Surgical removal of coccyx (coccygectomy)

See also personal experiences of coccygectomy

Summary: Surgery is sometimes used when other treatments have failed. Before going for surgery, be sure of two things: that you are a good candidate for surgery, and that your surgeon has plenty of experience and success with this operation. If you do that, there's an 80% chance of getting rid of the pain. The best indications of being a good candidate are an unstable coccyx or a spur on the coccyx. You can see a list of doctors and specialists recommended by other patients here.

The operation is normally carried out under general anesthetic, and lasts about an hour. The pain caused by the surgery makes it very painful to sit down for up to a month afterwards. Because of the position of the coccyx close to the anus, there is a danger of infection of the wound. Not all patients are suitable candidates for surgery (see below). The treatment may take from 3 months to a year or more to be effective.

Success rates for surgery

This operation used to have a bad reputation among some doctors, and some will still advise you that it should never be done. But clinical trials show success rates of 50-90%, rising to 80-90% in patients who are 'good candidates' for surgery, and have it performed by a surgeon with plenty of experience and success with this operation. A study published in 2001 summarised 24 separate trials of this operation. The trials covered a total of 702 patients operated on. The result was reported as 'good' or 'excellent' in 83% of cases.

There are at least three factors which could influence the likelihood of success:

  1. Selection of patients. Success rates appear to be much higher if patients are carefully selected to be 'good candidates' for surgery:
  2. Surgical procedure. Surgeons use similar techniques, with some variations - here are some examples:
  3. Experience and skill of the surgeon.

If you are considering surgery, here are some points for and against.

Recovery from surgery

Surgery may increase your pain in the short term, though your surgeon should put you on painkillers to reduce that. The time required off work varies, and depends on whether you have to sit to work. I (Jon) had 6 weeks off work, followed by a few weeks working part-time. Some people need more than that, some less.

Full recovery will probably take months, it could be a year or even more. Partly that is because you have to sit on the scar.

Infection delays healing. Here are pictures, one from an uninfected patient at 18 days after surgery, and one from a patient at week two who developed an infection.

week2   week2

Here are some more pictures of some patients' scars after surgery: Anonymous 1, Anonymous 2, Anonymous 3, Carol, Miriam, Kimberly, Gary.

Sally has written about trapped nerves following surgery

In some cases absorbable sutures can cause adverse reactions, stopping the wound from healing.

Relevant medical papers:

Updated 2012-07-01

What is coccydynia? | Investigation and diagnosis | Treatment | Coping with coccyx pain | Find a doctor or specialist

Medical papers | Personal experiences | Links to other sites | Support groups | Site map