Coccyx pain

tailbone pain - coccydynia - coccygodynia

coccyx Does it hurt to sit?
You're not alone, and you're not going mad! There are effective treatments, and the great majority of sufferers can be cured. Here you will find information about coccyx pain, but you will have to go to a specialist for diagnosis and treatment of your particular problems.

This website includes contributions from leading specialists treating coccyx pain, including Dr Jean-Yves Maigne, Paris, Dr Michael Durtnall, London and Dr Patrick Foye, New Jersey. The site is run by Jon Miles, a long-time sufferer from coccyx pain, who has been invited to give presentations at three international medical symposiums on coccyx disorders.

Update, 2024-03-17: Personal experiences + Specialists in Spain

Update, 2024-03-10: Specialists in the USA (Florida)

Update, 2024-03-04: Coccyx cushions + Specialists in the USA (New Jersey)

Causes

Coccyx pain is often due to to a dislocation at one of the coccyx joints, or stiffness of one of the joints, or a spasm of the muscles attached to the coccyx. It can follow after falls, childbirth, repetitive strain or surgery or for no obvious reason. The pain can disappear by itself or with treatment, or it can continue for years, and may get worse. It is five times more common in women than men, probably because the female pelvis leaves the coccyx more exposed.

The coccyx consists of three to five bone segments which have thin disks between them or may be fused together. Sometimes the disks get damaged and the segments dislocate when you sit down. This repeated dislocation can cause chronic inflammation. In other cases there is a spur of bone on the end of the tailbone, and pressure on this causes the pain. There is more information about causes in the What is coccydynia? section.

Diagnosis

X-rays, CAT scans, MRI scans and diagnostic injections may be used to find out what is causing the pain. Physical examination can help to find out whether the coccyx is loose, out of its normal position, angled backwards or forwards, or to one side.

Two tests are particularly helpful, Dynamic (sit/stand) x-rays and injection of local anesthetic. For the Dynamic x-rays, two x-rays are taken, one with the patient standing, and one with them sitting. Comparing the two x-rays shows whether the coccyx is moving more than normal when the patient sits.

A diagnostic injection of a local anesthetic allows the doctor to make sure that the pain is actually caused by the coccyx, not referred pain from somewhere else. If the injection makes the pain disappear until the local anesthetic wears off, the doctor knows that it is the tailbone causing the pain.

Unfortunately, many doctors are not familiar with the use of Dynamic x-rays and injections of local anesthetic for diagnosis of coccydynia. Doctors listed in the Find a doctor or specialist section are more likely to be aware of these tests. See the Investigation and diagnosis section of this site for more information on the tests used.

Treatment

If the coccyx is identified the source of the pain, a number of people have reported good results from manual treatments of the coccyx, when applied by experts in this technique. Orthopedic specialists, on the other hand, will normally give an injection of an anti-inflammatory drug around the coccyx as the initial treatment.

If such methods are not successful, the coccyx may be removed if the patient is regarded as a good candidate for surgery. Before going for this option, make sure that you are a good candidate, and that your surgeon has plenty of experience and success with this operation.

Controlling the pain by methods which don't affect the underlying condition (such as drugs and blocking pain signals in the spinal cord) have good and bad sides. The obvious good point about pain control is that it stops the suffering and depression that pain causes, and allows you to carry on a more normal life. The other good point about pain control is that it can prevent the changes in processing of pain messages in the central nervous system that chronic pain can cause. Unrelieved pain can put the system out of balance and lead to more widespread pain that is difficult to treat.

But controlling pain has serious drawbacks as well. If your pain is caused by an unstable coccyx, for instance, and you can't feel the pain of that any more, then you may well cause further damage to it without realising. You therefore need to be careful not to make your condition worse. Another problem with pain control is that some methods, such as drugs, have side-effects which may be unpleasant themselves, or even have long-term consequences if continued for a long time.

See the Treatment section for more details.

Coping with coccyx pain

It can be difficult to find a specialist to treat tailbone pain, and treatment may take time before it is effective, so many people suffer sitting pain for months or years.

Patients have worked out lots of tricks to avoid or reduce the pain of sitting. Special seats or cushions, or using a sit/stand desk at work can help. There is more detail in the Coping with coccyx pain section.

People are often too embarrassed to use the tricks for avoiding pain, like standing when others are sitting, or carrying a coccyx cushion with you. You imagine that everyone is watching you. You have to ignore this feeling, and do what is best for yourself. The first time is the hardest. But if you take it as something natural, everyone else will as well.

Find a doctor or specialist

People often find it hard to find a specialist near them to treat their tailbone pain. The Doctors and Specialists section lists over 600 specialists in 41 countries.

Specialists are listed on this site for one of three reasons: they were recommended by a coccyx pain patient; they are the authors of a relevant medical paper; or they they have informed coccyx.org directly that they have success in treating coccyx pain. The reason for listing each one is given against their entry in the list.

Personal experiences

More than 2,000 people have added their personal experiences of tailbone pain and treatment to this site. Because there are so many, it can be hard to find exactly exactly what you want in them. Here is a way to search through them.


Author: Jon Miles

Updated 2024-03-17