Why Is Lower Back Pain Such A Common Problem
The bottom part of your back typically has just five vertebrae fewer than your neck and mid-back. And these vertebrae do a lot of heavy lifting! Your lower back is where your spine connects to your pelvis, bearing the weight of your upper body. This area experiences a lot of movement and stress, which may lead to wear, tear and injuries.
Possible Causes Of Coccydynia
A diagnosis of coccydynia will usually identify one of the following underlying causes of pain:
- Local trauma. A direct injury to the coccyx is probably the most common cause of coccydynia. A fall on the tailbone can inflame the ligaments and injure the coccyx or the coccygeal attachment to the sacrum. Coccygeal trauma usually results in a bruised bone, but may also result in a fracture or dislocation either in the front or back of the coccyx.
- Repetitive stress.. Activities that put prolonged pressure on the tailbone, such as horseback riding and sitting on hard surfaces for long periods of time, may cause the onset of coccyx pain. Tailbone pain from these causes usually is not permanent, but if inflammation and symptoms are not managed, the pain may become chronic and cause long-term altered mobility of the sacrococcygeal joint.
- Childbirth. During delivery, the baby’s head passes over the top of the coccyx, and the pressure against the coccyx can sometimes result in injury to the coccygeal structures . While uncommon, the pressure can also cause a fracture in the coccyx.
- Tumor or infection. Rarely, coccydynia can be caused by a nearby tumor or infection that puts pressure on the coccyx.
- Referred coccyx pain. In rare cases pain will be referred to the coccyx from elsewhere in the spine or pelvis, such as a lumbar herniated disc or degenerative lumbar disc.
Treatment Options For Acute Lower Back Pain
Most low back pain is due to muscle strain and spasm and does not require surgery. To treat the pain, medications such as acetaminophen , nonsteroidal anti-inflammatory agents , gabapentin or pregabalin can be used. NSAIDs suppress inflammation, pain and fever by inhibiting certain inflammation-causing chemicals in the body. Acetaminophen reduces pain and fever, but does not inhibit inflammation. Gabapentin and pregabalin, medications that have been used for antiseizure activity, also have the ability to block pain. Opioids provide pain relief and may at times be prescribed to manage severe back pain. However, opioids have many problems, such as habituation, constipation and lightheadedness, and are avoided when possible and used for the shortest possible duration. Epidural injection is an option if the back pain does not respond to these treatments. Each person is different in terms of response to medication.
Other nonsurgical treatments for lower back pain include Intradiscal electrothermal therapy , nucleoplasty, and radiofrequency lesioning.
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What Type Of Doctor Should I See For Back Pain
This depends on your condition or symptoms. If you have no obvious injury that would explain your pain, you may want to start by seeing a . This is a specialist in physical medicine who can diagnose back pain and determine whether nonsurgical treatments such as physical therapy may help. Depending on those findings, a physiatrist may also refer you to a , doctor or other type of back specialist, , for additional discussion.
What Should I Do If My Tailbone Hurts
See your doctor if the pain is severe or lasts more than a few days. Most of the time, tailbone pain isnt serious. It can sometimes be a sign of an injury. In very rare cases, tailbone pain can be a sign of cancer.
You may get an X-ray or MRI scan to look for signs of injury, such as a bone fracture or a tumor pressing on the bone. X-rays may be taken both sitting and standing to show possible problems with your tailbone in different positions.
The doctor will also feel around the area for any growths that might be putting pressure on your coccyx.
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Physical Therapy To Treat Tailbone Pain
A physical therapist can show you exercises to strengthen the muscles that support your tailbone. These include your stomach muscles and pelvic floor.
You can also try a technique called coccygeal manipulation. This is when a doctor inserts a gloved finger in your rectum and moves the tailbone back and forth to shift it back into position.
Causes Of Tailbone Pain
Common causes of tailbone pain include:
- pregnancy and childbirth
- an injury or accident, such as a fall onto your coccyx
- repeated or prolonged strain on the coccyx for example, after sitting for a long time while driving or cycling
- being overweight or underweight
- joint hypermobility of the joint that attaches the coccyx to the bottom of the spine
Sometimes the cause of tailbone pain is unknown.
Page last reviewed: 15 March 2022 Next review due: 15 March 2025
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Symptom Are You Experiencing Muscle Pain Near Your Tailbone
The tailbone, also called the coccyx, is located at the bottom of your spine. Usually, it aids in stabilization of your body and your pelvis, specifically when sitting. And muscle pain near your tailbone may become uncomfortable in seated positions. It might ache or feel sore. It may even be tender to touch near or around the area. So whats going on?
What Is The Tailbone/coccyx
Your coccyx is made up of three to five fused vertebrae . It lies beneath the sacrum, a bone structure at the base of your spine. Several tendons, muscles and ligaments connect to it. Both the coccyx and the ischial tuberosities bear your weight when you sit down. Two-thirds of adults have a coccyx that curves a bit instead of pointing straight down, but one that is curved too far is abnormal and, therefore, painful.
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Be Diligent And Get Rid Of The Pain
Youve got all the information youll need to fix that lower back pain right above the tailbone. Follow each step consistently, and perform the movements exactly as Ive shown them. If youre careless, youll risk worsening the pain and lengthening your recovery time.
If youre diligent about following this pain-relief routine, youll not only get rid of that back pain, but youll enjoy the benefits of increased hip mobility and a powerfully developed core.
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What Are The Symptoms
The symptoms of coccydynia are persistent pain in the area of the tailbone between the buttocks. It can be especially painful when sitting. Some people have difficulty riding in a car. Pain may be felt all the time or worsen with activities that put pressure on the coccyx, such as bicycling or horseback riding. Pain also can be worse when moving from a sitting to standing position or vice versa.
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Muscle Strain Or Sprain
A muscle strain or sprain is the most common cause of low back pain.
A strain is a tear or stretching in a tendon or muscle, while a sprain is a tear or stretching in a ligament.
Sprains and strains usually happen when you twist or lift something improperly, lift something heavy, or overstretch your back muscles.
These injuries can cause swelling, difficulty moving, and back spasms.
What Can I Do For Low Back Pain At Home
If your lower back pain has just started, the best thing you can do is start a log. Record your symptoms, times, dates and which activities trigger the pain or make it worse or better. Take this information to your family physician if the pain doesnt resolve on its own. It will make diagnosing the cause much easier.
Once you know which motion or position causes your lower back pain, try to avoid it and see if you get better. Icing the painful spot can also help. And so can over-the-counter pain relievers that help reduce inflammation. Just remember that pain killers treat only the symptom pain and not its cause.
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Coccydynia Makes Sitting Painful
A relatively uncommon cause of chronic pain in women is coccydynia, or tailbone pain. Your pain can come on gradually or suddenly after an impact to the area at the end of your spine.
Women are 5 times more likely than men to develop coccydynia. Pregnancy-related injuries and the less-protected position of the tailbone in women are considered major reasons for the disparity.1
During childbirth, the pressure of the babys head against the coccyx can injure the area. One research study of women with coccydynia found a connection between the condition and births that were described as difficult.2
Coccydynia affects women of all ages, but age 40 is the average age of onset. It usually goes away in weeks or months, but it can become chronic and impact daily life, preventing you from driving or bending over without pain. Rarely, coccydynia may be due to a tumor or infection.
How Doctors Diagnose Coccydynia
The doctor primarily relies on your medical history and a physical exam to diagnose coccydynia. While imaging scans are typically not needed, your doctor may order a computed tomography scan or magnetic resonance imaging scan if he or she suspects a separate bone, nerve or tissue problem to be the cause of your tailbone pain.
Your medical history is important, as your doctor wants to know whether youve been through a fall, accident, or other recent trauma that may have caused your tailbone pain.
After reviewing your medical history, your doctor conducts a physical exam and asks you about your symptoms. Coccydynia pain is usually localized to your tailbone area, which makes it relatively straightforward to diagnose. Your doctor wants to know whether you have tailbone pain when sitting or leaning back. He or she may also ask you to point to where you feel pain. Pointing to the tailbone may be enough to distinguish your pain as coccydynia . Your doctor may also touch your tailbone area to feel for areas of inflammation.
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What Are The Causes Of Lower Back Pain
The vast majority of patients experience back pain because of mechanical reasons. They strain a muscle from heavy lifting or twisting, suffer a sudden jolt in a car accident, experience stress on spinal bones and tissues resulting in a , or suffer from osteoarthritis, a potentially painful degeneration of one or more spinal joints. Common causes for low back pain are:
- mechanical or functional injury
- active infection
To choose the safest and most effective therapy, doctors need to consider the full spectrum of possible underlying issues, such as inflammatory conditions, fracture, infection, as well as some serious conditions unrelated to the back that radiate pain to the back.
How Common Is Tailbone Pain
Tailbone pain is common.
Women are five times more likely than men to develop coccydynia. Adults and adolescents get it more often than children. Obese persons are three times more susceptible than those at the ideal weight according to the BMI scale. Youre also more vulnerable if you lose weight too quickly.
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More About Tailbone Pain
The medical term for tailbone pain, especially the persistent type, is coccydynia. This is because the medical term for your tailbone is your coccyx, a term youre probably at least slightly familiar with. The coccyx sits at the very bottom of the spine and, even though it is small, holds a few important jobs. Most importantly, the coccyx supports the pelvis. It also provides you stability as you sit or stand. Within and beside the coccyx are many supporting muscles, tendons, and ligaments, which can be irritated and inflamed.
Patients may first feel coccydynia when they attempt to stand or sit, or when you lean back in your chair while sitting. Women may also notice tailbone pain when they are menstruating, and both sexes can feel pain during sex or when using the bathroom. Standing is reported to relieve pressure, which helps the pain go away. Pain can also be felt in the length of the legs, such as a shooting pain.
What To Do When Coccydynia Becomes Chronic
A small portion of people with coccydynia develop chronic coccydynia, which means tailbone pain that lasts for more than 2 months. Chronic coccydynia can take a major toll on your quality of life, so talk to your doctor if your symptoms arent going away. He or she may refer you to a doctor who specializes in coccydynia pain management.
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Further Treatments For Tailbone Pain
If at-home methods fail to relieve the pain, your doctor may suggest physical therapy to stretch and strengthen the muscles of the lower back and pelvis. Pelvic floor relaxation exercises, such as deep breathing, and massaging the muscles around the tailbone can also help relieve pain. For temporary relief of more extreme pain, your doctor may inject a nerve-blocking agent in the coccyx area.
In extremely limited instances when other remedies are ineffective, a coccygectomy, or removal or the coccyx, may be recommended. But that is only as a last resort and rarely performed.If youre experiencing tailbone pain and want to find relief, schedule an appointment with a doctor right away. At New York Bone & Joint Specialists, we are experts in the causes and treatments of all kinds of back pain including tailbone pain. If youre experiencing pain in your lower back and buttocks, we can help you overcome the discomfort and get on with living your life to the fullest. Contact us today for a consultation.
Age And Gender Issues
Age and gender are important factors to consider when diagnosing low back pain. In a young patient, a benign tumor of the spine called an osteoid osteoma may be the culprit. Inflammatory bowel disease in young people can be connected with spondylitis and sacroiliitis . Low back pain from disc disease or spinal degeneration is more likely to occur as people get older. Conditions such as abdominal aneurysm or multiple myeloma are also considered in older individuals.
Osteoporosis and fibromyalgia are much more common triggers of back pain in women than in men. Osteoporosis is a progressive decrease in bone density that leaves the bones brittle, porous and prone to fracture. Fibromyalgia is a chronic disorder that causes widespread musculoskeletal pain, fatigue, and multiple tender points in the neck, spine, shoulders, and hips.
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Tailbone Pain Without Injury: Causes And Treatments
May 09, 2021
Most offices dont spring for the most expensive, most comfortable office chairs, leaving their employees to instead sit in uncomfortable office chairs for long periods of time that can cause damage to the neck, back, spine, buttocks, and hips over the years.
However, upgrading to a new office chair, especially one made to treat tailbone or another type of lower back pain associated with prolonged sitting, can be expensive. Instead, you should look into other more affordable relief options, such as alternative chair types and seat cushions.
Who Is Impacted By Coccydynia
The major risk factor associated with coccydynia is an injury to the coccyx or nearby pelvic bones. When trauma occurs, it can cause the coccyx to become inflamed. Although there are a few conditions that mimic coccydynia, like sciatica, fractured bones or infection, the most common causes include:
- Injury or accident, usually a fall
- A repeated and prolonged strain on the coccyx, often experienced by those participating in sports
- A bony growth on the coccyx
- A tailbone that is too flexible or rigid
- Age-related wear and tear
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Referred Pain To And From The Lumbar Spine
Pain in the area of the lumbar spine may be due to important problems that are actually unrelated to the back. Referred pain occurs when a problem in one place in the body causes pain in another place. The pain travels down a nerve.. Sources of referred pain to the low back may include abdominal aneurysm , tubal pregnancy, kidney stones, pancreatitis, and colon cancer. Clues to these maladies include pain that waxes and wanes over a short period, with frequent peaks of intense pain, weight loss, abnormalities found during abdominal exam, and trace amounts of blood in the urine. On the other hand, pain can be referred from the low back and be felt in another location, as is often the case with . For example, it is not rare for a patient with a slipped disc in the lower back to have pain in the back of the thigh, or in the calf or even the foot, and not have any low back pain. This situation requires a doctor to sort out the type of pain and to do the examination required to show that the pain is actually coming from the spine .
Mechanical Low Back Pain Without Sciatica
About 80 percent of people will experience mechanical back pain. Mechanical means that the pain comes from the spine or its supporting structures. Sometimes, people experience sciatica with their low back pain. Sciatica is a general term to describe pain that travels from the back into the leg. Most of the time, it is unclear to doctors what exactly causes the episode of low back pain. However, it is most often due to a muscle strain, or an injured tendon or ligament. A slipped or herniated disc is also a possible cause. Fortunately, in any of these cases, initial treatment is the same. Pain usually goes away within 4-6 weeks, often sooner.
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