Dr. Ebraheim’s educational animated video describes the condition of coccydynia.
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Coccydynia
The coccyx is commonly referred to as the tailbone. It is the final segment of the vertebral column comprising of two to four separate or fused vertebrae (the coccygeal vertebrae) and it lies below the sacrum. The coccyx is a very small bone and most doctors are not very familiar with this bone. The coccyx provides an important attachment for tendons, ligaments, and muscles. Lumbosacral spine x-rays and MRI will not show the coccyx. If you want to view and review the coccyx, order coccyx views or MRI. Dynamic stress views of the coccyx while the patient is sitting and leaning backwards. These x-rays should then be compared to a non-weight bearing film with the patient standing or lying to the side. Excessive movement of the coccyx is abnormal. When sitting, the coccyx shifts forward and acts as a shock absorber. The coccyx bears more weight when the person is sitting and leaning backwards compared to when leaning forward. Coccyx pain symptoms include pain during sitting or when getting up from sitting, pain originating in the middle just above the anus, pain while leaning forward or to the side, or local tenderness over the area. Most frequent causes of coccyx pain include falling onto the buttocks or falling backwards, fracture or dislocation due to trauma or injury, malignancy, pregnancy/labor, or idiopathic. Falling on the tailbone can lead to coccygeal pain known as coccydynia, resulting in chronic inflammation of the sacrococcygeal joint. Types of coccyx injuries include anterior dislocation, posterior dislocation, anterior angulation, and hooked coccyx. In addition to hooking and dislocation causing pain, there may be a side bend deformity causing the coccyx to be angled sharply. The side bend deformity is usually to the left. Dural tension causing sacrococcygeal syndrome, low back pain, and other symptoms is a nonproven theory. Curving of the coccyx causes increased dural tension. Coccygeal extension relieves tension and back pain. treatment of coccygeal injuries include manipulation, therapy, cushion for sitting (doughnut, balloon, etc.), injections, or surgery as a last resort. Surgical treatment of a coccyx injury is removal of the mobile or fractured coccyx.
