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Coccydynia Overview


Coccydynia (pain in the coccyx, sometimes called coccygodynia, or pain in the tailbone) is a common, painful condition that is easily diagnosed. Though coccydynia usually resolves over weeks to months with supportive care, it is sometimes protracted and debilitating. Prolonged symptoms may lead to aggressive diagnostic tests and interventions that are not supported by strong research evidence of effectiveness. Most publications on coccydynia are case reports, case series, and reviews, and there are few rigorous research studies.

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The coccyx projects distal to the sacrum, curving posteriorly and then anteriorly at the tip (figure 1). It juts into the birth canal in women and is exposed to blunt trauma posteriorly. The coccyx, along with the two ischial tuberosities, bears weight when a person is sitting, with an increased weight load on the coccyx when a person leans back in the sitting position.

The coccyx typically has 3 to 5 segments, with fibrocartilaginous joints between sacrum and coccyx and between segments. These joints are comparable to those seen in higher intervertebral spaces, but may be fused in the coccyx. Muscles that insert on the coccyx (the levator ani and its component parts) support the pelvic floor and participate in voluntary control of the bowel. Sacrococcygeal ligaments attach anteriorly, posteriorly, and laterally.

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The rate of coccydynia in the general population has not been reported. A busy primary care practitioner might see a few new cases per year. Intractable coccydynia is uncommon; few referral physicians have a primary interest in, or extensive experience with, the syndrome.
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This information is not designed to replace a physician's independent judgment about the appropriateness or risks of a procedure for a given patient.
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