Your Coccyx lies at the very bottom of your spine as a small extension of your sacrum. A small amount (+/-30˚) of movement occurs here to allow you to sit in comfort, go to the toilet, make love, and birth a child (for the ladies of course). A set of ligaments connect your coccyx to your sacrum, providing reinforcement that helps maintain the position of your coccyx and correctly distribute force. In addition, your coccyx also provides an attachment point for most of the pelvic floor muscles and soft tissue structures of the pelvis.
If you have ever taken a fall and landed directly on your derriere, chances are you have experienced some degree of Coccydynia. Simply put, Coccydynia is the term used to describe pain over the Coccyx, or in layman’s terms: the tailbone.
What causes Coccyx pain?
Pain in this area usually occurs when the coccyx is held at an excessive angle, either forwards or backward, on the sacrum. Excessive forward angulation results in “slackening” (loss of tone) in the pelvic floor muscles and an increase in pressure against the coccyx when sitting. Excessive backward angulation results in “tightening” or increased tone/spasm of the pelvic floor muscles. Both scenarios produce pain due to the altered mechanics in the area.
Excessive angulation is commonly caused by:
- Spasm of the pelvic floor muscles which pull the coccyx forward.
- Direct trauma from a slip or fall which lands bum first and pushes the coccyx forward.
- Slouchy or slumpy sitting habits which consistently place the coccyx in a forward position.
- Birth trauma resulting in excessive backward angulation.
- Changes in pelvic floor tone and lower back mechanics during pregnancy.
In the case of direct trauma; bruising and possible spraining of the surrounding ligaments may also contribute to the development of pain. Furthermore, depending on the severity of the injury, fracture or dislocation of the coccyx may also contribute to the experience of pain.
The resultant combination of altered pelvic floor muscle tone, spraining and abnormal positioning of the coccyx lends to the development of inflammation and inflexibility in the area, resulting in a rather uncomfortable situation!
What does it feel like?
Localised pain is experienced right at the bottom of the spine over the tailbone between the butt cheeks, while referred pain from the coccyx may be felt on the outside of the hips, at the back of the thighs, and in the groin.
Generally, the pain is most severe when sitting in a soft chair, standing for prolonged periods or during repetitive activities such as climbing the stairs. It is usually described as a sharp achy sensation and most people will balance their weight on one butt cheek when sitting or lean to one side to elevate their coccyx and relieve the pain.
Can it be treated?
- Frequent icing to control inflammation.
- Sitting on a doughnut cushion to relieve direct pressure during healing.
- Assessment and correction of poor sitting postural habits.
If abnormal angulation has been present for a while or is the result of a significant trauma; manual therapy is often a required addition in order to restore movement and flexibility and normalise pelvic floor muscle tone.
Many people think the only way to restore movement is with a rather invasive approach of internal mobilisation. As result, people often choose to preserve their modesty and wait much longer than necessary to seek treatment as they view internal adjustments as a last resort for when they absolutely can’t bear the pain any longer. Luckily (for you and for me) EXTERNAL mobilisation techniques are extremely effective in restoring movement, normalizing pelvic floor tone and relieving pain!
The technique is somewhat up-close-and-personal, quite uncomfortable, and does cause a little bruising in and of itself, however, the pros far out-weigh the cons!
Depending on your level of sensitivity, a short course of anti-inflammatory medication may be recommended to further aid in the healing process; and most often it is advisable to continue using a doughnut pillow even after pain has subsided to keep pressure off the coccyx and ensure complete healing.
When should I seek treatment?
If you are experiencing Coccydynia it is best to get checked out as soon as possible so a thorough assessment can be performed, an accurate diagnosis made, and the appropriate treatment administered.
There is no need to suffer unnecessarily when treatment can be so simple and effective; Coccydynia no longer has to be such a pain in the butt!
Move Well. Live Well.