Most often, the cause of coccydynia is unknown (“idiopathic”). Other causes include trauma (for example, from falls and childbirth); abnormal, excessive mobility of the tailbone; and – very rarely – infection, tumor, or fracture. A number of different conditions can cause pain in the general area of the coccyx, but not all involve the coccyx and the muscles attached to it. The first task of diagnosis is to determine whether the pain is related to the coccyx. A simple single injection of local anesthesia into the area can sometimes give a more accurate diagnosis.
Why It Occurs
One way of classifying coccydynia is whether the onset was traumatic versus non-traumatic. In many cases the exact cause is unknown and is referred to as idiopathic coccydynia. Coccydynia is often reported following a fall or after childbirth. In some cases, persistent pressure from activities like bicycling may cause the onset of coccyx pain. Coccydynia due to these causes usually is not permanent, but it may become very persistent and chronic if not controlled. Coccydynia may also be caused by sitting improperly thereby straining the coccyx.
The classic symptom is pain when pressure is applied to the tailbone, such as when sitting on a hard chair. Symptoms usually improve with relief of pressure when standing or walking. Other symptoms can include: Immediate and severe pain when moving from sitting to standing, pain during bowel movements, pain during sex, or deep ache in the region of the tailbone. It often takes many weeks to months to improve due to the many structure near the area.
Treatment most often is conservative and consists of non-steroidal anti-inflammatory drugs (NSAIDs) — such as ibuprofen and naproxen — to reduce inflammation, and the use of a therapeutic sitting cushion to take the pressure off of the tailbone when sitting. It might take many weeks or months of conservative treatment before significant pain relief is felt. If conservative treatment fails to relieve the pain there are injections and blocks that can help relieve the pain and help control return to more normal function.