Coccydynia: Symptoms, Causes, and When to Seek Help

Coccygeal issues

A few days ago, I started experiencing pain in my coccyx, accompanied by the discharge of a yellow, foul-smelling fluid.
Initially, the pain was mild and did not affect my daily life, so I thought it would resolve itself in a few days and did not pay much attention to it.
However, after a few days, the pain became severe, and I noticed swelling, along with symptoms resembling a cold.
Pain relievers have not been effective.
Now, I experience pain while walking or sitting, and I can only sleep on my side.
What could be the issue, and which specialist should I see?

Mr. Yang, 10~19 year old female. Ask Date: 2018/04/25

Dr. Shi Guozheng reply Orthopedics

It is possible that there is localized inflammation, and it may be necessary to consult a physician.
If there is an infection, prompt treatment is essential.

Reply Date: 2018/04/25

More Info

Coccydynia, or tailbone pain, can be a distressing condition that significantly impacts daily life. The symptoms you are experiencing, including pain in the coccyx area, discharge of yellowish fluid with an unpleasant odor, swelling, and associated systemic symptoms like fever, suggest that there may be an underlying infection or inflammation that requires medical attention.

Symptoms of Coccydynia
Coccydynia typically presents as localized pain at the base of the spine, which can be exacerbated by sitting, standing, or moving from a seated position. The pain can range from mild discomfort to severe, debilitating pain. In some cases, individuals may also experience swelling or tenderness in the area, and in your case, the discharge of foul-smelling fluid raises concern for possible infection, such as a pilonidal cyst or an abscess.

Causes of Coccydynia
The causes of coccydynia can vary widely. Common causes include:
1. Trauma: Injury to the coccyx from falls or prolonged sitting on hard surfaces.

2. Infection: Infections can lead to abscess formation, which may present with discharge and systemic symptoms.

3. Inflammation: Conditions like arthritis or inflammation of the surrounding tissues can contribute to pain.

4. Cysts: Pilonidal cysts, which can become infected, are common in the coccygeal region and may lead to similar symptoms.

When to Seek Help
Given the progression of your symptoms—specifically the severe pain, swelling, and discharge—it is crucial to seek medical attention promptly. You should consider visiting a healthcare provider who specializes in conditions of the spine or a general practitioner who can evaluate your symptoms. In particular, a visit to an orthopedic specialist or a pain management clinic may be beneficial.

Recommended Actions
1. Medical Evaluation: A thorough examination is necessary to assess the coccyx and surrounding tissues. Imaging studies, such as X-rays or MRI, may be ordered to rule out fractures or other structural issues.

2. Treatment Options: Depending on the diagnosis, treatment may include:
- Pain Management: Non-steroidal anti-inflammatory drugs (NSAIDs) can help alleviate pain and inflammation.

- Infection Management: If an infection is present, antibiotics may be required.

- Physical Therapy: Strengthening and stretching exercises can help alleviate pain and improve mobility.

- Surgical Intervention: In cases of severe infection or persistent pain, surgical drainage of an abscess or removal of the coccyx (coccygectomy) may be considered.

3. Home Care: While waiting for your appointment, you can try to manage your symptoms by:
- Using a cushion when sitting to relieve pressure on the coccyx.

- Applying ice packs to reduce swelling.

- Taking over-the-counter pain relievers as needed.

Conclusion
Your symptoms indicate that you may be dealing with a more serious condition than simple coccydynia, especially with the presence of discharge and systemic symptoms. It is essential to seek medical attention as soon as possible to receive an accurate diagnosis and appropriate treatment. Early intervention can prevent complications and help you return to your normal activities more quickly.

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