Dr. Minal M. Shah

Coccydynia - Tailbone Pain: 

The back bone or spine is made of a series of bones extending all the way from the neck (cervical) to the tail (coccyx). These joints, like others, are prone to inflammation, sprain and strain, some more than the others. The coccyx in particular is highly prone to inflammation and can lead to localized pain, which is very typical, with the pain in the tailbone. This is known as coccydynia. 

What is coccydynia?

• Literally, coccydynia translates to tailbone pain.
• It is characterized by a sharp, localized pain between the buttocks in the tail bone.
• It is often caused by injury to the pelvic area or the tail bone.
• Sitting and/or leaning against the buttocks make it worse.
• Pregnancy, when the additional hormones relax on the pelvic floor, also leads to increased pain of the tailbone.

Diagnosis: 
The pain can be easily confused with other conditions like sciatica, fractured tailbone, tailbone infections like shingles, etc. However, for a trained medical person, the symptoms of tenderness and pain are quite diagnostic. Pilonidal sinus, fistula, pudendal neuralgia is also same as coccydynia and show same symptoms. 

Management:

• If there is a rash or inflammation, it needs to be evaluated further for additional problems.
• Where possible, rest completely for a short period of time till the acute phase of pain subsides.
• In case of injury, ensure there is no repeat injury to the same area.
• Pain medications are used to relieve pain, where it is severe and intolerable.
• In severe cases, cortisone injection may be given in the doctor s office. In addition to pain relief, it may even take care of the underlying problem per se.
• Avoid sitting for prolonged periods where possible.
• After the acute phase is over, when sitting for prolonged periods, sufficient padding is advised. This could be in the form of pillows or padded seats.
• Sleeping on the sides is difficult, so sleep straight. If required, take a pillow in the middle.
• Physiotherapy is also helpful in some people who have repeat attacks. This helps in pain management and controlling acute phases. There are specific tailbone stretches, which should be done under supervision.
• Walking is one of the many effective ways to keep the tailbone unlocked, which helps in getting rid of the pain and avoiding spasms of the muscles around the tailbone.
• Best internal manipulation and pain management can be done with coccyx exercise.
• The time taken for healing of the tailbone depends on whether it is a simple bruise or a severe one. The former would heal completely in about four weeks, while the latter will take about 12 weeks.