What is The Coccyx (Tailbone) ? Why Does The Coccyx Pain?
The coccyx, the final section of the spine, is a triangular structure formed by the fusion of three to five bones located above the hip. This bone is commonly known as the “tailbone,” “coccyx,” or “coccygodynia,” and medically as the “coccyx.”
The coccyx plays a crucial role in facilitating interaction between muscles, tissues, and tendons.
It increases the spine’s flexibility and reduces the burden on a person sitting.
Although the coccyx is a small bone located at the base of the spine, it serves a vital role in the body.
These include providing balance and support. Furthermore, as a connecting point for muscles and ligaments, the coccyx helps maintain spinal health by eliminating the pressure exerted on the spine during sitting and movement.
The Coccyx: From an Evolutionary Perspective:
The coccyx is considered a remnant of the tail that existed in human ancestors. For this reason, it is also called a “rudimentary” or vestigial organ. Although humans lack a visible tail, the coccyx bears traces of this past in the skeletal system.
Confusions with the Coccyx:
- The coccyx is often confused with the spinal column, but the lumbar region is located much higher.
- The sacrum and coccyx, while close to each other, are different bones.
What is Coccyx (Tailbone) Pain?
Coccyx pain is discomfort and pain felt in the coccyx region and bones. Causes of coccyx pain include trauma, fractures, inflammation, childbirth, and prolonged sitting.
What Are The Functions of The Coccyx (Tailbone)?
The coccyx (medically known as the coccyx) is a small but important bony structure in the human body. Although we no longer have a “tail” due to evolutionary reasons, the coccyx still performs some essential functions.
Functions of The Coccyx:
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Provides an Anchor for Muscles, Ligaments, and Tendons:
- Some of the muscles that make up the pelvic floor attach to the coccyx.
- These muscles play a role in supporting the intestines, bladder, and reproductive organs.
- Important muscle groups, particularly the levator ani and gluteus maximus, attach to this area.
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Provides Balance in Sitting:
- The coccyx supports the skeletal system while sitting.
- Particularly when sitting upright, a portion of the body’s weight is transferred to the coccyx region.
- Together with the sacrum, it forms a triple support point (the two sitting bones and the coccyx).
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Contributes to Body Posture:
- It plays a small but effective role in maintaining posture.
- Coccyx misalignments can trigger back pain.
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Provides Flexibility During Childbirth (Women):
- The coccyx is slightly more mobile in the female pelvis.
- This flexibility helps the birth canal widen.
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Function as an Evolutionary Vestigious Organ:
- Humans do not have a tail, but the coccyx bone is a vestige of our evolutionary ancestors’ tail structure.
- Although it no longer functions as an active tail, it is scientifically important in this respect.
What are The Causes of Coccyx (Tailbone) Pain?
The most common causes of coccyx pain are as follows:
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Impact:
Impact can occur on the coccyx or surrounding muscles. For example, falling off a bicycle can injure the coccyx itself, while a collision can cause pain that radiates from other muscles to the coccyx.
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Sitting:
Sitting, especially in unhealthy positions for long periods, can cause coccyx pain.
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Being Overweight or Underweight:
Individuals who are overweight put more pressure on the coccyx when sitting. Underweight individuals may have less fat to protect this bone.
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Repetitive Strain Injury:
This type of injury is particularly common in cycling.
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Pregnancy or Childbirth:
During the third trimester of pregnancy, a woman’s body releases hormones that soften the area between the sacrum and coccyx. This allows the pelvic area to expand to facilitate labor. This also allows the coccyx to move properly during labor. While this is a normal bodily process, movement can unnecessarily strain the ligaments and muscles surrounding the coccyx and cause further discomfort. These soft tissues are under so much stress that they can’t hold your coccyx at a normal angle.
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Levator Syndrome:
This condition causes spasms in the anal muscles, and pain can radiate to the tailbone, hips, or other nearby areas.
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Strain:
This is often caused by constipation or hemorrhoids.
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Spinal Problems:
For example, spinal surgery or degenerative lumbar disc disease can cause pain.
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Infections, Tumors, Bone Spurs, and Growths:
Rarely, coccyx pain can also occur in these medical conditions.
What are The Symptoms of Coccyx (Tailbone) Pain?
Symptoms of coccyx pain typically manifest as localized pain around the tailbone (coccyx). The pain can worsen over time and can be triggered by movements such as sitting or changing positions.
Symptoms of Coccyx Pain:
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Pain When Sitting:
This is the most common symptom. Sitting on a hard surface or for long periods of time increases the pain.
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Pain When Standing:
There may be a stabbing pain in the coccyx area when rising from a sitting position.
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Tenderness When Pressed on The Coccyx:
Touching the area may increase tenderness or throbbing.
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Numbness or Burning Sensation When Sitting for Prolonged Periods:
This is particularly common in office workers. There may be discomfort while sitting.
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Pain When Toileting:
Rarely, pain may be felt in the coccyx area during defecation.
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Discomfort During Intercourse (More Common in Women):
This symptom may occur if the nerves associated with the pelvic floor are affected.
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Pain Radiating to the Leg or Buttock (Rare):
If the nerves near the coccyx are affected, the pain may radiate to the buttocks, lower back, or legs.
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Discomfort While Lying (Rare):
There may be discomfort due to pressure when lying on the back.
How Is Coccyx (Tailbone)Pain Diagnosed?
The following methods may be used to diagnose coccyx pain:
Physical Examination:
The doctor will examine your coccyx area, checking for symptoms such as pain, tenderness, and swelling. They will also evaluate your range of motion and posture.
Imaging Methods:
X-Rays:
X-rays may be taken to check for fractures or dislocations in the coccyx.
Magnetic Resonance Imaging (MRI):
MRI can be used to view soft tissues (such as muscles, ligaments, and nerves) in greater detail and detect nerve compression or other problems.
Computed Tomography (CT):
CT can be used to view bone structures in greater detail and detect fractures or other bone problems.
Laboratory Tests:
If infection is suspected in coccyx pain, blood tests may be ordered. These tests are used to detect increased white blood cell counts or specific infection markers, which are signs of infection.
Anesthetic Injections:
For diagnostic purposes, a local anesthetic injection can be administered into the coccyx region. If there is a significant reduction in pain after the injection, the coccyx is confirmed to be the source of the pain.
Dynamic Imaging:
Dynamic X-rays taken in sitting and standing positions show the movement of the coccyx and any possible abnormalities. This method is particularly practical for evaluating movement-related pain.
Differential Diagnosis:
To rule out other potential causes of coccyx pain, doctors may also evaluate conditions such as pilonidal cysts, pressure sores, osteomyelitis, or sacroiliac joint dysfunction. This is essential for an accurate diagnosis and treatment plan.
In conclusion, diagnosing coccyx pain requires a comprehensive evaluation combined with appropriate diagnostic tests. Accurate and early diagnosis is a key criterion for developing an effective treatment plan.
How is Coccyx (Tailbone) Pain Treated?
Outpatient or surgical treatment is rarely necessary. You can overcome the process with home remedies.
Home remedies for coccyx pain include:
- Using painkillers and anti-inflammatory medications recommended by your physician,
- Avoiding prolonged sitting,
- Lowering the pain threshold by relaxing the muscles in a hot bath with thermal effects,
- Increasing bowel movements by boosting metabolism,
- Performing exercises that stretch and strengthen the lower back muscles,
- Using a coccyx cushion while sitting,
Wearing clothing that does not constrict the area. Outpatient treatments for coccyx pain may include the following:
- Nerve blocking with medication,
- Massage therapy,
- Physiotherapy with exercise and acupuncture,
- Transcutaneous electrical nerve stimulator device support,
Surgery is rarely recommended for coccyx pain:
- Removal of a portion of the coccyx,
- Surgical removal of the entire coccyx.
Recovery after surgery can be lengthy. Therefore, it is not a popular treatment option for these pain symptoms.
Ganglion Impar Blockade:
This is a treatment method used to relieve coccyx pain. The ganglion impar is a bundle of nerves in the sympathetic nervous system that transmits pain signals to the lower pelvis. Ganglion impar blockade aims to reduce pain in the coccyx region by temporarily numbing or blocking this bundle of nerves.
Manipulation for Coccyx Pain:
Manipulation for coccyx pain can be beneficial in some cases. However, it should be performed with caution by an orthopedic surgeon or physical therapist. Manipulation in the coccyx area can increase mobility of the coccyx joints and tissues, which can reduce pain.
Surgery for Coccyx Pain:
Coccyx pain is generally a non-surgical condition and can be managed with conservative treatments in most cases. However, in rare cases, surgical options may be considered.
For example:
Removal of Coccygeal Cysts:
Fluid-filled cysts can form in the coccyx and sometimes require surgical removal.
Repair of Coccyx Trauma:
Severe coccyx trauma can result in fractures or dislocations, which may require surgical intervention.
Treatment of Other Serious Conditions Causing Coccyx Pain:
In rare cases, surgical treatment may be necessary for an underlying condition (e.g., a tumor) causing coccyx pain.
However, surgical options should always be considered a last resort and should be discussed with your doctor, weighing the risks and benefits. In most cases, conservative treatments (rest, physical therapy, medications) may be sufficient to relieve coccyx pain.
What Helps Coccyx Pain?
Coccyx pain is an uncomfortable condition that can occur for a variety of reasons. The area just above the coccyx can often cause pain due to factors such as poor sitting, falling, childbirth, or prolonged immobility.
Here are some methods that can help relieve coccyx pain:
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Applying a Hot or Cold Compress:
Cold Compress:
If the pain began after a traumatic fall or impact, applying a cold compress for the first 24-48 hours can reduce swelling and inflammation.
Hot Compress:
Later, applying a hot compress can help relax the muscles.
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Posture and Sitting Position:
Proper Sitting:
If you sit for long periods, try to keep your hips and back straight. Using a pillow or a special coccyx pillow (a coccyx pillow can reduce pressure while sitting) may be helpful.
Standing:
It’s important to stand and stretch occasionally instead of sitting for long periods.
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Stretching and Light Exercises:
Some simple stretches and light exercises can help relieve coccyx pain by loosening muscles and reducing pain. Stretching the lower back and hip muscles can be particularly beneficial.
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Painkillers and Anti-Inflammatory Medications:
For mild pain, painkillers or anti-inflammatory medications (such as ibuprofen) can be used. However, it’s best to consult a doctor before using medication.
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Physical Therapy:
If the pain persists, you can seek help from a physical therapist. Physical therapy can provide effective treatment by targeting the source of the pain.
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Postural Correction:
Coccyx pain can sometimes be caused by poor posture. It’s important to maintain proper posture and maintain the natural curve of the spine. Using a supportive chair while sitting can alleviate the pain.
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Gently Massage:
Gently massaging the coccyx area can help relax the muscles. However, avoid applying excessive pressure.
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Sometimes Psychological Factors:
Stress and anxiety can cause muscle tension. In this case, relaxation techniques (deep breathing, meditation, yoga) can also be helpful.
If these methods do not relieve your pain, it may be important to consult a doctor to discuss further treatment options.
Causes of Coccyx Pain During Pregnancy
Growing Uterus and Weight Distribution:
As pregnancy progresses, the growing uterus puts pressure on the lower pelvis. This pressure can strain the muscles, ligaments, and joints in the coccyx area, causing pain.
Hormonal Changes:
During pregnancy, the hormone relaxin is released, allowing the body to relax. This hormone helps the pelvis expand by allowing the ligaments to stretch. However, this can also cause the ligaments surrounding the coccyx to loosen, making the joints in this area more sensitive.
Posture Changes:
Body weight changes during pregnancy, and the alignment of the pelvis changes. This places uneven load on the lower back and coccyx. Especially with advanced pregnancy, the body shifts forward, which can cause pain in the coccyx.
Baby Position:
As the baby settles into the birth position, it can put pressure on the coccyx. Especially before the baby descends head-down, excessive pressure can occur on the coccyx.
Increased Pelvic Pressure Later in Pregnancy:
Increased Pelvic Pressure Later in Pregnancy, especially in the last trimester, the baby’s growth and pressure on the pelvis put strain on the muscles, ligaments, and joints in this area.
Excess Weight:
Excess weight gained during pregnancy places additional strain on the body, which can cause pain in the coccyx area.
Lack of Physical Activity:
Decreased mobility during pregnancy can lead to weakening of muscles and stiffening of the structures surrounding the joints. This can worsen coccyx pain.
Treatment Methods for Coccyx (Tailbone) Pain During Pregnancy
Proper Sitting and Sleeping Positions:
Pay Attention to Sitting Position:
Sit comfortably with your back straight. Keeping your knees slightly bent and using a pillow can relieve pain.
Use a Pillow When Sleeping on Your Side:
Placing a pillow between your legs while sleeping can reduce pressure on your lower back and pelvis. This can relieve coccyx pain.
Heat or Cold Application:
Hot Compress:
Applying a light warm compress to the coccyx can relax the muscles and reduce pain. However, be careful not to apply heat for too long.
Cold Compress:
If the pain started suddenly and there is swelling, applying a cold compress may be helpful.
Pelvic Exercises and Stretching:
Pelvic Tilt Exercises:
This exercise can restore the natural alignment of the pelvis and reduce pressure on the coccyx area. This exercise strengthens the abdominal muscles and relaxes your back.
Gentle Stretching:
Stretching the lower back and hip muscles, in particular, can help relieve coccyx pain.
Physical Therapy and Massage:
A physical therapist can alleviate pain by recommending safe movements and positions that you can practice during pregnancy.
Gentle massage of the coccyx area can also help relax the muscles and reduce pain.
Choosing The Right Shoe:
Wearing comfortable and supportive shoes supports posture and can alleviate pain. Avoid high heels, as they can put extra pressure on the coccyx.
Increasing Physical Activity:
With your doctor’s approval, taking regular light walks can strengthen muscles and reduce pain in the pelvic area. Regular movement can improve your overall health.
Pillows for Back and Pelvic Support:
Using special pregnancy pillows can support your lower back and pelvic area while sleeping and resting.
Painkillers:
If the pain becomes unbearable, you can consult your doctor and use safe painkillers such as paracetamol. However, you should never take medication without a doctor’s advice.
Stress Relief and Relaxation:
Relaxation techniques such as yoga, meditation, or deep breathing exercises can reduce muscle tension and help you relax.