Coccyx Pain=Coccygodynia
Coccyx Pain (Tailbone Pain=Coccygodynia=Sacrum Pain)The coccyx, the coccyx in Latin, the tailbone in English, is the last part of our spine, the area often called the "pöçük" bone in our society. The tailbone is the attachment point of some ligaments in the pelvis, and these ligaments are the structures that support the organs in the pelvis, which we call the pelvic floor.
Coccyx pain may occur after trauma, sitting on a hard or narrow surface for a long time, joint calcification in the ossicles forming the tailbone (degenerative joint changes), or after vaginal delivery. However, the cause of coccyx pain in the majority of patients is unknown (idiopathic pain).
Coccyx pain is often felt as blunt pain but typically sharpens during certain activities such as sitting, rising from a sitting position to a standing position, or standing for long periods of time. Similarly, defecation and having sex can be painful. For women, tailbone pain can make menstrual periods even more unbearable.
Tailbone pain, also called sacrum pain or coccygodynia, usually goes away on its own within a few weeks or months. In the meantime, the following methods can help to reduce tailbone pain:
- Leaning forward while sitting
- Sitting on a ring-shaped pillow or wedge (V-shaped) pillow
- Applying heat or ice to the affected area
- Painkiller use
If your tailbone pain does not improve (chronic coccydynia) with all these methods, it is useful to consult a doctor. A rectal examination may be needed to rule out other potential problems. Magnetic resonance imaging (MRI) should be done to find out if there are fractures, dislocation, degenerative changes, or rarely a tumor. In addition, if an angled fracture is detected in the examinations of the last regions of the intestine called the rectum and anus adjacent to this region, the fracture or dislocation can be corrected by manipulation from the rectal region in the early period, that is, by pulling the tailbone. However, this method may not always be successful.
If the pain prolongs and becomes chronic, the following treatment methods can be applied:
- Hot water sitz bath: A 20-30 minute sitz bath in a tub or basin can be beneficial, especially for the pain of unknown reasons.
- Physical Therapy: It can be relieved by relaxation techniques such as the Pelvic floor, accompanied by a physiotherapist, deep breathing, and total relaxation.
- Manipulation: Massaging the muscles attached to the tailbone can help relieve pain. Manipulation is typically done through the rectum.
- Injection: Local anesthetic and steroid injection around the tailbone can relieve pain for several weeks. In the method called ganglion impar block, the blockage can be applied to the area where the nerves of the anal and genital region pass with the help of a needle.
- Medications: In addition to pain medications, some anti-depressant or anti-epileptic medications can also relieve tailbone pain.
- Surgery: In cases where all other methods have failed, the coccyx bone is surgically removed. Surgery may be the first option in cases such as tumors. Otherwise, this option should be left for last. Because this area is close to the anus, infection and wound problems may develop after removal. Although not every patient may experience problems such as pain due to sagging of the pelvic floor after a while. Even if everything goes well after surgical treatment, the pain may not completely go away or may continue for a long time.