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WHAT IS IT?
WHAT CAUSES IT?
HOW CAN PHYSIO HELP?
WHAT IS IT?
Coccydynia or coccygodynia is pain in or around the coccyx (tailbone), the bony end point of the spine. It is a very important structure as it serves as an attachment for several ligaments, tendons and muscles. The deep pelvic floor muscles insert on the anterior surface of the coccyx, and the largest gluteal muscles (buttock) originate partly on its posterior surface. In the sitting position, the coccyx becomes a weight-bearing structure along with the two ischial tuberosities (sitting bones).
Coccydynia can feel dull or like a deep ache, but can also feel sharp with certain movements or positions such as sitting, prolonged standing or moving from a sitting to standing position. Sexual intercourse, direct pressure on the coccyx and stool evacuation may also be uncomfortable. Some people have even noted an improvement in their pain following a bowel movement or walking. Although it is more common in women, it can affect men also.
The pain usually passes over a few days to a few weeks, but in some cases it may develop into a more chronic pain syndrome. If severe or persistent, coccydynia may impact a person’s ability to perform various daily activities.
Coccydynia can feel dull or like a deep ache, but can also feel sharp with certain movements or positions such as sitting, prolonged standing or moving from a sitting to standing position. Sexual intercourse, direct pressure on the coccyx and stool evacuation may also be uncomfortable. Some people have even noted an improvement in their pain following a bowel movement or walking. Although it is more common in women, it can affect men also.
The pain usually passes over a few days to a few weeks, but in some cases it may develop into a more chronic pain syndrome. If severe or persistent, coccydynia may impact a person’s ability to perform various daily activities.
WHAT CAUSES IT?
There are several possible causes for coccydynia. A common trigger is local trauma to the coccyx. The trauma can be abrupt and acute, for example a fall onto the coccyx (external trauma) or vaginal childbirth (internal trauma from the pressure as the baby descends through the pelvis) causing the coccyx to be fractured, bruised or displaced. The trauma can also be progressive, for example with prolonged sitting on a hard surface. Some people develop coccydynia following certain medical procedures.
Other possible sources of coccydynia include malignancies, infections, degenerative joint changes of the sacrococcygeal and intracoccygeal junctions, or excessive and abnormal mobility of the coccyx.
The pain may also be referred from another structure, such as a lumbar disc herniation at the lumbosacral level (especially if palpation of the coccyx itself is not painful) or in many cases be idiopathic (without an identifiable cause).
Other possible sources of coccydynia include malignancies, infections, degenerative joint changes of the sacrococcygeal and intracoccygeal junctions, or excessive and abnormal mobility of the coccyx.
The pain may also be referred from another structure, such as a lumbar disc herniation at the lumbosacral level (especially if palpation of the coccyx itself is not painful) or in many cases be idiopathic (without an identifiable cause).
HOW CAN PHYSIO HELP?
Complete pain relief can occasionally occur via natural recovery over time (a few weeks to a few months). Early pelvi-perineal rehabilitation can help prevent coccydynia from developing into the more chronic stage by addressing issues with the pelvic floor musculature and ligaments. This may include education regarding your posture and lifestyle habits, stretching exercises, massage, deep breathing and relaxation techniques to release tense ligaments and pelvic floor muscles. If hypermobility of the coccyx is a problem, strengthening exercises for the supporting muscles may help. If the coccyx is displaced, mobilisations and manipulations that move it back into its proper position can relieve pain.
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