What is Coccydynia?
Coccydynia refers to pain and discomfort in the region of the coccyx, which is the small triangular bone at the base of the spine, commonly known as the tailbone. The pain can vary in intensity and may range from a dull ache to a sharp, stabbing sensation. Although small, the tailbone has several important functions. The coccyx is the insertion site for multiple muscles, ligaments, and tendons of the pelvis and provides weight bearing support while in the seated position. Coccydynia can literally be a pain in the ass so let’s get into some of the causes and more importantly how we can treat it.
Causes of Coccydynia:
1) Trauma: The most common cause of coccydynia is trauma or injury to the tailbone, often resulting from a fall on your bottom or direct blow to the area. Even minor incidents, such as landing on a hard surface, can lead to coccyx pain.
2) Prolonged Sitting: Sitting for extended periods, especially on hard surfaces or with poor posture, can put excessive pressure on the coccyx, leading to irritation and inflammation.
3) Childbirth: Women who have given birth may experience coccydynia due to the pressure and trauma endured during labor and delivery. Coccydynia most commonly occurs in women who are positioned on their backs during labor and childbirth, which does not allow the tailbone to move out of the way as the baby moves through the pelvis. Laboring on your side, in quadruped, or in a deep squat position, and placing a towel roll under your sacrum while laying on your back can help decrease pressure on the tailbone during childbirth.
4) Repetitive Strain: Activities that involve repetitive movements, such as cycling or rowing, can irritate the coccyx and surrounding structures.
5) Pelvic Floor Tension: This is most likely the culprit of your tailbone pain if your pain occurred with no clear cause. There are a number of muscles that attach to the sides of your tailbone, including the pelvic floor muscles and glutes. If these muscles become tight, shortened, or develop trigger points, they can pull on the tailbone and even cause the tailbone to slightly deviate from its neutral position at midline. Ouch!
Some reasons why our pelvic floor muscles may develop tension:
Jaw or butt clenching
Orthopedic injury to our lower extremity (ankles, knees, hips)
Changes in activity level
Kegels (If your pelvic floor muscles are alright tight, contracting the muscles repetitively can make the tightness worse and contribute to your pain.)
6) Medical Conditions: Certain medical conditions, such as arthritis, infection, or tumors near the coccyx, can also cause coccyx pain.
Symptoms of Coccydynia:
The symptoms of coccydynia may vary from person to person, but the most common ones include:
Pain and tenderness around the tailbone region
Pain with prolonged sitting and when transitioning from sitting to standing
Pain during bowel movements
Shooting pain that radiates from the tailbone into the lower back and legs
Pain with sex
Pelvic Floor Physical Therapy for Coccydynia:
Pelvic floor physical therapy is a conservative, evidence-based approach to treating coccydynia. Physical therapy treatments for tailbone pain typically include:
Manual therapy, including myofascial release, soft tissue massage, trigger point release, and visceral mobilization, to address muscle tension in the glutes, pelvic floor, and surrounding muscles
Teaching you how to connect to and relax the muscles of the pelvis
Education and lifestyle modification
Posture and body mechanics
Stretches and exercises to perform at home
Conservative treatment, including pelvic floor physical therapy, has been shown to be successful in up to 90% of patients with coccydynia. Through a combination of manual treatments, exercise, and lifestyle modifications, pelvic floor physical therapy addresses the root causes of coccyx pain, facilitating healing and preventing future occurrences. If you or someone you know is experiencing coccydynia, don't hesitate to consult a pelvic floor physical therapist for a comprehensive evaluation and personalized treatment plan.