Coccyx Pain After Exercise: Causes and When to Seek Help

Coccydynia after exercise?

Hello Doctor: I haven't exercised for a long time, and yesterday I went to the gym to work out.
I did sit-ups, lying flat with my legs raised and lowered without letting my feet touch the ground, which is an abdominal muscle workout.
However, when I sat on the bed before sleeping, I started to feel soreness near the coccyx, which is the kind of pain that hurts with slight pressure.
After lying down to sleep, I still felt that soreness in the coccyx area.
Upon waking up the next day and sitting in my office chair, I could still feel the soreness.
I would like to ask: 1) Should I go to an orthopedic doctor for an X-ray examination? 2) Could this soreness be due to a muscle strain, and is it just because of the location near the coccyx that it causes this pain? 3) Could a brief one-hour workout cause a herniated disc?

Ms. Chen, 30~39 year old female. Ask Date: 2020/12/23

Dr. Chen Bochen reply Orthopedics

1) Should I go to an orthopedic specialist for an X-ray? No, bones do not spontaneously dislocate due to minor exertion; the human body is not that fragile.

2) Could this soreness be due to a muscle strain, specifically because of its location at the coccyx? The coccyx has many tendons and ligaments attached, and soreness is usually caused by tendon or ligament strain.
Typically, rest will improve the condition, and using topical medications or taking oral medications can expedite recovery.
3) Can a brief hour of exercise cause a herniated disc? No, exercise is beneficial for both physical and mental health, but it should be done progressively.

Reply Date: 2020/12/23

More Info

Coccyx pain, or coccydynia, can be a common issue, especially after engaging in physical activities that the body is not accustomed to. Your experience of tailbone discomfort following a workout, particularly after performing exercises like sit-ups, raises several important considerations regarding the underlying causes and when to seek medical attention.

1. Should You Get an X-ray?
If the pain persists or worsens, it may be advisable to consult with a healthcare professional, such as an orthopedic specialist. An X-ray can help rule out any fractures or structural issues with the coccyx. However, if the pain is mild and manageable, it may not be necessary to pursue imaging right away. Instead, you might consider conservative management strategies first, such as rest, ice application, and over-the-counter pain relief medications.

2. Muscle Strain vs. Coccydynia:
The discomfort you are experiencing could indeed be related to muscle strain, particularly if the pain is localized around the tailbone area. When performing exercises that engage the abdominal muscles, it's possible to inadvertently strain the muscles around the pelvis and lower back, leading to referred pain in the coccyx region. This is especially true if you have not been active for a while, as your muscles may not be accustomed to the sudden increase in activity. Additionally, poor form during exercises can exacerbate this issue.
3. Risk of Disc Herniation:
It is unlikely that a single hour of exercise would directly cause a disc herniation, especially if you were performing exercises that primarily target the abdominal muscles. Disc herniation typically results from cumulative stress or trauma rather than a single event. However, if you have pre-existing conditions or if the exercises were performed with improper technique, there could be a risk of aggravating underlying issues.

Recommendations:
- Rest and Recovery: Allow your body some time to recover. Avoid activities that exacerbate the pain, particularly those that involve prolonged sitting or pressure on the tailbone.

- Ice Therapy: Applying ice to the affected area for 15-20 minutes several times a day can help reduce inflammation and alleviate pain.

- Pain Management: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help manage pain and reduce inflammation.

- Modify Activities: When you return to exercise, consider modifying your routine to include low-impact activities that do not place stress on the coccyx, such as swimming or cycling. Gradually reintroduce core exercises with proper form and technique.

- Seek Professional Help: If the pain persists beyond a few days, worsens, or is accompanied by other symptoms (such as numbness, tingling, or severe pain), it is important to seek medical attention. A healthcare provider can perform a thorough evaluation and determine if further imaging or treatment is necessary.

In summary, while your symptoms may be related to muscle strain from a sudden increase in activity, it is important to monitor your condition. If the pain does not improve with conservative measures, or if you have concerns about potential injuries, consulting with a healthcare professional is the best course of action.

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