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Coccyx Pain | Coccydynia

DEFINITION

The Coccyx bone is part of the pelvic floor. The coccyx ( tail bone ) can be a source of back and pelvic pain. Painful coccyx is called Coccydynia or Coccygodynia. Symptom of coccydynia is midline pain at the very end of the spine, triggered by sitting. Coccyx pain is often due to a backward fall and landing on the buttock, resulting in injury to the coccyx. Falling backward is common in active youth but can happen in any age. Other causes of coccyx pain include pregnancy, vaginal delivery of a large baby, aggressive bike rides (spin classes) and ligament laxity. The chanceof developing coccydynia is higher in skinny individuals and people with hooked coccyx (sharp angle). 

DIAGNOSIS

Clinicians rely on a detailed history, physical examination, and imaging and diagnostic injections to make such a diagnosis. In most cases imaging is done to determine any severe and alarming changes that may require surgical intervention, including fractures, tumors, large herniation and cord compression. These finding are uncommon but it is medically necessary to understand the anatomy in full detail before any invasive treatments including spinal injections or surgery. X-ray is the first test of choice and if physical therapy does not help the symptoms, then an MRI is indicated. An MRI may demonstrate degenerative changes in the facet joints, discs and soft tissues. Your clinician can correlate the findings on the MRI to your symptom presentation and examination.

NON-SURGICAL TREATMENT

Most patients get better if they spend 10 visits in a physical therapy program and combine this with NSAISDS (motrin, advil, naproxen). In some cases, muscle relaxants can help expedite improvement but they can be sedating. Correcting desk ergonomics and sleeping hygiene (firm memory foam pillow, sleeping surfaces) and observing a healthy balance between using electronic devices (Cell phones and tablets, Laptops) and intermittent breaks in between use can improve the symptoms in most cases. Another factor to consider is the use of headsets instead of traditional phone for individuals who spend more than 30 min a day on the phone. Acupuncture, Trigger point injections, chiropractic care and therapeutic soft tissue manipulation and message can be good adjunct treatments. If the combined treatments are not effective, minor procedures such as a coxxyc injection can decrease pain and improve quality of life.