There are many coccydynia treatments for tailbone pain.
What is Coccydynia?
By definition, the term coccydynia means “pain in the coccyx or tailbone area”. Other names for this condition are coccyx or coccygeal pain, coccygodynia, and coccalgia. The coccyx is the tailbone, and it is “made up of 3 to 5 vertebrae, some of which may be fused”. The main causes of coccydynia are an impact from a fall or pressure from childbirth. Repetitive trauma and excessive sitting are other cause of pain and inflammation in the coccyx region. Doctors may perform a rectal examination, use x-rays and MRI scans, and try other diagnostic methods to make sure the pain is coccyx-related. One test for coccyx involvement is to inject a “local anesthetic into the area” to see if there is relief. If there is, the coccyx is suspected to be the problem. The bones may be fractured from falls, cycling, horseback riding, skateboarding, or from childbirth. The pain could be chronic if not controlled, and sitting improperly or constipation might worsen the condition. Coccydynia is rarely caused by a tumor. Anyone can be affected by coccydynia, but women and those around the age of 40 are most likely to be impacted.1 There are other conditions that may be mistaken for coccydynia, including shingles, pilonidal cysts, sciatica, and sacroiliitis.2
Patients with this condition have pain that worsens when sitting, local tailbone pain that is worse when any pressure or touch is applied, worsening pain when changing from sitting to standing, and constipation pain that improves with a bowel movement.3 Of course, pressure from the baby’s head in late pregnancy can cause coccyx pain. Sneezing and coughing could worsen the symptoms, as can childbirth labor or intercourse. For some, positions such as “lying on the back, sitting on the hard surface, moving from sitting to standing, (and) prolonged standing” trigger the pain. For others, the activities of “walking, running, cycling, riding, driving, lifting heavy objects, doing squats or jumping” are problematic. To improve symptoms, patients can try home care for coccydynia treatments. They should avoid prolonged walking or standing, and they should not bend over to pick up objects. Patients may wish to wear “shoes with cushy soles” instead of high heels. A maternity belt might also be useful, for support. Patients can relieve the pain by emptying the bowel, changing positions often, or even try swimming or yoga to alleviate coccydynia symptoms.4
Various coccydynia treatment options range from stool softeners and dietary fiber, to prevent constipation, to NSAIDs and other anti-inflammatory medications, nerve block injections, or even “manipulation by a chiropractor, osteopathic physician (D.O.) or physical therapist”. It is rare that surgery is recommended as part of coccydynia treatments, but a coccygectomy is the removal of the coccyx. This is used for patients who have not responded to medications, seat cushions, or other treatments, but especially for those with cancer. Body positioning is important to reduce stress on the coccyx. Everyday activities and sitting on hard surfaces, as well as engaging in certain sports can aggravate coccydynia. Those who are obese are at higher risk, as are people who perform contact sports where falling is probable. It is important to wear proper safety equipment, such as, for example, special hockey pants that cushion the thigh, buttocks, and coccyx to prevent trauma.5 Patients should sit on padded seats and avoid prolonged sitting. Some patients may receive a cortisone injection to relieve pain. Most recover with conservative treatments.6 Patients might wish to utilize an ice pack for the first few days of pain, followed by heat. A donut-shaped or custom pillow can also provide relief. The U- or V-shaped pillows are often preferred to keep all pressure off of the tailbone. Chiropractic manipulation and stretches can be provided as coccydynia treatments. Some patients may benefit from “physical therapy with ultrasound”.7 One chiropractor presented trial results in which using manipulation had left “73% of patients improved by 70-100% over an average of less than 7 treatments” by “using specific manipulation, acupuncture, physical therapy and robust exercise”. The manual treatments are external and internal. External manipulation is “pulling the tip of the coccyx backwards through the skin just above the anus”. Internal manipulation is performed with “a gloved finger into the anus of the patient, and gently massaging or stretching the muscles attached to the coccyx”.8
One exercise or stretch that might be useful for coccydynia is the “kneeling groin stretch”, which should be performed after prolonged sitting. Other stretches include the “piriformis stretch and hands to feet stretch”, which also release muscle tension.9 There are several coccydynia exercises the can reduce pain in the tailbone, including yoga, squats, and the “clamshell exercise”. Even after the discomfort is resolved, patients should continue to exercise to keep the area strong. There are other forms of coccydynia treatments such as yoga poses for tailbone pain, and the best ones are Locust Pose, Cobra Pose, and Half Locust Pose.10 Some healthcare providers recommend walking at least one hour per day. This should be gradually built up until it is less painful, and patients should take short breaks. For some, swimming will provide relief. There is an exercise called the “Anal Lock”, which is performed in bed, and the patient tenses the anal sphincter. Weightless squats and hamstring stretches are other exercises patients can do. The “clamshell” is an exercise that a person can performed on their side, with the knees stacked and bent, and then the knees are opened and closed.11 Some patients may get relief from Kegel exercises, which strengthen the muscles that control urination, and others may wish to do abdominal exercises. A treadmill could also be a useful tool, even for a few minutes a day. An additional yoga pose to try is the bridge. All exercises and stretches should be done under a healthcare professional’s supervision.12
Learn more about coccydynia.