Doctor's Notes on Tailbone Pain (Coccydynia)
The tailbone (coccyx) is a triangular bony structure located at the bottom of the spinal column between the buttocks. Pain in the tailbone area, also called coccydynia, can be caused by injury to the coccyx (such as falls, direct blows, during childbirth, or repetitive strain as from sports such as cycling or rowing), bone spurs, compression of nerve roots, localized infections, pilonidal cysts, and tumors. In some cases, the cause of coccydynia is unknown.
The symptoms of tailbone pain usually worsen when there is pressure or contact with the coccyx and the pain is often relieved when pressure is removed from the coccyx. Symptoms of tailbone pain may include severe localized pain or a deep ache in the tailbone area when touched, bruising if there has been traumatic injury to the coccyx, pain that worsens when sitting for long periods of time or on hard surfaces, painful bowel movements, and painful sexual intercourse (in women).
Tailbone Pain (Coccydynia) Symptoms
The symptoms of tailbone pain are typically exacerbated by actions that exert pressure or directly contact the coccyx. The pain is usually relieved by removing pressure off the coccyx, such as occurs when standing or walking.
- Severe localized pain or a deep ache may be felt in the tailbone area when touched.
- If the injury is traumatic, a bruise may be visible in the coccyx area.
- The pain is generally worse when sitting for prolonged periods of time on a hard surface or with direct pressure to the tailbone area.
- Bowel movements and straining may be painful.
- Some women may experience pain during sexual intercourse.
Tailbone Pain (Coccydynia) Causes
There are many different conditions that can lead to tailbone pain. Often, the cause of the pain is unknown (idiopathic) and never determined. Conditions known to lead to coccyx pain include the following.
- A fall onto the tailbone in the seated position, usually against a hard surface, is a common cause of coccyx injury.
- A direct blow to the tailbone, such as those that occur during contact sports, can also injure the coccyx.
- The coccyx can be injured or fractured during childbirth.
- Repetitive straining or friction against the coccyx (as happens in bicycling or rowing) can injure the coccyx.
Less common causes of coccyx pain include bone spurs, compression of nerve roots, localized infections, pilonidal cysts, and tumors.
Sciatica is a pain that radiates from the low back down a lower extremity; it is caused by irritation of the sciatic nerve. The sciatic nerve transmits sensation from the lower extremities and lumbar area of the low back. It is common for people to recover from sciatica without a surgical operation.
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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.