COCCYDYNIA
Coccydnynia, meaning coccy (coccyx) and dysnia (pain), is the fancy name for pain in your tailbone aka coccyx; and is described as pain on or around your coccyx bone.
The pain can range from a dull ache to an intense sharp pain. Females are 5 times more likely than men to suffer with coccydynia. The greater prevalence in females can be mainly attributed to pregnancy, where pregnancy can literally be a pain in the butt.
Where is the coccyx bone?
The coccyx bone is at the base of your spine and consists of 3-5 vertebra that are typically fused. As a unit, the coccyx forms a joint with the sacrum (the triangular bone, located between your hips), this is known as the sacrococcygeal joint.
The coccyx bone is an important attachment site for the ligaments and muscles of the pelvic floor.
What causes coccydynia?
There are many causes of coccydynia, including:
Direct impact or fall onto your coccyx bone
Excessive pressure (stress and strain) placed on the coccyx, which sits behind the uterus and birth canal (vagina), during prolonged labor can result in post partum coccydynia
The release of a pregnancy a hormone called relaxin. This hormone relaxes the ligaments that support joint, this allows for more movement to occur at the sacrococcygeal joint which can alter the position of your coccyx bone. In turn this can cause strain to the area resulting in coccydynia,.
Hypertonic pelvic floor. As mentioned above, many of the pelvic floor muscles attach onto the coccyx bone; when they are tight they can displace or move the position of the bone, resulting in tenderness and pain.
Prolonged sitting with poor posture can result in extra force on the coccyx bone rather than the sit bones (ischial tuberosities).
Pelvic imbalance, which causes stress and strain on the coccyx or sacrococcygeal joint.
A postural imbalance that puts stress on the coccyx bone, sacrococcygeal joint and or any soft tissue (muscle, or ligament) that attaches to the coccyx can result in coccydnyia
Gradual onset with no apparent cause.
My coccyx bone is so tiny, does it really matter if it’s causing me some pain?
As with all regions of the body, when we are experiencing pain the nearby muscles tend to tighten up to protect the area, the coccyx region is no different.
In the case of the coccyx bone the muscles we tend to tighten when we are experiencing pain are the pelvic floor muscles. If the pelvic floor remains tight, it can increase the pressure and discomfort on the coccyx bone. Which can result in a vicious cycle.
A tight pelvic floor may be reduced in its ability to perform normal functions including:
Maintaining bladder and bowel control
Sexual function
Spinal (core) stability
Lymphatic drainage
It is essential no coccyx pain be ignored; the consequence to pelvic floor health, sexual function and core stability can have long-term consequences.
Osteopath considerations for Coccyx pain
Whole body assessment – The coccyx sits at the base of the spine and its position can be greatly affected by imbalances in the pelvis, sacrum and the spine as a whole. As an osteopath, when treating a person with coccydynia, we will assess the whole body to identify any regions local or distal that may be impacting on the balance of your coccyx, sacrococcygeal joint and surrounding soft tissues. It is essential when treating coccydynia, that the alignment of the whole body is considered.
Sitting posture – Education regarding correct sitting posture is essential to minimize the pressure and force placed on the coccyx bone; for some people, a small donut cushion can also be a useful tool.
When we sit, our pelvic floor is shortened which can add to pressure to the coccyx. When standing up from a seated position, we go from a shortened to a relatively lengthened position of the pelvic floor, which, in turn can pull on your coccyx.
Stretches for the pelvic floor – Advice on stretches and techniques to relax your pelvic floor can assist in lengthening a tight pelvic floor, which may assist in relieving coccyx pain.
Pelvic health osteopath – Many patients seek care at Eastern Osteopathy because we specialise in internal coccyx treatment. This involves a thorough assessment and treatment via a rectal approach. Often, coccyx pain is influenced by a tight or overactive pelvic floor, which may contribute to or worsen the pain. Our pelvic health osteopaths are skilled in techniques to release pelvic floor tension and to help realign the coccyx bone, supporting improved comfort and function.
Coccydynia Osteopath Melbourne
At Eastern Osteopathy Melbourne, all of our osteopaths have experience treating coccydynia, whether it’s from a fall, pregnancy, or other causes. Our team has completed extensive training in pelvic floor health to provide holistic care for your needs. Kathryn, Meg, Nikki, Geetha and Rose are trained in the internal rectal techniques, while Mia and Chloe can assist with external treatment.
Kathryn, our clinic director, also trains other osteopaths in the assessment and treatment of the coccyx using both external and internal techniques, demonstrating our commitment to excellence and innovation in pelvic health care.
It’s important to note, if you would prefer no internal techniques, that is absolutely fine.
