Located at the base of the spine, the coccyx (tailbone) consists of up to five vertebrae with an articular disc in between. They can vary quite considerably when it comes to shape. A physical examination is often carried out by a doctor and a local anaesthetic used to determine where exactly the pain is coming from. Active X-rays can help so too can steroid injections. Stretching exercises such as yoga and a coccyx pillow can also help.
Osteopathic treatment includes manual therapy using internal techniques and work on the nearby muscles and ligaments to help relieve pressure on the coccyx.
How to tell if you have a problem with the coccyx
- Pain on sitting after playing sports and landing on your coccyx
- Pain after horse riding or giving birth
Causes of Coccyx Pain (Coccydynia)
Firstly pathology must be ruled out; this is uncommon but is essential!
Through evolution we have lost certain muscles and ligaments that were used to control and move our tails. So now we lack the ability to manipulate our coccyx back into the correct position and must be done so by an external force that I shall explain more later.
But first, here are common reasons for injuring ones coccyx: falls onto your coccyx, impact sports, winter/extreme sports, horse riding, child birth/pregnancy.
Investigations and Treatment
A physical examination is usually performed by your practitioner. This can involve both internal and external examination of the coccyx, sacrum and surrounding muscles and ligaments.
A local anesthetic can also be used to make sure that it is the coccyx that is causing the pain and is not being referred from another structure, such as the low back.
Active x-rays can be performed comparing the seated and standing positions, however, many Dr are not aware of this test and it is rarely used.
Orthopaedic specialists will often use local steroid injection into the coccyx or in extreme cases remove the coccyx.
As an osteopath, manual therapy has moved to be very effective at easing and relieving coccyx pain. We use both external and (less commonly) internal techniques to take the coccyx back into extension and reverse the affects of any falls that the coccyx has felt. We also work on the surrounding muscles and ligaments to ease the pressure being placed on the coccyx.
Some exercises to extend the back through Yoga or through a lumbar extender have been shown to ease the pain. Also suitable coccyx pillows can help to control the tenderness whilst sitting.
If you feel like this is affecting you then please feel free to give us a call.