Coccydynia is pain that is felt at your coccyx or tailbone.
Your coccyx is formed by 3 to 5 small vertebra at the lower end of your spine. When we are children they are connected to your lower sacrum, and to each other, by layers of cartilage. As we grow they eventually become fused together, and in adults they form into one solid piece of bone connected to the lower sacrum.
Injury to your coccyx and the surrounding area are common. The small bones may be fractured or bruised, or there may be injury to the surrounding ligaments and muscles.
This can occur from a fall onto your buttocks, or other direct impact while participating in sports.
It is not uncommon for women to injure their coccyx during childbirth.
The Exact Cause may never be known.
In many cases coccyx pain is spontaneous and no clear cause can ever be identified.
This type of pain can be very difficult to treat and may become a chronic condition with occasional twinges of pain occurring years after the initial injury.
Coccydynia is not a life threatening condition.
However, it can be painful. You may have increased pain was sitting on hard surfaces such as benches or bleachers. You may have pain during a bowel movement or during sex. There may be discomfort, or a general throbbing ache that is constantly present.
Your sacrum is at the base of your lumbar spine.
Your coccyx or coccygeal vertebrae
are below your sacrum.
Image thanks to Wikimedia Commons
If there has been a fall or other injury home treatments can be helpful and provide some relief while giving an injury time to heal.
The heating pad or warm bath can increase blood flow to the injured area and provide some relief. However, be careful, because sitting in a hard bathtub may make your pain worse.
Cold packs applied to the area can reduce swelling and provide some numbing comfort.
Sitting on an inflatable doughnut from the drugstore will relieve pressure on the tender area.
This type of injury may take several weeks to several months to heal because of constant aggravation and repeated injury to the area from simply living your life. Things like getting dressed, taking a shower, and sitting in the car can slow the healing process and cause increased pain.
Over the counter anti-inflammatory drugs such as naproxen or ibuprofen can be helpful for relieving inflammation and pain.
These types of medications can have side effects involving your blood pressure, kidneys, and stomach so you should discuss any new medication that you are considering with your doctor.
Topical treatments such as capsaicin can be helpful for relieving pain. However, they may cause some increased pain in the beginning that is difficult for you to tolerate.
Narcotic Pain Medications
Narcotic pain medications can be helpful for this type of pain but they also have risks.
If you have a history of alcohol or drug abuse they may not be appropriate for you. You can discuss the risks of dependence, tolerance, and addiction with your doctor.
The ganglion impar is a group of nerves located near the tip of your coccyx. It receives that nerve impulses from several different parts of your anatomy in an area including your coccyx, rectum, and perineum.
Ganglion Impar Block
Injections of steroid medication and local anesthetic around your ganglion impar can be helpful for blocking pain in that area.
The exact position of the ganglion impar is somewhat variable between individuals so repeated injections may be necessary to obtain maximum relief.
Your Sacrum and Coccyx
Image thanks to Gray's Anatomy, via Wikimedia Commons
Relief may not last but you don't know if you don't try.
How long the relief lasts is also variable depending on the exact cause of your pain. Some people will receive one injection and be good for months or even years. Other people will receive three injections and return the next month complaining of recurrent pain.
When you are having severe pain and limitation that does not respond to more conservative treatments surgery may be recommended. Unfortunately, because of scarring, injury to nerves and other possible problems, even surgery to remove your coccyx does not always relieve the pain and get can always make the pain worse.
Coccydynia can be a difficult problem causing chronic pain that never goes away completely. If conservative home treatments fail to make you comfortable you will need to contact your doctor.
He may want to order xrays or other studies to confirm your diagnosis. He may give you a short term trial of stronger pain medications. If these are not helpful he can refer you to a pain management specialist to consider ganglion impar blocks and other possible treatments.