Tailbone Pain

Tailbone pain can be a nuisance, making everyday activities like sitting or standing uncomfortable. This common condition affects the small bone at the base of the spine, causing discomfort and limiting mobility. There are various reasons for tailbone pain, ranging from injuries to medical conditions. Let's explore the causes of tailbone pain, its symptoms, and potential complications. We'll also discuss tailbone pain treatment options and tailbone pain relief methods to help manage the discomfort. 

What is Tailbone Pain? 

Pain on the tailbone, medically known as coccydynia, is the discomfort or pain experienced in the coccyx. The coccyx is a small triangular bone located at the spinal base. The coccyx, commonly called the tailbone, plays a crucial role in supporting body weight when sitting and is an attachment point for various tendons, ligaments, and muscles. 

The tailbone pain is typically localised to the sacrococcygeal joint and is often described as a "pulling" or "cutting" sensation. Many individuals report tenderness when the area is touched. 

Causes and Risk Factors of Tailbone Pain 

Tailbone pain can have various causes and risk factors. These include: 

• External Trauma: It typically results from a backward fall. This can lead to a bruised, dislocated, or broken coccyx. 
• Internal Trauma: The coccyx is susceptible to injury during complex or instrumented deliveries. 
• Repetitive Strain Injuries: Activities like cycling and rowing, which involve leaning back and forth, can strain the tissues around the tailbone. 
• Prolonged Sitting: Hard or uncomfortable surfaces can place excess pressure on the coccyx and cause tailbone pain when sitting. 
• Gender: Women are five times more likely to develop tailbone pain than men. 
• Pregnancy and Childbirth: Hormonal changes can soften the area between the tailbone & sacrum, which can sometimes lead to excessive stretching of muscles & ligaments around the tailbone. 
• Weight: Being overweight creates additional pressure on the coccyx, potentially causing it to lean backwards. Conversely, being underweight can lead to less cushioning in the buttocks, causing the tailbone to rub against muscles and ligaments. 
• Other Factors: These may include poor posture, joint hypermobility, and degenerative joint or disc disease.

Symptoms of Tailbone Pain 

Tailbone pain can manifest in various ways, such as: 

• Pain and Tenderness: It is experienced at the base of the spine, near the top of the buttocks. 
• Pain in Tailbone When Sitting: It often worsens during prolonged periods of sitting or standing. 
• Pain While Transitioning: The pain may intensify when leaning back while seated or transitioning from sitting to standing position. 
• Uncomfortable during Bowel Movements: Some individuals find it particularly uncomfortable during bowel movements or sexual activity. 
• Other symptoms may include: 
  • Swelling in the tailbone area 
  • Back pain and sciatica 
  • A feeling of numbness or tingling sensation in the arms, legs, or groin 
  • Difficulty sleeping 
  • Depression and anxiety 
  • Bowel or bladder problems 
  • A noticeable mass in the tailbone region 

Complications 

Tailbone pain, while often manageable, can cause health hazards if left untreated or if it becomes chronic. These may involve: 

• Chronic Pain Syndrome: This condition can significantly impact a person's quality of life, affecting daily activities such as standing or even sitting for extended periods. 
• Pelvic Floor Dysfunction: The pelvic floor muscle complex, which attaches around the tailbone, may be affected, resulting in pain during intercourse, urinary incontinence, and discomfort during bowel movements. 

Diagnosis 

The steps are: 

• Personal History: Your doctor asks about any past injuries or trauma to the tailbone area (falls or difficult childbirth experiences). They also inquire about the nature and duration of the symptoms. 
• Physical Examination: They inspect the skin around the tailbone for signs of infection, pilonidal cysts, or haemorrhoids. They may perform external palpation to check for localised tenderness over the coccyx. 
• Radiological Investigations: 
  • X-rays are commonly used to confirm the occurrence of fractures or dislocations of the tailbone. 
  • Dynamic X-rays, taken in both sitting and standing positions, can be beneficial in assessing coccygeal mobility and identifying abnormalities that might be missed on standard radiographs. 
  • CT Scan or MRI: These tests can reveal fractures, tumours, and other structural abnormalities. 
  • Coccygeal Discogram: This imaging involves injecting contrast and local anaesthetic into the sacrococcygeal region. 

Treatment for Tailbone Pain 

The approach to treating tailbone pain depends on its cause and severity. 

• Home Remedies: These include:  
  • Taking nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and swelling 
  • Sitting on a doughnut pillow or wedge-shaped gel cushion to alleviate pressure on the tailbone 
  • Apply hot or cold packs to the lower back for 20 to 30 minutes several times daily. 
  • Taking hot baths can also help relax muscles and ease discomfort. 
  • For those experiencing pain during bowel movements, stool softeners may be beneficial.
• Nonsurgical Treatment: These can include: 
• Coccygeal nerve blocks (injecting numbing medications and steroids) to reduce pain and inflammation. 
• Massage therapy 
• Physical therapy to improve posture and stretch muscles 
• Acupuncture 
• Transcutaneous electrical nerve stimulation (TENS) 
• Surgical Treatment: 
  • They are employed when other treatments have failed. They include partial or total coccygectomy (removal of part or all of the coccyx). 

When to see a doctor 

Seeking medical attention is crucial in some instances, such as: 

• If the pain persists for more than a few weeks despite trying self-care treatments 
• If individuals experience additional symptoms like pain in other areas of the body, such as the hips, lower back, or abdomen. 
• If there is a high fever, particularly one reaching 39.4 degrees Celsius or higher, in combination with tailbone pain 

Prevention 

There are several measures individuals can take to reduce their risk. These include: 

• Maintain good posture, especially when sitting for lengthy time periods. 
• Using a specially designed coccyx cushion or sitting on an exercise ball 
• Take regular breaks and avoid sitting on hard surfaces. 
• Wearing loose-fitting clothes around the bottom and lower back area 
• Engaging in pelvic floor exercises, particularly during pregnancy, to strengthen the muscles supporting the tailbone 
• Minimising the chances of accidental falls by installing railings on stairs and ensuring good lighting 

Conclusion 

Tailbone pain can have a big impact on daily life, making simple activities like sitting uncomfortable. By following the tips and advice provided, many people can find relief & improve their quality of life. Remember, if pain persists or worsens, seek medical help. With the right approach, most cases of tailbone pain can be managed successfully, allowing individuals to return to their normal activities with greater comfort. 

FAQs 

1. What causes tailbone pain without injury? 

Prolonged sitting, especially on hard surfaces, creates excessive pressure on the coccyx, leading to discomfort. Poor posture and being overweight or underweight can also contribute to tailbone pain. In some cases, pregnancy and childbirth may cause tailbone pain due to hormonal changes and the added pressure on the pelvic area. 

2. Is walking good for tailbone pain? 

Walking can benefit tailbone pain as it promotes blood circulation and helps relieve tension in the muscles surrounding the coccyx. 

3. Should I worry if my tailbone hurts? 

In most cases, tailbone pain is not a cause for serious concern and often improves with home remedies and rest. However, if the pain continues to happen for more than a few weeks, is accompanied by signs & symptoms like numbness or tingling in the legs, or interferes with daily activities, it's advisable to seek medical attention. 

4. What should I avoid if my tailbone hurts? 

Avoid sitting for long periods to alleviate tailbone pain, especially on hard surfaces. Refrain from wearing tight-fitting clothes around your bottom and lower back. It's also best to avoid activities that put direct pressure on the tailbone, such as cycling or rowing until the pain subsides. Also, try not to sleep on your stomach, which can worsen discomfort. 

5. What foods help tailbone pain? 

While there's no specific diet for tailbone pain, certain foods can help reduce inflammation & promote overall bone health. Dairy products, Omega-3 fatty acids, and leafy green vegetables are good for bone health. Additionally, ensuring adequate intake of vitamins B6, B12, and D can benefit bone health and pain management. 

6. How should I sleep to relieve tailbone pain? 

To relieve tailbone pain while sleeping, try lying on your side with a thin pillow between your knees to keep your hips aligned. Alternatively, sleeping on your back with a wedge pillow beneath your knees can help relax your lower back and tailbone. Avoid sleeping on your stomach. This can damage the natural curve of your spine and exacerbate tailbone pain. Using a firm mattress and supportive pillows can maintain proper spinal alignment during sleep. 

Dr. Sohael Mohammed Khan

MBBS, MS (Orthopaedics), Diploma (Spine Rehabilitation)
Ganga CARE Hospital Limited, Nagpur

To Book an Appointment, call:

+91 406 810 6585