Manual treatment of the coccyx, as taught by a specialist in women's health

A graduate student of physical therapy writes:

It has come to my attention (from my professor) that there are only a handful of therapists available (at least in the USA) that are truly qualified to treat this condition. My professor says that it requires a specialisation (she is a specialist in woman's health). Many of the sufferers of this condition who have reported poor outcomes from physical therapy probably did not receive a proper treatment approach.

She recommends intravaginal and/or intrarectal stretching of the ligaments and pelvic floor musculature (obturator internus and coccygeus muscles). In addition, she utilises ultrasound of the coccyx, stretching exercises of the piriformis muscle (which is an external rotator of the hip and frequently involved) and exercises for the pelvic floor musculature (relaxation exercises with biofeedback and strengthening exercises).

It is also important for the patient to avoid long periods of sitting.

This condition is difficult to treat because pain in the coccyx is frequently referred from the sacroiliac joint (junction of the sacrum and ilia), the hip, or the low back. Thus, pain in the coccyx may be originating from other locations.

Updated 2001-04-02

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