What is Coccydynia?

It is a group of ailments that cause discomfort in the coccyx (tailbone) region.

Why does Coccydynia occur?

There are four main causes of discomfort in the area of the tailbone.

1. The cause of common (idiopathic) coccydynia is not well known. Numerous theories have been put up regarding the source of the pain, including the pericoccygeal soft tissues, pelvic floor muscle spasm, lumbar nerve referral, etc. None of these have received solid confirmation as of yet.

2. Patients frequently cite giving birth or falling on their buttocks as the trigger for their pain, suggesting a mechanical reason. Furthermore, the bulk of the time, the pain is limited to the sitting posture. A fall to the bottom is the most frequent type of trauma. Most commonly, it’s accidents like slipping on a slippery floor or falling while skating or walking down stairs.
3. Pregnancy can also put tension on the coccyx. It seems that when pregnancy draws to a close, the joints surrounding the pelvis flex more to facilitate the birth of the child. This makes it easier to push the coccyx out of place.

4. Some women experience discomfort only during pregnancy, while others experience agony both during and after the baby is delivered.
Some less common causes of this condition are bursitis-like conditions that can occur in thin patients with little buttock fat padding, allowing the tip of the coccyx to rub against the subcutaneous tissues, causing friction; cyst formation; infection; lump around the region; and nerve pain secondary to repeated damage.

How is it Diagnosed?

A comprehensive medical examination and the patient’s whole medical history are necessary. Nearly invariably, the diagnosis is clinical.

Symptoms typically follow a familiar pattern, such as pain that is exacerbated or caused on by sitting.

The primary goal of a doctor’s visit is to rule out the previously mentioned additional causes.

X-rays and blood tests can be used to rule out alternative reasons of the issue or to reassure the patient, but they are not helpful in identifying the disease.

Even though a variety of X-rays have been cited in the literature, there is no proof that they are particularly helpful in diagnosing or controlling the issue.

Only in extreme circumstances, when the diagnosis is unclear or all other possibilities have been ruled out, are additional specialized tests, such as MRIs and bone scans, performed.

How to Manage Coccydynia?

The most common kind of treatment is conservative, involving taking pills to relieve inflammation, like ibuprofen and naproxen. A small dose of paracetamol taken beforehand will often alleviate discomfort and is a highly safe option if an extended duration of sitting is anticipated.

To ease discomfort, using a therapeutic sitting cushion to relieve pressure on the tailbone when seated may be beneficial. (Figure) 


Before experiencing a noticeable reduction in pain, conservative treatment may be required for several weeks or months. Nonetheless, the natural history is one of recuperation on its own.

Your doctor or the visiting surgeon may recommend an injection if the symptoms continue. Usually, this is at the sacro-coccygeal joint, which is assumed to be the source of the pain. Up to three injections of a combination of corticosteroids and local anesthetic can be administered. Even if the symptoms are only temporarily relieved, this is still a valuable diagnostic tool. These injections provide very little risk.

Although significant research has been done, it appears that physiotherapy and coccyx manipulation are not very helpful.

Usually the last option, coccygectomy surgery is performed. Surgery is rarely necessary for the people who initially present with tailbone pain. The choice of patient is usually crucial, and it is believed that those who react well to injections will fare better. Among the risks associated with surgery are infection, ongoing issues, scarring, and harm to nearby tissues. Approximately 60–70% of patients in various case series who were carefully chosen for the study had satisfactory or exceptional results.

Are there any long-term problems with Coccydynia?

Granted that it takes a while for symptoms to go away, coccydynia is typically a benign and self-resolving condition. After five years, people hardly ever have pain. Coccydynia has not been linked to any documented long-term health problems or difficulties.