Diagnosis and Treatment of Coccydynia

Coccydynia is pain in the coccyx, the tailbone, which can cause a great amount of discomfort and limit mobility. Sometimes, this pain is not taken seriously by general practitioners but it is important to learn the cause if the pain persists. In some cases, the cause is obvious as pain develops after a fall or injury. A pilonidal cyst also creates pain in the coccyx and since there is often a visible abscess, diagnosing the problem is simple. 

Other causes of coccydynia are more complex and require a thorough examination and diagnosis. One of the first goals is to rule out the possibility of cancer as a cause of the pain. Before deciding upon a plan of treatment, it is important to distinguish coccyx pain from low back pain or other causes not related to the coccyx. 

Diagnosing Coccydynia

• History and Physical must be completed.


• CT Scan (Computerized Tomography)


• MRI ( Magnetic Resonance Imaging)


• Dynamic X-rays -this means x-rays taken when sitting and standing. A comparison may show a coccyx that dislocates when the patient sits, causing pain. 

Treatment Of Coccydynia

Falls

• Use a cushion or well padded seat to relieve pressure on the coccyx when sitting. Several new devices have been developed which are far superior to rubber donuts or foam pads. Many can be found on the internet when doing a search for 'coccyx cushions'. This cushion may be necessary for an extended period of time.


• Rest and avoid re-injury.


• Anti-inflammatory medications, such as ibuprophen and naproxyn, are helpful.


• Corticosteroid or local anesthetic injections may dramatically relieve persistent pain. 

Unstable Or Dislocating Coccyx

• Rest and avoid re-injury.


• Corticosteroid injections are helpful.


• If pain persists and corticosteroids are unsuccessful, the coccyx may be removed surgically. 

Childbirth

• Rest often allows the coccyx to return to its normal position.


• If this fails, treatment as for Unstable or Dislocating Coccyx is appropriate. 

Repetitive Strain

This is due usually to long periods of rowing or bicycle riding.

• Rest - avoid activities that caused the pain.


• Anti-inflammatory medications, such as ibuprophen or naproxyn relieve discomfort. 

Misaligned or Long Coccyx

• Injections of corticosteroids are often helpful.


• Surgery is not recommended. 

Boney Spur or Spicule On Coccyx

• Local injection of corticosteroids and/or local anesthetic have been helpful.


• Surgery has been successful.

 
Muscle Spasms Of Gluteus Maximus Muscle

• Physical therapy and massage have been effective in relieving spasm. 

Piriformis Syndrome

• Physical therapy


• Stretching exercises


• Injections of Corticosteroids Locally 

Pilondal Cyst

• Surgical removal is necessary as infection reoccurs repeatedly. 

Coccyx pain and the associated difficulty with sitting and movement can be most miserable and memorable. Sufferers who gain relief are always anxious to avoid any recurrence whenever possible.