Pain in the Tailbone (Coccydynia)
Pain In The Tailbone: Coccydynia
Pain in the tailbone or in the coccyx is known as coccydynia. Your coccyx is the bone that is located at the very bottom of your spine. It is slightly curved, small and is shaped like a "V."
Coccydynia has a long history of being misjudged. In the mid-1900s, coccydynia was a mainstream determination for a wide range of lower back pain. A genuinely extraordinary treatment, the surgical removal of the coccyx (coccygectomy), was ordinarily embraced to treat low back pain. Best case scenario, this operation had variable outcomes.
General supposition at that point changed totally, and it was frequently proposed that since the condition, for the most part, influenced ladies, it was somehow identified with "mental issues." The suspicion was that if the operation did not work, it was on the grounds that the pain was mental in the source.
Specialists that have measured the viability of psychotherapy as the treatment for coccydynia have discovered little success, and reason that coccydynia exists as a therapeutic condition.
Other terms for pain in the tailbone include:
- Coccyx pain
- Tailbone pain
- Coccyaglia
- Coccygeal pain
- Coccygodynia
Prevalence
Pain in the tailbone is not very common, but there is no specific data pointing to the exact prevalence and incidence of the disorder. Approximately one out of every 100 cases of lower back pain is thought to be the result of pain in the tailbone.
Coccydynia occurs to men as well as to women, but women are up to five times more likely to develop pain in the tailbone than men. One risk factor for coccydynia that is gender-specific is the trauma related to childbirth. Substantial pressure may be exerted on the coccyx as a baby passes through the pelvis during the birthing process.
People of all ages can be affected by coccydynia, including children, but older adults are the most likely age group to develop pain in the tailbone. This seems to be due to the fact that degenerative changes and fusion of the sacrococcygeal and Intra coccygeal junctions increases with age.
Reasons for Pain in the Tailbone
Coccydynia can be caused by stress or injury affecting the tailbone or the nerves or muscles that surround it. Possible causes of pain in the tailbone include:
- Strain or pressure, such as what occurs during childbirth
- A fall or other trauma
- Spinal tumor or cyst
- Shifting or dislocation of the bones due to injury or obesity
- Repetitive stress (such as bicycle riding, motorcycle riding or horseback riding)
In up to one-third of the cases of coccydynia, no apparent cause for the pain in the tailbone is found. It is believed that age-related degeneration or "wear and tear" may be partly responsible.
A conclusion of coccydynia will more often than not recognize one of the accompanying hidden reasons for torment:
- Injury. Immediate damage to the coccyx is presumably the most widely recognized reason for coccydynia. A fall on the tailbone can kindle the muscles and harm the coccyx or the coccygeal connection to the sacrum. Coccygeal injury, for the most part, brings about a wounded bone, however, may likewise bring about a crack or disconnection either in the front or back of the coccyx.
- Anxiety. Exercises that put direct pressure on the tailbone, for example, horseback riding and sitting on hard surfaces for stretches of time, may cause the beginning of coccyx pain. Tailbone pain from these causes, as a rule, is not changeless, but rather if aggravation and side effects are not dealt with, the pain may wind up plainly ceaseless and cause long-term modified versatility of the sacrococcygeal joint.
- Labor. Amid conveyance, the infant's head disregards the highest point of the coccyx, and the weight against the coccyx can result in damage to the coccygeal structures (the disc, tendons, and bones). While unprecedented, the weight can likewise cause a fracture in the coccyx.
- Tumor or disease. Once in a while, coccydynia can be caused by an adjacent tumor or contamination that puts weight or pressure on the coccyx.
- Referred coccyx pain. In uncommon cases, the pain will be diverted to the coccyx from somewhere else in the spine or pelvis, for example, a lumbar herniated disc or degenerative lumbar plate.
Risk Factors
You may have a greater chance of developing coccydynia if you have the following risk factors for the condition:
- Sex: Pain in the tailbone is more prevalent in females.
- Other medical conditions: Having a history of other medical problems like osteoporosis (brittle bones), arthritis and low back pain increases your risk of coccydynia.
- Certain hobbies and habits: Participating in certain activities like bicycle riding, riding motorcycles and riding horses increases your risk of pain in the tailbone
- Obesity: People who are overweight are at greater risk for coccydynia
- Infections: Having certain infections like osteomyelitis and tuberculosis increases your risk of pain in the tailbone
- Sitting on hard surfaces for extended periods: This causes increased stress on the coccyx and nearby structures, increasing your chances of developing coccydynia
Complications
Coccydynia-related side effects, for the most part, don't bring about difficulties. In any case, surgical treatment for coccydynia (coccygectomy) has a high rate of postoperative disease and can bring about damage to the rectal musculature that may advance to fecal inconsistency. Surgical harm to the coccyx can bring about the removal of the pelvic floor.
Tailbone Pain: Symptoms
The most obvious symptom of coccydynia is the pain with any kind of pressure on the tailbone. People who have tailbone pain symptoms find it very difficult to sit down on a firm surface. The pain is usually relieved when the pressure is removed.
Other tailbone pain symptoms might include:
- Pain when changing positions from sitting to standing up
- Pain with bowel movements
- Pain during sexual intercourse
- A deep, aching sensation in the tailbone area
Tailbone pain is typically joined by other, more particular tailbone pain symptoms that can some of the time show how pain is happening. Coccydynia might be additionally described by one or a mix of the accompanying tailbone pain symptoms:
- Restricted pain and fragility. Pain is, for the most part, kept to the tailbone, and does not transmit through the pelvis or to the lower furthest points. It is normally portrayed as a hurting soreness and can run from mellow to serious. Snugness or general uneasiness around the tailbone might be steady, or pain may travel every way with development or weight.
- Expanded pain with sitting. Coccydynia is more serious when pressure is put on the tailbone, as in when a man reclines in a sitting position. Moreover, sitting on hard surfaces without a pad, (for example, a wooden or metal seat) or reclining against a divider put included pressure on the tailbone, making pain exacerbate. This is one of the most common tailbone pain symptoms.
- Pain that is more regrettable while moving from sitting to standing. While moving from a situated position to standing or the other way around, the movement of the pelvic bones (and muscle developments that help this turn) might be difficult. It might be hard to stand or sit, expecting one to incline toward a more solid position.
- Pain that may increment with solid discharge or sex. A few patients encounter increased pain amid bowel movement or sex, because of the closeness of the coccyx to the buttocks and genitals.
Diagnostic procedures
Coccydynia is not a life-threatening condition but it can be very painful and also debilitating. It's important to visit your doctor to find out what is causing tailbone pain symptoms.
Your physician will ask you questions to determine if there is anything in your medical history that might be relevant to your tailbone pain symptoms. A physical examination will help your doctor see or feel if there are any signs of infection or abnormal tissues in the area that could be causing tailbone pain symptoms.
X-rays are the most common type of imaging test used in diagnosing tailbone pain symptoms. If your doctor needs more detailed images of your spine or other tissues, more sophisticated tests might be recommended such as magnetic resonance imaging (MRI), computerized tomography (CT) scans or bone scans.
Diagnostic tests are typically not required for tailbone pain symptoms. Sometimes of serious, tenacious agony, a demonstrative test might be utilized to decide how torment is being caused and how it can best be reduced. Demonstrative tests for coccydynia may include:
- Dynamic X-ray imaging tests. While there is some civil argument over the viability of imaging tests for diagnosing coccydynia, it is, for the most part, concurred that dynamic x-ray imaging is useful. A dynamic X-ray produces two pictures—one of the patient sitting and one more of the patient standing. A specialist will review the scans and measure the range of pelvic rotation and also the coccyx's adjustment in position from sitting to standing. On the off chance that these estimations are outside of the ordinary range (in the vicinity of 5 and 25 degrees), excessively or too minimal coccygeal development can be recognized as the reason for pain.
- Coccygeal discogram. Like a similar technique done on the lumbar spine, a coccygeal discogram comprises an infusion of neighborhood anesthesia in the sacrococcygeal locale. The infusion focuses on a particular territory in the spine, for example, an intervertebral joint or circle, to recognize the exact area where torment is being caused.
- CT or MRI checks. A static picture of the coccyx taken by MRI or CT examine (one that does not represent pelvic revolution or development) might be utilized if the associated cause with torment is a fracture, tumor, or unusual versatility of the sacrococcygeal joint. Static pictures, be that as it may, are typically not accommodating for diagnosing coccydynia and are utilized sparingly when a variation of coccydynia can't be obviously determined to utilize different means.
In uncommon cases, routine blood tests are conducted to discount the likelihood of a disease or tumor. A specialist may likewise arrange a guaiac stool test to decide whether the issue has its source in the gastrointestinal tract.
Tailbone Pain: Treatment and Care
Nonsurgical Treatment
Tailbone pain treatment is usually done conservatively. Non-invasive tailbone pain treatment like the following can help provide relief from tailbone pain:
- Sitting only on surfaces that provide padding and cushioning for the coccyx
- Avoid episodes of prolonged sitting, such as airline flights or long events and programs which can increase the pain of coccydynia
- Adequate rest is important in helping to avoid re-injury of the coccyx and a good tailbone pain treatment
- Medications such as non-steroidal anti-inflammatory drugs (NSAIDs) are recommended in some cases of persistent coccydynia. Medications like naproxen and ibuprofen help to decrease inflammation and serve as tailbone pain treatment. If these are not effective, the doctor may suggest the administration of a local nerve block. This is an injection of a steroid under fluoroscopic guidance directly into the irritated nerve that is causing coccydynia. For patients who have severe or recurrent tailbone pain, these injections can sometimes provide immediate and long-lasting relief and be a tailbone pain treatment.
In the event that tailbone pain is industrious or serious, extra non-surgical tailbone pain treatment choices for coccydynia may include:
- Injection. An infusion of a desensitizing specialist (lidocaine) and steroid (to diminish irritation) in the territory encompassing the coccyx may give pain help. The doctor utilizes imaging direction to guarantee that the infusion is managed to the right range. Pain alleviation can last 1 week or longer. On the off chance that the principal infusion is viable, patients may get up to 3 infusions in a year.
- Manual control. A few patients discover pain alleviation through manual control of the coccyx. Through manual control, the joint between the sacrum and the coccyx can be balanced, conceivably diminishing pain caused by insufficient coccyx portability.
- Back massage. Coccydynia might be lessened or lightened by rubbing tense pelvic muscles that append to the coccyx. Tense muscles in this district can put included strain the tendons and sacrococcygeal joint, constraining its versatility or pulling on the coccyx.
- Extending. Delicately extending the tendons joined to the coccyx can be useful in diminishing muscle pressure in the coccygeal zone. A physical specialist, chiropractor, physiatrist, or other fittingly prepared human services professional can give a guideline on proper extends to easing coccyx pain.
- TENS unit. Transcutaneous Electrical Nerve Stimulator (TENS) units apply electric incitement that meddles with the transmission of pain signals from the coccyx to the mind. These devices can be an excellent alternative for patients who wish to keep their intake of pharmaceuticals to a minimum. There are numerous assortments of TENS units, with some utilizing high-recurrence signals that are worn for brief time frames, and others utilizing low-recurrence signals that might be worn longer.
Subsequent to achieving adequate pain help so development is better endured, every day low-affecting oxygen-consuming action is advantageous, as the expanded blood stream conveys supplements to the range and supports the body's characteristic recuperating capacities. An extra advantage of vigorous action is the arrival of endorphins, the body's intrinsic pain assuaging chemicals.
On the off chance that non-surgical medicines or pain administration techniques are viable, delayed utilization of these strategies is a sensible treatment alternative. In uncommon cases, a patient's pain does not react to non-surgical medications and surgery on the coccyx might be considered.
Surgical Treatment
Rarely, surgery is performed for coccydynia. In a coccygectomy, the tailbone is removed. This tailbone pain treatment is considered to be a low-risk procedure and is usually effective for tailbone pain, but it can increase the chance of a perineal hernia occurring later in life.
Specialists may adopt marginally unique strategies to the tailbone pain treatment. Maybe the greatest distinction between specialists is that some expel just a piece of the coccyx, while others suggest removing the whole coccyx.
All in all, the tailbone pain treatment surgery includes the accompanying strides:
- A one to two-inch entry point is made over the highest point of the coccyx, which is found directly under the skin and subcutaneous fat tissue. There are no muscles to dismember.
- The defensive ligament over the bone (the periosteum) is removed from the bone beginning on the back and bore the front.
- The coccyx is then removed. It might get a biopsy if a tumor is suspected.
The operation takes around thirty minutes to perform and should be possible on an outpatient premise. The most troublesome piece of the operation is the long recuperating process. By and large, it takes 3 to 12 months after the tailbone pain treatment surgery before patients see any help from their side effects, and sitting is troublesome all through the recuperating procedure.
Useful Advice
Protect Your Tailbone
While there is no way to prevent all cases of coccydynia, taking some precautions can help reduce your risk. Use extra caution when participating in ice skating, rollerblading and roller skating. When you are bicycling, riding a motorcycle or horseback riding, take frequent breaks to allow your nerves and tissues time to rest to avoid the pain of coccydynia. Always be careful to avoid falls.
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