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.

Osteopathic 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 – If you are concerned that your pelvic floor may be tight or in spasm with relation to your coccyx pain, a pelvic health osteopath can assist with techniques to relax your pelvic floor and help with the alignment of the coccyx bone.

Eastern Osteopathy Melbourne.

At Eastern Osteopathy Melbourne, all of our osteopaths have experience with treating coccydnyia, whether it be from a fall or in relation to pregnancy.

If you are concerned about your pelvic floor or believe your coccyx pain has impacted your pelvic floor health, Kathryn and Elizabeth have completed extra training in the area of pelvic floor health.  They are both qualified to assess your pelvic floor using either the real time ultrasound and/or internal vaginal assessment.

Kate and Liz have over 30 years combined experience can assess both your bodies alignment and the condition of your pelvic floor, providing education and rehabilitation, with the aim of sustained relief and no reoccurrence of the condition.