Introduction

Coccydynia, commonly referred to as tailbone pain, is a condition that can significantly impact your quality of life. While both men and women can suffer from coccydynia, it is more common among women due to anatomical and lifestyle factors.

What is Coccydynia?

Coccydynia is pain that occurs in the region of the coccyx, or tailbone, which is located at the bottom of the spine. This pain can be sharp or achy and may worsen with sitting, standing up, or during prolonged periods of standing. The coccyx consists of three to five vertebrae fused together forming a tail-like structure at the base of the spine.

The coccyx, or tailbone, serves several important functions:

Attachment Point for Muscles, Tendons, and Ligaments: The coccyx provides a place for various muscles, tendons, and ligaments to attach. These include muscles involved in activities like sitting, walking, maintaining balance, and supporting the pelvic organs. In my mind, it is the cornerstone of the whole body!
Support : The coccyx supports some pelvic organs especially those with direct connections to the rectum through pelvic floor musculature connections.
Role in Childbirth: In women, the coccyx can move during childbirth to provide more space for the baby to pass through the birth canal.

Despite its small size, the coccyx plays a crucial role in the structural integrity and functionality of the pelvis. Women are more likely to experience coccydynia because anatomically, women have a broader pelvis, which can make the coccyx more susceptible to injury.

Causes of Coccydynia

Coccydynia can result from a variety of causes. In my experience, most people suffered a fall, possibly even years ago, injuring their tailbone. Trauma takes a while to surface, so don’t be surprised if you don’t have a sudden injury. Other causes of coccydynia include::.

Childbirth: During childbirth, the coccyx can be injured or dislocated due to the pressure exerted as the baby passes through the pelvis

Repetitive Strain: Activities that put repeated stress on the tailbone, such as cycling or rowing, can lead to coccydynia.

Degenerative Joint Changes: Arthritis or other degenerative changes can affect the joints around the coccyx, leading to pain.

Infections or Tumors: Though rare, infections or tumors in the tailbone region can also cause coccydynia.

Symptoms of Coccydynia

Coccydynia, or tailbone pain, can present with a variety of symptoms, including:

Localized Pain: Pain localized at the tailbone (coccyx) area, which may be sharp or aching.
Pain When Sitting: Increased pain when sitting down, especially on hard surfaces. The pain often worsens after sitting for extended periods.
Pain When Standing Up: Pain when transitioning from sitting to standing or when rising from a seated position.
Pain During Specific Activities: Increased pain during activities that put pressure on the tailbone, such as cycling, horseback riding, or prolonged sitting.
Pain During Bowel Movements: Pain or discomfort during bowel movements due to pressure on the coccyx.
Pain During Sexual Intercourse: Discomfort or pain during sexual intercourse, particularly in women.
Swelling or Tenderness: Swelling or tenderness around the tailbone area.
Radiating Pain: Pain that radiates to the lower back, hips, or legs in some cases.

If these symptoms persist or worsen, it's important to seek medical evaluation, such as from a pelvic floor physical therapist, to rule out other potential causes and to develop an appropriate treatment plan.

Impact of Coccydynia on Daily Life

Ouch! No one wants to experience tailbone pain - it can distract from your everyday life. It can make sitting for long periods uncomfortable, affecting work, travel, and social activities.

Standing up from a seated position can be painful, and engaging in physical activities such as exercise or sports may become challenging. Chronic pain can also lead to psychological distress, including anxiety and depression.

How Pelvic Floor Physical Therapy Can Help

A good physical therapist will look at your overall movement, movement of hips and spine and your core strength to determine how to solve the problem of your coccyx pain. Treatment during pelvic floor therapy focuses on releasing tight muscles and stabilizing loose ligaments and connective tissues in the pelvic region, which play a crucial role in supporting the coccyx.

Types of Treatment for Coccydynia

Manual Therapy:

Internal and External Manipulation: A trained pelvic floor physical therapist can perform internal and external manipulations to help realign the coccyx and alleviate muscle tension. This can reduce pain and improve mobility.

Myofascial Release: This technique involves applying gentle, sustained pressure on the connective tissues to release tension and improve blood flow.

Pelvic Floor Muscle Training:

Strengthening Exercises: Strengthening the pelvic floor muscles can increase support to the coccyx and reduce pain.
Relaxation Techniques: Learning to relax the pelvic floor muscles can also be crucial, as tension in these muscles can exacerbate coccydynia. Breathwork is a great way to help relax your pelvic floor muscles.

Postural Training:

Ergonomic Adjustments: Therapists can provide guidance on proper sitting and standing postures to reduce strain on the tailbone. This may include the use of cushions or ergonomic chairs.

Body Mechanics Education: Learning proper body mechanics for activities such as lifting, bending, and sitting can help prevent further injury and manage pain.

Stretching and Mobility Exercises:

Tailbone Stretches: Specific stretches targeting the muscles and ligaments around the coccyx can improve flexibility and reduce pain.
Hip and Lower Back Mobility: Improving the mobility of the hips and lower back can alleviate pressure on the coccyx.

Lifestyle and Activity Modifications:

Activity Modification: Therapists can help identify and modify activities that exacerbate pain, such as adjusting workout routines or changing sitting habits.

Conclusion

Coccydynia is a painful and often debilitating condition that affects many women, particularly those who have experienced trauma or childbirth. Understanding the causes and impact of coccydynia is crucial for effective treatment of this condition.

Pelvic floor physical therapy offers a comprehensive approach to managing coccydynia, with techniques that address muscle tension, alignment, and overall movement, core strength and function. If you or someone you know is suffering from tailbone pain, consider consulting me, an experienced pelvic floor physical therapist to discover how to heal from your coccyx pain .

Learn more about working with me here