Coccyx Bone Pain

Coccyx Bone Pain is also known as Coccydynia or Tailbone Pain. The coccyx is at the base of the spine. This is the vestigial remnant of a tailbone that most other animals and primates have. For us, this bone also is of importance as it has a weight bearing function when we sit on the ground. Constant heavy pressures related to hard seats and hard impacts from trauma may push the coccyx out of position, relative to its position adjacent to the sacrum in a stable spine. These are the most common causes of tailbone pain. Other causes of tailbone pain are related to damage caused to the ligaments, joints, and discs that hold the coccyx together and that connect it to the sacrum. Though scientists know a lot about this type of pain, and what causes it, more is still being learned. For example, in the past it was thought that the coccyx was one fused structure in the adult spine. Now we know that the coccyx still exists as separate segments in many adult spines. This may point to the cause of Coccyx bone pain to be related to hypo-mobility or hyper-mobility among the individual coccygeal segments. More is being discovered every year. Here's what we know so far, and what options we have for managing or treating this condition.

Coccyx: the coccyx is composed of 3-5 vertebra that are completely separated at birth. The coccyx articulated superiorly with the sacrum. The coccyx is the base of our spine. Together, the sacrum and coccyx together form the shape of a downward pointed arrowhead, with the coccyx at the tip of this structure.

The joint that connects and is located between these two structures is the sacrococcygeal symphysis. The sacrococcygeal symphysis is a amphiarthrodial joint, which means that it is slightly movable. Other slightly movable joints in the sacral spine include the sacro-iliac joints, which attach the sides of the sacrum with the wall of the pelvis. These joints allow for some shock absorption related to the bottom of the spine's weight bearing functions, and the weight bearing function of the coccyx when we are sitting. It is though that the cause of lower back pain and coccyx bone pain may be due to the hyper-mobility or hypo-mobility of these joints.

Pathology:
  • A fractured tailbone may be a cause of pain in this region of the spine. A fractured tailbone may also be called a broken tailbone or a fracture of the coccyx. A fracture of this structure in healthy people is uncommon, and would require a fall of significant force onto the seated position. Risk factors for a broken tailbone include a violent event, osteoporosis, advancing age, and reduced muscle mass. Women are more prone to a fracture of this bone structure due to their wider pelvis.
  • Infection and tumors: Infections and tumors are probably the least common cause of tailbone pain. Sacrococcygeal teratoma is the most common tumor that involves the coccyx. Coccygectomy - the surgical removal of the coccyx - may be required for these types of tumors.
  • Childbirth: Tailbone pain may linger beyond the delivery of the baby due to the pressure the baby's head put on the coccyx, discs, and ligaments.
  • Pressure: Horseback riding, and other seated activities that involve either bouncing or hard surfaces may put enough pressure on the tailbone and attaching structures to cause irritation.


Local Trauma: A direct impact on the tailbone caused by a slip or fall may traumatize the coccyx itself or the coccygeal attachment to the sacrum. This is considered to be the most common cause of coccyx pain. Icing and anti-inflammatories are recommended for acute pain related to this type of trauma. If this condition threatens to develop into a chronic problem, the patient may have two options:
  1. Manual manipulation: Chiropractors and Osteopaths (Osteopathic physicians) are both trained to stabilize the spine through manual manipulation. This may correct problems such as subtle dislocations of the sacrococcygeal symphysis connecting the sacrum to the coccyx.
  2. Injections: Steroid injections may provide pain relief for months to several years, in some cases. An injection procedure involves a numbing agent (Lidocaine) followed by a steroid injection into the area of inflammation. For best results, it is recommended that the physician delivering the injection do so under Fluoroscopic guidance.