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A Pain in the Tail...bone (Part 1- What is it? How does it happen? How does it feel?)

Let me tell you a little story... The truth is, my story is not a totally uncommon one. I sat in one place for 7 hours straight (likely in a slumped posture)-- and my tailbone didn't like it. I was lucky, because I know about tailbone pain...I was able to get it treated and I got better very quickly. Many people with the same pain will stay in pain for a long time before getting the treatment that helps. So, my goal today is to tell you exactly what tailbone pain is, how it happens, and what it feels like... and then in part 2 to tell you what you can do about it.

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 A Pain in the Tail...bone (Part 2: Treatment)

"Due to the dearth of research available and the low levels of evidence in the published studies that were located we are unable to recommend the most effective conservative intervention for the treatment of coccydynia. Additional research is needed regarding the treatment for this painful condition." This statement comes from a 2013 systematic review on conservative treatments for coccydynia... isn't it so encouraging? We discussed what coccyx pain meant, the causes, and the examination approach last week in Part 1 of "A pain in the tail...bone." Today's post will take a close look at my approach for treating people with tailbone pain and what we do know in the current research. Unfortunately, as you see from the comment above, research for the best treatment for tailbone pain is significantly lacking...so we'll have to rely on my clinical experience as well as the knowledge from courses I have attended and practitioners I have collaborated with in the past.

 A Tailbone of Two Injuries

The coccyx, colloquially referred to as the tailbone, is a small, often overlooked anatomical landmark that sits below the lumbar spine and sacrum. Despite it’s tiny size, it is extremely clinically significant. Think of it as the Grand Central Station of your pelvic floor, so to speak. The coccyx serves as the attachment site of the gluteus maximus and levator ani muscles (which include the coccygeus, iliococcygeus, and pubococcygeus muscles) and ligaments (including the anterior, posterior, and lateral sacrococcygeal, sacrotuberous, and sacrospinous ligaments). Injury to the coccyx can affect the aforementioned muscles and/or ligaments. Conversely, injury to the muscles and/or ligaments can affect coccyx alignment. Symptoms of coccyx dysfunction include coccyx pain (referred to as coccydynia), pain with defecation, pain with intercourse, pain with prolonged sitting, pain with transitional movements (such as sit to stand), coccyx pain, low back pain, and even neck pain.

Articles of Interest

Causes of Coccydynia (Tailbone Pain)

A direct injury to the coccyx is probably the most common cause of coccydynia. A fall on the tailbone can inflame the ligaments and injure the coccyx or the coccygeal attachment to the sacrum. Coccygeal trauma usually results in a bruised bone, but may also result in a fracture or dislocation either in the front or back of the coccyx.

Coccydynia: An Overview of the Anatomy, Etiology, and Treatment of Coccyx Pain

Despite its small size, the coccyx has several important functions. Along with being the insertion site for multiple muscles, ligaments, and tendons, it also serves as one leg of the tripod—along with the ischial tuberosities—that provides weight-bearing support to a person in the seated position. The incidence of coccydynia (pain in the region of the coccyx) has not been reported, but factors associated with increased risk of developing coccydynia include obesity and female gender.

Coccyx pain

Does it hurt to sit? You're not alone, and you're not going mad! There are effective treatments, and the great majority of sufferers can be cured. Here you will find information about coccyx pain, but you will have to go to a specialist for diagnosis and treatment of your particular problems. Coccyx pain is often due to to a dislocation at one of the coccyx joints, or stiffness of one of the joints, or a spasm of the muscles attached to the coccyx. It can follow after falls, childbirth, repetitive strain or surgery or for no obvious reason. The pain can disappear by itself or with treatment, or it can continue for years, and may get worse. It is five times more common in women than men, probably because the female pelvis leaves the coccyx more exposed.

Don’t Disregard the Coccyx

Pain while sitting is a common client complaint, but massage therapists often disregard the coccyx as a possible pain generator. This is due to a lack of biomechanical knowledge about the coccyx, as well as concerns about how to safely assess and treat this structure. When seated, the coccyx and bilateral ischial tuberosities form an elegant weight-bearing tripod. Although the coccyx bears minimal weight when sitting — about 10 percent like the fibula — it can be a major pain generator. Events such as childbirth or falling on the tailbone can lead to coccygeal pain, known as coccydynia. In most cases, the pain is caused by an unstable coccyx, resulting in chronic inflammation of the sacrococcygeal joint, along with protective guarding in associated muscles

Tailbone Pain & Healing Coccydynia

Does that pesky “little” tailbone hurt when you sit for prolonged periods of time? Do you experience a deep ache around your tailbone? Is your tailbone sensitive to touch and painful with intercourse, bowel movements, and menstrual cycles? You could be suffering from coccydynia.

Tailbone Pain Postnatal (coccyx pain) is common BUT NOT NORMAL… Don’t live with it!

The coccyx can commonly be injured or disrupted during birth, this is far more common with labours where you are lying on your back, or in the semi-sit position particularly, labours that have been going on for a long time, prolonged pushing, or with epidural, episiotomy, forceps and ventousse deliveries.

Tailbone stretches for pain and soreness relief

Persistent tailbone pain is known as coccydynia. If the tailbone is sore and inflamed, overactivity of the pelvic floor and hip-opening muscles can worsen pain symptoms. Performing specific stretches may help to relieve tension in the tailbone. This article will cover stretches that people can use to relieve pain.

Resources

Coccyx.org

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Tailbone Doctor

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