Coccydynia: Tailbone Pain After Severe Coughing

Coccygeal issues

Hello Doctor: About a month ago, I had a severe cold and was coughing a lot.
Initially, I didn't have many symptoms, but after a while, I started to feel some soreness in my coccyx (the area where the tailbone is located).
I could feel it whether I was standing, sitting, lying down, or bending over.
When I followed up with an ENT specialist, I asked the doctor about it, and he suggested that it might be due to leaning forward while coughing, combined with the intensity of the cough, which could have caused a strain.
Since the end of July, I have been coughing less frequently, but when I do cough, it is quite intense, and I still tend to lean forward.
What puzzles me is that the discomfort in my coccyx seems to be getting worse; initially, it was just soreness, but now it also hurts, and I can feel it clearly regardless of my position.
I can't maintain any posture for too long, and bending over or squatting is quite difficult; I have to do it very slowly and carefully to avoid pain.
I'm not sure if this is due to the coughing, my lazy sitting posture during the summer, or other reasons.
I would like to ask the doctor what symptoms this might be more likely related to.

Dai Mao, 10~19 year old female. Ask Date: 2019/08/09

Dr. Li Yongheng reply Orthopedics

Hello, based on your symptoms, it is likely that you have coccydynia due to improper posture or exertion, which may have led to coccygeal fasciitis.
It is recommended that you visit an orthopedic clinic for an X-ray examination for peace of mind.
If necessary, you may need to take some anti-inflammatory medication.

Reply Date: 2019/08/09

More Info

Coccydynia, or tailbone pain, can indeed arise from various causes, including trauma, prolonged sitting, or even repetitive strain from activities like severe coughing. In your case, it seems that the intense coughing episodes you experienced may have contributed to the discomfort in your tailbone area. When you cough, especially if you lean forward, it can place significant stress on the pelvic region and the coccyx, leading to inflammation or strain in the surrounding muscles and ligaments.

Understanding Coccydynia
Coccydynia is characterized by pain in the coccyx or tailbone area, which can be exacerbated by sitting, standing, or transitioning between positions. The pain can be sharp, aching, or throbbing and may radiate to the lower back or buttocks. In your situation, the progression from mild discomfort to more severe pain suggests that there may be inflammation or irritation of the coccyx or the surrounding soft tissues.

Possible Causes
1. Trauma: Even if you haven't experienced a direct injury to the coccyx, the force exerted during severe coughing can lead to microtrauma in the area.

2. Muscle Strain: The muscles and ligaments that support the coccyx can become strained from repetitive movements or awkward postures during coughing.

3. Postural Issues: If you've adopted poor posture while sitting or standing, especially during your illness, this could contribute to the discomfort.

4. Inflammation: The repetitive strain from coughing may lead to inflammation of the coccygeal region, causing pain.

Treatment Options
1. Rest and Activity Modification: Avoid activities that exacerbate the pain, such as prolonged sitting or any movements that put pressure on the coccyx.

2. Pain Management: Over-the-counter pain relievers like ibuprofen or acetaminophen can help reduce inflammation and alleviate pain. Always consult with a healthcare provider before starting any medication.

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

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

5. Heat or Ice Therapy: Applying heat or ice to the affected area may help reduce pain and inflammation.

When to Seek Further Evaluation
If your symptoms persist or worsen despite conservative management, it may be necessary to seek further evaluation. This could include imaging studies such as X-rays or MRI to rule out any underlying structural issues, such as fractures or cysts that may be contributing to your pain.

Conclusion
In summary, your tailbone pain following severe coughing could be attributed to muscle strain or inflammation due to the repetitive nature of your cough and the posture you adopted during that time. With appropriate management, including rest, pain relief, and possibly physical therapy, you should see improvement. However, if the pain continues or escalates, further medical evaluation may be warranted to ensure there are no other underlying issues. Always consult with a healthcare professional for personalized advice and treatment options tailored to your specific situation.

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