Coccydynia: Pain at the Tailbone During Recovery

Coccydynia

Hello, doctor.
Due to a leg injury, I have been in a cast and hospitalized for about two weeks.
Recently, I have noticed pain in the coccyx area; it hurts when I gently touch or apply pressure to it.
However, I do not feel any discomfort while lying flat.
Instead, when I am lying on my side and try to return to a supine position, I experience sudden, severe pain.

Ni Ni, 10~19 year old female. Ask Date: 2015/07/16

Dr. Shi Guozheng reply Orthopedics

Patients who remain bedridden for extended periods often experience this phenomenon because the soft tissue thickness around the coccyx or sacrum, located at the end of the spine, is relatively thin, often described as "skin over bone." Prolonged pressure can lead to injury and inflammation of the subcutaneous tissue, resulting in pain, commonly referred to as periostitis.
If the pressure is sustained for too long without regular repositioning, skin breakdown can occur, leading to pressure ulcers (also known as bedsores).
This can cause even more pain.
Additionally, there are many ligaments attached to these bones, which may be strained during body movements, contributing to the pain.
Treatment is generally not difficult and can involve oral medications or topical applications, with improvement typically seen within a few weeks.
It is also important to avoid applying pressure to the painful areas and to refrain from maintaining the same position for too long.

Reply Date: 2015/07/16

More Info

Coccydynia, or pain at the tailbone, is a condition that can arise from various factors, including trauma, prolonged sitting, or even postural issues. In your case, it seems that the pain has developed during a period of immobilization due to a leg injury, which is not uncommon. When a person is bedridden or spends extended periods in one position, the pressure on the coccyx can lead to inflammation and pain.

Understanding Coccydynia
The coccyx, or tailbone, is a small triangular bone at the base of the spine. It can be sensitive to pressure, and when you are lying in bed or sitting for long periods, the weight of your body can exacerbate any existing inflammation or irritation in the area. The fact that you experience pain when transitioning from a side-lying position to lying flat suggests that the movement may be putting stress on the surrounding muscles and ligaments, which could be inflamed or strained.

Symptoms and Diagnosis
Common symptoms of coccydynia include localized pain at the tailbone, tenderness when pressure is applied, and discomfort during sitting or transitioning between positions. In your case, the pain during movement indicates that there may be some underlying muscle or ligament strain, possibly exacerbated by your current immobilization.

Treatment Options
1. Pain Management: Over-the-counter pain relievers such as NSAIDs (e.g., ibuprofen or naproxen) can help reduce inflammation and alleviate pain. Always consult with your healthcare provider before starting any medication.

2. Cushioning: Using a coccyx cushion or a donut-shaped pillow can help relieve pressure on the tailbone when sitting. This can be particularly beneficial if you need to sit for extended periods.

3. Physical Therapy: Engaging in physical therapy can be beneficial. A physical therapist can provide exercises to strengthen the pelvic floor and surrounding muscles, which may help alleviate pain and improve mobility.

4. Heat Therapy: Applying heat to the area can help relax tight muscles and improve blood flow, which may aid in recovery.

5. Avoid Prolonged Sitting: If possible, try to change positions frequently and avoid sitting for long periods. Standing or lying down can help relieve pressure on the coccyx.

6. Gentle Stretching: Once you are able, gentle stretching of the lower back and pelvic area can help alleviate tension and improve flexibility.

When to Seek Further Help
If your pain persists or worsens, or if you experience additional symptoms such as numbness, tingling, or bowel and bladder dysfunction, it is essential to consult a healthcare professional. These could be signs of more serious underlying issues that may require further investigation.

Conclusion
Coccydynia can be a challenging condition, especially when compounded by other injuries. It is essential to manage your pain effectively and to take steps to alleviate pressure on the coccyx. With appropriate care and attention, many individuals find relief from their symptoms and can return to their normal activities. Always keep an open line of communication with your healthcare provider to ensure that you are on the right track for recovery.

Similar Q&A

Understanding Coccydynia: Causes and Relief for Tailbone Pain

Hello, Dr. Hsu. I have been suffering from coccyx pain for the past three days. I am not sure how this pain started; I only know that on the first morning, the pain was very mild. However, by that night, around 9 PM, while watching TV in the living room, I experienced pain while ...

Dr. Xu Zhaoren reply Orthopedics
The coccyx is the terminal part of the vertebral column, equivalent to the tail in animals, and serves as an attachment point for many muscles and ligaments in the perineal region. There are numerous potential causes of pain in this area, which may include bruising, fractures, pr...

Understanding Coccydynia: Managing Tailbone and Buttock Pain

Hello Doctor: Last year, I injured my coccyx while playing basketball. The pain lasted for two to three days and then subsided, but I didn't exercise again until April of this year. After exercising, I experience pain at the tip of my coccyx and in the muscles near the right...

Dr. Shi Guozheng reply Orthopedics
Coccydynia is often associated with impact injuries, and some individuals may continue to experience pain for a period after the injury. Taking pain relievers and soaking in warm water can help alleviate the discomfort. Generally, it takes some time for recovery.

Understanding Coccydynia: Managing Tailbone Pain After Injury

I slipped and fell while getting off the bus at the age of 15, resulting in an X-ray that showed a fracture in my coccyx, which is slightly inwardly displaced. Since then, the area above my groin has been consistently swollen, and I have been unable to sleep flat on my back for m...

Dr. Shi Guozheng reply Orthopedics
If pain recurs, medication can be used for treatment, or local heat application or steroid injections may be considered. It could be due to inflammation of the periosteum or tendons. Try to avoid putting pressure on the area to minimize pain.

Understanding Coccydynia: Causes, Symptoms, and Treatment Options

Recently, I have been spending a lot of time studying and attending tutoring sessions. During class today, I suddenly felt a sharp pain in my coccyx, which was very uncomfortable. This is the first time I've experienced this sensation. When I got home, I researched online an...

Dr. Wang Shouji reply Orthopedics
Felix: Generally speaking, if you are of an age without trauma and have been sitting for a long time, it is possible to experience coccydynia (tailbone pain). It is recommended not to sit for too long and to use a cushion on your chair. At home, apply heat and take warm baths; th...