Coccydynia makes sitting and daily activities extremely painful. Traditional medical care can include costly medicines, with side effects and risks of addiction. Chiropractic may be a very effective alternative in helping patients with their recovery and rehabilitation from this injury. The coccyx is the tailbone at the base of the spinal column. When there is an injury to this area, the condition (coccydynia) is very painful. Injuries to this region can consist of breaks or bruising, and they can be very slow to heal. Coccydynia occurs more in women, due to females’ broader pelvises.1 The coccyx can sustain trauma from many activities, including a fall onto a hard surface, a direct blow (such as from sports), during childbirth, friction, and straining (i.e., cycling and rowing), and several other less common factors.2 When an injury occurs, there is severe pain, possible bruising, and discomfort from sitting and bowel movements. Coccydynia is a serious injury because it affects most aspects of regular, daily life.3
Traditional Treatments for Coccydynia
Doctors will perform examinations and scans to diagnose a fractured coccyx. They will decide whether or not the cause of the coccydynia was traumatic or unknown (idiopathic). Because some activities that can cause the problem are often repeated (i.e., cycling, childbirth, etc.), this can be a recurring condition. Even sitting improperly can cause repetitive strain to the coccyx. Doctors may start a patient out with a special cushion for sitting. This is not the “donut cushion”, but a special one with a “cutout at the back under the coccyx”. They may suggest stool softeners and increased fiber in the diet. Persistent pain will typically lead to anti-inflammatory medications or even anti-depressants. Some doctors will add a local nerve block or suggest surgery to remove the coccyx (coccygectomy).4 Medications often carry the risks of possible side effects and the potential for patients to become addicted. Surgery is a serious and permanent treatment option with its own potential dangers. Patients should always consider alternative options and treatment, such as chiropractic care, before committing to such decisions as surgery and dependence on medication. While not every case can be treated with alternative care, an attempt to seek out less invasive treatment should be made on the patient’s and their medical care providers’ part first.
While pain in the coccyx may arise from trauma, it can also be referred pain from “the sacroiliac joints, pelvic muscles and the lower back”. The coccyx may be unstable from strain. Chiropractors might use scans and x-rays to determine the cause of the problem, and they will palpate and examine related areas. They will also decide whether or not the condition should be treated with chiropractic therapy.5 Treatment should be gentle. If a patient is pushed too hard on the tailbone, the pain can worsen. Only skilled practitioners should attempt adjusting the region. The two types of manipulation used on the coccyx are “external and internal”, which have been described in chiropractic literature.6 Other advice from chiropractors includes sitting properly and avoiding painkillers, anti-inflammatories, and cortisone.7 They will typically encourage patients to lose weight and become more active, in order to prevent future problems and to release endorphins. Patients are usually taught proper stretching techniques, and they may even receive chiropractic therapy with ultrasound.8
Other Treatments For Coccydynia
Massage that is meant to treat lower back pain might also treat the symptoms and source of coccydynia. The lower back is a very common target for massage therapy, and its use can also improve range of motion, sleep, anxiety, circulation in the blood, relax the muscles, and increase levels of serotonin and dopamine. Releasing the tight or injured muscles, which often become locked in place and increase pain, is a step towards recovery from coccydynia. With the muscles relaxed and the pain relieved, the patient is better able to take treatment into their own hands at home and perform physical activities.9 Yoga poses are also used to treat pain in the tailbone. Cat-cow pose strengthens the back and stomach. The pose begins in a neutral position with the hands and knees on the floor. The hands should be shoulder width apart while the knees should be hip width apart. Beginning with a straight back, the patient should exhale and move into cat pose, with the spine rounded and the tailbone tucked inward. The head is dropped and the chin is also tucked inwards. Upon inhalation, the patient will move into cow pose. The tailbone is upward, the spine is arched towards the floor, and the head looks up to the ceiling. Cobra pose begins with the patient lying on their stomach, hands flat on the floor right below the shoulders with the elbows in. They will then push up from the floor, chest upward while the lower ribs and pelvic bone stay on the floor, holding for five breaths. Standing forward bend, reclining twist, and downward facing dog are three more poses that stretch the tailbone and strengthen the core.10