Coccydynia: Causes, Symptoms, and Treatment Options

Coccygeal injury

Around June, while I was at home, I got up from sitting on the floor (in a half-squat position) and when I sat back down, my coccyx hit my heel.
It was very painful at that moment, and I felt a lingering pain while walking.
A few days later, the pain while walking subsided, but I still felt pain at certain angles when sitting.
In July, there were days when I felt no pain at all, but sometimes even sneezing would cause significant pain.
Recently, I have been uncomfortable even when sitting upright.
I visited a doctor in July, but I only received anti-inflammatory medication.
I would like to ask: 1.
What could be the extent of my injury? 2.
If it heals, will there be any long-term effects?

jeff, 10~19 year old female. Ask Date: 2016/08/15

Dr. Shi Guozheng reply Orthopedics

Typically, a coccygeal bone contusion may sometimes result in a fracture, but the pain usually subsides after a period of time.
If pain persists, taking analgesics along with applying heat can help, and most cases do not lead to any long-term complications.

Reply Date: 2016/08/15

More Info

Coccydynia, or tailbone pain, is a condition that can arise from trauma to the coccyx, which is the small bone at the base of the spine. Your experience of pain after a fall or impact to the coccyx is not uncommon, and it can lead to a range of symptoms and discomfort, particularly when sitting or transitioning between positions.

Causes of Coccydynia
The primary cause of coccydynia is trauma to the coccyx. This can occur from falls, prolonged sitting on hard surfaces, or repetitive strain. In your case, the incident of sitting down and hitting your tailbone against your heel likely caused a bruise or strain to the coccyx or the surrounding soft tissues. Other potential causes include:
- Infections: Rarely, infections can occur in the area around the coccyx.

- Tumors: Though uncommon, tumors can develop in the coccyx region.

- Inflammation: Conditions like coccydynia can also be associated with inflammation of the coccyx due to various reasons, including arthritis.

Symptoms
Symptoms of coccydynia typically include:
- Pain at the base of the spine, which may worsen when sitting, standing, or transitioning between positions.

- Discomfort during bowel movements or sexual intercourse.

- Pain that may radiate to the lower back or buttocks.

In your case, the pain that varies in intensity, especially when sitting or during certain movements like sneezing, suggests that the coccyx may have been bruised or strained, leading to inflammation and sensitivity.

Treatment Options
Treatment for coccydynia generally focuses on pain relief and may include:
1. Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help reduce pain and inflammation. If you were prescribed anti-inflammatory medication, it is likely aimed at alleviating your symptoms.

2. Physical Therapy: A physical therapist can provide exercises to strengthen the pelvic floor and improve flexibility, which may help alleviate pain.

3. Cushions: Using a cushion or a doughnut-shaped pillow when sitting can relieve pressure on the coccyx.

4. Heat or Ice Therapy: Applying heat or ice to the area can help reduce pain and inflammation.

5. Injections: In some cases, corticosteroid injections may be recommended to reduce inflammation.

6. Surgery: This is a last resort and is rarely needed, but in severe cases where conservative treatments fail, surgical removal of the coccyx (coccygectomy) may be considered.

Prognosis and Potential for Residual Pain
Regarding your questions about the extent of the injury and potential long-term effects:
1. Extent of Injury: It is difficult to determine the exact extent of the injury without imaging studies such as X-rays or MRI. However, if the pain has decreased over time and you are experiencing intermittent discomfort, it may indicate a mild to moderate injury that is healing.

2. Long-term Effects: Many individuals recover from coccydynia without any long-term issues. However, some may experience chronic pain or discomfort, especially if the coccyx was significantly injured. Factors such as the severity of the initial injury, adherence to treatment, and individual healing responses can influence outcomes.

In conclusion, while coccydynia can be quite painful and disruptive, most cases improve with conservative treatment. If your symptoms persist or worsen, it would be advisable to follow up with your healthcare provider for further evaluation and management options. Regular follow-ups can help ensure that any underlying issues are addressed and that you receive appropriate care.

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