Coccydynia, otherwise known as tailbone pain is something that can present in my office. A fall on the stairs, slip on ice, or prolonged sitting can cause pain in the lowest part of the spine called the coccyx or tailbone. The pain is likely to be localized pain at the very bottom of the spine. It is often described as a dull ache or bruise that ranges from mild to severe but may become sharp with certain activities. While it doesn't usually cause radiating pain into the legs, it can cause soreness in the low back, pelvis, or groin. Difficulty going to the bathroom and inability to sit comfortably are common presentations. Tailbone pain may resolve on its own in some cases, however, if pain persists for more than 2 weeks I would recommend seeing a specialist.
Chiropractic treatment for tailbone pain consists of a detailed history, physical examination, and X-rays if necessary. Treatment then involves specific palpation to the spine, sacrum, and tailbone. If a misalignment is present a chiropractic adjustment will be performed. A chiropractic adjustment restores optimal joint alignment, neurological function, and muscle function caused by stress or trauma. In addition, we typically include soft tissue work using the Arthrostim which alleviates optimal muscle spasms and improves circulation to muscle knots and trigger points. Chiropractic care for tailbone pain is usually not painful however some temporary soreness may occur. Pain may be relieved after only a few sessions. Home care for tailbone pain includes ice, rest, soft cushion, donut pillow, postural corrections, and pain medication as needed.
The most common causes of tailbone pain are:
Trauma or Injury - A direct blow to this area is the most common cause of tailbone pain and is when the tailbone hit with a direct force. This acute injury causes a sudden increase in inflammation on the joints of the spine and surrounding soft tissue.
Repetitive stress - Another common cause of tailbone pain is repetitive stress from prolonged sitting. Women are more likely to suffer from this due to the angle of the pelvic bones. In men, the pelvis is positioned more upright so the weight distributed while sitting is more on the ischial tuberosities rather than the coccyx. In women, the pelvis is angled outward slightly so when sitting the weight is distributed between the coccyx and the ischial tuberosities causing more inflammation and injury to the tailbone.
Referred pain - Within the lower part of the spine, there are spinal nerves. When these nerves are pinched, irritated, or compressed they can transmit pain signals to other parts of the body. Nerves are coming from the spine that controls the skin, muscles, and joints in the tailbone area. This is called referred pain. It is pain that is elicited from somewhere else in the body such as a herniated disc or degenerative disc disease.
Childbirth - Giving birth can cause tailbone pain due to the baby passing through the birth canal which is very close to the tailbone. In most cases, tailbone pain will improve with rest and ice. Rarely, the coccyx will fracture with too much pressure.
Infections or Cysts - In rare cases, pain in the tailbone area is due to an infected ingrown hair. This results in an abscess formation and a pilonidal cyst which is almost always found on the tailbone. Tarlov cysts are also commonly located in the sacrum and tailbone area. Fortunately, these types of cysts rarely cause symptoms or need any treatment however they can be large enough to compress spinal nerves which may induce pain. Removal of the cyst may be necessary in these cases.
Tumor - Rarely tailbone pain is caused by a nearby tumor. Spinal tumors are usually associated with other symptoms such as weight loss/gain, fever, chills, nausea, vomiting, and pain that doesn't improve with rest.
From the desk of Dr. Lisette Miller Kondrad. Dr. Miller is a licensed Chiropractic Physician and Board Certified Acupuncture Provider who has been in clinical practice for over 7 years. She has helped hundreds of patients through chiropractic care and acupuncture. Click here to contact Clark Road Chiropractic Center with any questions or to schedule your appointment!