has not been effective in relieving the pain.

This article provides an in-depth review of the causes of coccydynia, diagnosis, and both nonsurgical and surgical treatment options.

History of Coccyx Pain

Coccydynia has a long history of being poorly understood. In the early 1900s, coccydynia was a popular diagnosis for all types of lower back pain. A fairly extreme treatment, the surgical removal of the coccyx (coccygectomy), was commonly undertaken to treat low back pain. At best, this operation had variable results.

Then the pendulum swung the other way, and the general opinion was that since the condition was mostly in women it was in some way related to "neurosis." The corollary was that if the operation did not work, it was because the pain was in the individual’s head; therefore the operation fell into disrepute and was no longer commonly performed. Subsequently, little research on the subject has been done.

Both extremes of opinion have long since fallen by the wayside, and it is now known that coccydynia does exist as a medical condition. However, it is fairly uncommon.