Coccygodynia is a pain syndrome characterized by a painful sensation around the last bone at the base of the spine, known as the coccyx.

The intensity of the pain can vary from mild to severe and is usually worse when:

• Sitting, especially when leaning back;
• Moving from sitting to standing;

Some of the people affected by the syndrome may not be able to stay in the same sitting position for more than a few minutes before they feel that they cannot tolerate the painful sensation and need to do something immediately, to ease it.

Pain in or around the coccyx can sometimes even make it difficult to perform daily activities such as driving, bending over, or sitting for long periods of time.

It may seem strange but standing on a soft surface sometimes causes more pain than sitting on a hard one. This is because when sitting on a soft surface, most of the body’s weight is concentrated on the coccyx rather than on the hard bones below the pelvis.

Other accompanying coccygodynia symptoms:

• Painful sensations all over the back;
• Stabbing pains down the legs;
• Pain before or during bowel movements;
• Painful sensations during sex;
• Pains all over the buttock and thighs;
• In women – stronger than usual pains during menstruation;

Those affected by the syndrome also complain of the inability to find a suitable comfortable position of the body, which, when trying to fall asleep and during sleep itself, does not cause painful sensations and, subsequently, disturbance of sleep.

Prolonged rolling and tossing in bed may be necessary until the affected person finds a comfortable position where it does not hurt.

What are the causes?

Pain syndrome can occur as a result of damage to the coccyx itself or the space around it, such as:

• The muscles and tendons that ensure the change in the location of the coccyx during childbirth;
• Trauma to the coccyx caused by an accident;
• Removal of the bone from its normal position due to an abnormal position of the body or repetitive activities such as cycling and rowing;

In about 1/3 of cases, no obvious cause is found, although wear and tear on the vertebrae due to advancing age is thought to have played a role.

When to seek medical attention?

See your GP if tailbone pain lasts more than 2-3 days.

Although in most cases the syndrome is not a serious clinical condition, a careful examination should be performed to exclude the possibility of a more serious cause such as a fracture.

The diagnosis is most often made based on the patient’s complaints and a physical examination of the lower back and the entire spine.

Treatment of coccygodynia

Initially, pain relievers such as ibuprofen are administered and in most cases the painful sensations subside after a few weeks. If that doesn’t happen, then stronger prescription drugs such as injectable steroids /corticosteroids/ are switched.

In a small number of cases, the pain can last for months, in which case the condition is referred to as chronic coccygodynia, and in this case it is least likely that the unpleasant things that worsen the quality of life of the affected person will are self-limiting and disappear by themselves, and it is necessary to apply several therapies at the same time.

To relieve pain you can use specially made pillows that provide stability to the coccyx and prevent it from concentrating most of the body mass.

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