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Coaxial bone pain: Tailbone (coccyx) pain – NHS

Tailbone (coccyx) pain – NHS

Tailbone pain is pain in the bone at the base of the spine (coccyx), near the top of your bottom. There are things you can do to ease the pain, but get medical help if it does not get better after a few weeks.

Check if you have tailbone (coccyx) pain

The main symptom of tailbone (coccyx) pain is pain and tenderness at the base of your spine, near the top of your bottom.

It may feel dull and achy most of the time, with occasional sharp pains.

The pain may be worse:

  • while you’re sitting down
  • when you sit down or stand up
  • when you bend forward
  • when you’re having a poo
  • during sex
  • during your period

You may also find it difficult to sleep and carry out daily activities.

How you can ease tailbone (coccyx) pain yourself

Tailbone (coccyx) pain may improve after a few weeks, but it can sometimes last longer. There are some things you can do to help ease the pain.

Do

  • sit correctly – maintain good posture with your lower back supported

  • use a specially designed coccyx cushion when sitting – sitting on an exercise ball can also help

  • lie on your side to reduce the pressure on your coccyx

  • try pelvic floor exercises (particularly important during pregnancy)

  • use an ice pack (or a bag of frozen peas) wrapped in a towel on the affected area for 20 to 30 minutes – you can also use a heat pack for longer

  • use non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen to help reduce the pain

  • use a laxative to soften your poo if the pain is worse when pooing – ask a pharmacist for a laxative that softens poo

Non-urgent advice: See a GP if:

  • tailbone (coccyx) pain has not improved after a few weeks of trying treatments at home
  • the pain is affecting your daily activities
  • you have a high temperature, tailbone pain and pain in another area, such as in your tummy or lower back

Treatments for tailbone (coccyx) pain

Further treatments are available if simple things like pelvic floor exercises and ibuprofen have not helped your tailbone (coccyx) pain.

The 2 treatments that may be recommended first are:

  • physiotherapy – the muscles around the coccyx can be manipulated to help ease the pain
  • corticosteroid and local anaesthetic injections – into the joint that attaches the coccyx to the bottom of your spine; you’ll usually have a maximum of 2 injections given on consecutive months

If physiotherapy and injections do not help reduce the pain, surgery to remove part or all of your coccyx may be recommended.

Causes of tailbone (coccyx) pain

Common causes of tailbone (coccyx) 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
  • poor posture
  • being overweight or underweight
  • joint hypermobility (increased flexibility) 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

Coccydynia | Pain Management

Coccydynia is pain in the tailbone. The main symptom of coccydynia is tenderness paired with a dull, achy pain in the tailbone area, at the very bottom of the spine, between the buttocks. This pain often gets worse when sitting or leaning against your backside.

Coccydynia can be a hard condition to diagnose since many disorders mimic the symptoms and type of pain that is present with coccydynia. It is important to see your doctor if you notice any coccydynia symptoms to make sure you rule out these other conditions.

You should see your doctor if you have symptoms of coccydynia, or a pain in your lower back that lasts for more than a few days.

Although coccydynia is not considered to be a serious condition, there are many other conditions that can cause the same symptoms of coccydynia, and may be more serious (such as a tailbone, hip, or spinal fracture). It is important for you to see your doctor as soon as possible to rule out other conditions or begin treatment right away, especially in cases where they may be more serious.

You should call your doctor immediately if you have pain in the tailbone and any of the following other symptoms:

  • A sudden increase in swelling or pain
  • Constipation that lasts a long time
  • Sudden numbness, weakness, or tingling in either or both legs
  • The inability to control your bowels or bladder

Other conditions that may feel like coccydynia, but are not, include:

  • Sciatica [sy-AH-tik-uh]
  • Sacroiliitis [SAH-krow-il-IY-tis]
  • Broken bone, such as a broken tailbone
  • Infections, for example, shingles of the buttocks
  • Pilonidal [py-LON-dee-uhl] cysts

Most of the time, coccydynia is caused by an injury or other trauma to the tailbone, which causes inflammation.

In rare cases, there may be no real injury or trauma to the tailbone, and this condition may seem to appear on its own, without any real cause.

Your doctor will most likely diagnose coccydynia based on your symptoms, as well as a physical exam of the area where the pain is.

Your doctor may also run tests for other conditions that have similar symptoms to coccydynia in order to rule out a more serious condition.

Your doctor may also request an x-ray or magnetic resonance imaging (MRI) scan if more information is needed to rule out a broken bone or fracture so that a proper diagnosis can be made.

A tailbone injury can be painful, and very slow and difficult to heal. Many people find pain relief from home treatments. Over-the-counter, anti-inflammatory medication, such as ibuprofen or naproxen, can help reduce coccyx inflammation that is causing pain.

You may also find pain relief from sitting on a heating pad or an ice pack several times a day. Spinal manipulation, massage, stretching exercises, or small amounts of electrical stimulation on the painful area are other nonsurgical treatments that could help you feel better.

Coccydynia requires rest and protection to properly heal. Your doctor may ask you to:

  • Stop certain activities that could make your coccydynia worse.
  • Use a padded seat cushion that looks like a donut, which will allow you to sit without putting any weight on the tailbone.
  • Avoid sitting for long periods of time to help prevent pain or additional damage to the tailbone.

As your tailbone heals, your doctor may request that you see a physical therapist to help with treatment and recovery.

If your coccydynia becomes persistent, meaning that it does not go away or does not respond to treatment, your doctor may also call for cortisone [CORE-tih-zone] injections, which can help reduce chronic (lasting) pain and resolve the symptoms of coccydynia. You may also benefit from a numbing injection that calms the nerves causing the pain.

In very rare cases, the coccyx pain does not go away with treatment. In these cases, your doctor may recommend surgery, where the bony point on the coccyx is removed to help fix the problem. These cases are very rare, though, and most cases of coccydynia respond to nonsurgical treatment.

Most people diagnosed with coccydynia are able to make a full recovery as long as they follow their doctor’s orders for treatment.

Because most cases of coccydynia are related to an injury of the tailbone, the best way to prevent coccydynia is to avoid injury or trauma to the tailbone, which might happen in car accidents or while playing sports.

Coccydynia [KAH-kih-DYE-nee-UH] is pain in the tailbone, or coccyx [KAH-syks], that is usually the result of inflammation in the tailbone. The coccyx is the small bone located at the very bottom of your spine.

Coccydynia can cause tenderness and a dull or achy pain in the low back or tailbone area. It is often caused by some sort of injury or other trauma [TRAW-mah] to the tailbone or pelvic bone.

Most of the time, coccydynia pain is only felt at the tip of the tailbone, located very low on the spine, between the buttocks. Often the pain is made worse by sitting.

Pain for coccydynia can be managed with treatments such as:

  • Taking over-the-counter anti-inflammatory medication, such as ibuprofen [ay-byoo-PRO-fehn] or naproxen [nah-PROKS-ehn]
  • Using supportive pillows
  • Modifying your activity
  • Applying hot or cold packs
  • Getting a cortisone [COR-tih-zone] or numbing injection

Coccydynia can be a tricky condition to diagnose since there are many disorders that mimic the symptoms and type of pain that is present with coccydynia. It is important to see your doctor if you notice any coccydynia symptoms to rule out these other conditions.

© 2018 Intermountain Healthcare. All rights reserved. The content presented here is for your information only. It is not a substitute for professional medical advice, and it should not be used to diagnose or treat a health problem or disease. Please consult your healthcare provider if you have any questions or concerns.  

Copyright ©2023, Intermountain Health, All rights reserved.

Bone Pain – General Information, Causes. Tomsk

Symptoms and diseases

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General information

Pain is the most important signal of the human body, indicating the presence of any pathological process. Bone pain is a common complaint among professional athletes, as well as people suffering from cancer. Bone pain can be of a different nature (depending on the causes that provoke its occurrence). It can be sudden and shooting, or it can be monotonous and aching. The nature of the pain is an important parameter in the diagnosis of the underlying disease. There are many diseases that cause bone pain. Some of them are quite safe, and sometimes it is enough to give your body enough time to rest, and the pain will go away on its own. However, some of these diseases can be quite dangerous and have many consequences. Qualified and timely treatment of the underlying disease will get rid of pain in the bones.

Causes

Bone pain can be caused by many factors. The most common causes of bone pain are:

  • Overexertion during prolonged sports. Overtraining usually results in aching pains in the bones, joints, and muscles that get worse with movement.
  • Infectious diseases. With syphilis, benign lymphoreticulosis, bone tuberculosis, osteomyelitis and some other diseases, periodic pains in the bone tissue are possible. With syphilis, as a rule, the pain occurs at night.
  • Bone tumors. The presence of pain in the bones is the most characteristic symptom of a bone tumor. Depending on the size, localization and other factors, the pain can be more or less pronounced and have a different character.
  • Diseases of the blood system. Diseases such as leukemia, myelogenous leukemia and multiple myeloma are characterized by the presence of pain in the bones, especially manifested by tapping.
  • Malignant tumors of other localization. Pain in cancer that is not localized in the bones occurs when metastases are isolated and the cancer spreads throughout the body, including bone tissue.
  • Metabolic bone diseases. Lack of certain minerals and vitamins can lead to impaired bone formation and, as a result, to bone pain. Vitamin D deficiency can provoke the process of osteomalacia, which is also accompanied by pain.
  • Endocrine diseases. Diseases of the parathyroid glands, accompanied by an increase in the production of parathyroid hormone, cortisol or T 3 , can lead to osteodystrophy.
  • Side effects of drugs. Especially often, long-term use of hormone-containing drugs leads to pain in the bones.
  • Too little physical activity. With prolonged physical inactivity, the rate of bone tissue formation slows down.
  • Paget’s disease or osteitis deformans.
  • Congenital disorder of collagen synthesis.

Why bones break due to weather and pressure, how osteoporosis is treated – June 1, 2021

1

Are all bones the same?

No, there are two main types of bone tissue: spongy and compact bone. Different bones are made up of different types of tissue.

— For example, long bones — thigh, lower leg, forearm, shoulder — are covered with compact tissue on the outside, they have spongy bone tissue inside, — says Anastasia Sarapulova, rheumatologist at the New Hospital Center for Clinical Rheumatology, Candidate of Medical Sciences. – Bones such as the pelvic bones or the spine are mostly compact bone tissue because they carry a lot of load and have to support a lot of weight.

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2

Do bones differ from person to person?

On average, bone tissue occupies from three to five percent of a person’s weight, in men the bones are heavier than in women. Alexey Bazhenov, a traumatologist at the UMMC-Health clinic, says that everything depends on the constitution of a person.

– Hypersthenics usually have dense, wide, heavy bones, as people say. It has a thicker cortical layer and is more resistant to mechanical factors,” explains the traumatologist. – If we talk about people with asthenic physique, then their bones, of course, are less strong. But if we are not talking about injuries, then any bone that is present in a healthy person in the body is definitely capable of carrying the weight of the body of the person to whom this bone belongs.

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3

How does age affect bones?

Bone density changes with age. Three main periods can be distinguished. The first, when bone density gradually increases, is childhood and adolescence. During this period, the cells that are responsible for building bone work harder than the cells that break down bone. The second stage is from about 25 years to 50–60 years: during this period, the amount of bone tissue formed is equal to the amount of destroyed bone tissue and equilibrium takes place. After 50-60 years (for men a little later than for women) – the stage when the destruction of bone tissue is stronger compared to its formation. At this point, osteoporosis can develop, which is manifested by increased bone fragility.

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4

Why do bones hurt?

Feeling of aching bones is a rather non-specific sign that can indicate a large number of symptoms.

– There may be several reasons. You should always think about some diseases, including bone tissue, explains Sarapulova. – It can be tumors, it can be pain due to some viral infections, the same COVID-19 has such a symptom as pain in the bones, joints and muscles. And finally, it can be pain associated with a change in the weather.

The traumatologist says that the bone tissue is very rich in receptors, signaling devices that react to the surrounding atmospheric pressure and can give a feeling of aching in the bones. More often, bones on which there was a fracture react to changes in atmospheric pressure. Also, aching bones can be from a lack of calcium – when it is low, bone density decreases. And if the bone density is below normal, then, loading your legs with body weight, a person may experience pain. Bazhenov says that first of all, patients, as a rule, complain of pain in the spine, in the lower leg and in the knee joints.

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5

What should I do if my bones start hurting?

To start with, go to a therapist to determine the preliminary causes of pain, get a referral to a specialist. Osteoporosis may need to be ruled out. To do this, you need to do a study called densitometry.

“This is akin to an X-ray study – the optical density of the bone is measured using a special densitometer apparatus,” says Bazhenov. – It is always measured at the same points, traditionally it is the femoral neck and the first lumbar vertebra. Depending on the density of these structures, the degree of osteoporosis or osteopenia, if any, is determined. You also need to take tests for calcium and vitamin D.

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6

Is there a cure for bone density disorders?

Yes, but the treatment will be individual for each case. It is enough for someone to change their lifestyle, someone will need to take vitamins and trace elements, in some cases hormone therapy is needed (usually older women). Treatment will depend on the underlying diagnosis.

— If the pain is associated with changes in atmospheric pressure, then there is no therapy here, only the strengthening and prevention of joint diseases: maintaining a healthy lifestyle, weight control, proper nutrition and doing gymnastics, says the rheumatologist.

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7

What can I do to keep my bones healthy?

When talking about the prevention of skeletal problems, people tend to think that it is enough to have a lot of calcium in the diet. However, it is not the only micronutrient that affects bone health.

— Calcium is basically contained in the products that we consume: cottage cheese, meat, milk, and various other products, — explains Bazhenov. – In general, this is not a deficient trace element that is lacking in our food. The question is how to digest it. It is well absorbed with adequate levels of vitamin D in the body. If there is no vitamin D, then you can eat any kind of calcium: even in tablets, even in cottage cheese – it is unlikely that it will enter the skeletal system in sufficient quantities.

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8

Who needs vitamin D?

Traumatologist says that almost everyone needs it, especially in regions where there is little sun (under the influence of sunlight, the body synthesizes vitamin D itself).

– In the absence of full sunlight for most of the time of the year, vitamin D is highly recommended for constant intake, says the doctor. – Better in oil form in the form of droplets. The exact dosage should be selected depending on the age of the patient and the initial level of vitamin D in the body.