The coccyx also called the tailbone is located at the bottom of the vertebral column. The pain associated with this area - Coccydyniais is usually a localized form of inflammation. The pain occurring in the coccyx region can be very painful as it is connected to many muscle innervations in the gluteal region. The surrounding muscles that arise and enervate at this junction are gluteal, rectus femoris and the muscles governing the sphincters of the anus.
Coccydynia is caused by trauma to the lower spine. This condition is common in the emergency room as it is associated with falls and accidents. Many athletes complain of the tailbone, which may include other reasons such as nerve compression, ligament tear and fractures. Some studies indicate the involvement of the inter-vertebral discs, which in conditions such as cystic fibrosis can cause inflammatory response leading to coccydynia. This particular condition is characterized by degeneration of intercoccygeal and sacrococcygeal discs. Based on etiological conclusions, coccydyniais is defined as a condition which can be idiopathic or traumatic in origin.
In some cases coccydyina can be caused by the anatomical deformities in which bony spicules and coccygeal retroversion are found. These are termed as type II, III and IV forms of coccyx. Other causes include inflammation of the pelvic bone floor muscles and the soft tissues surrounding the coccyx and also compression of sacral nerve roots. Infections also play a major role in the onset of this condition. The most predominant forms of infections associated with coccydynia are tuberculosis, meningitis (bacterial and viral), arthritis and clostridium related infections. Sometimes, trauma to the coccyx results from an accident, poor posture or even during childbirth.
Although coccydynia is often mild in origin with respect to its occurrence, the progression of the condition can worsen and affect the lifestyle of a person - making the person slower as the pain radiates causing restricted movements and abstinence from prolonged physical activity, which may sometimes include daily routines. Coccydynia is more prominent in women than men due to the associated osteoporotic condition in which the calcium and phosphate imbalance is noticed to a larger extent in the deterioration of the bones. Elevated pain during sexual intercourse, premenstrual period and also in defecation are noticed. The pain is usually worse when sitting down or moving from sitting to standing position. Other symptoms include painful buttocks and hips and shooting pain down the legs.
Radiological diagnosis is more significant in coccydynia as CT, MRI and PET scans reveal the gross anatomy of the coccyx. Sagittal rotation, hard stools, angle of pelvic rotation and angle of mobility can pave the way for definitive diagnosis of this condition.
Patients with coccydynia are advised to avoid long hours of sitting as this elevates the pressure on the tailbone. In most cases anti-inflammatory drugs are given and patients with persistent coccydynia are treated with cortisone injections. Physiotherapy can provide short-term relief from pain. Surgical interventions such as coccygectomy are done to remove any bony prominence in the coccyx region.
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Collection of Pages - Last revised Date: October 19, 2020