- Patrick M Foye, MD
Patrick M Foye, MD
- Professor and Interim Chair of Physical Medicine and Rehabilitation
- Rutgers University New Jersey Medical School
- Section Editors
- Patrice Eiff, MD
Patrice Eiff, MD
- Section Editor — Adult Orthopedics; Sports-Related Injuries
- Professor of Family Medicine
- Oregon Health & Science University
- Mark D Aronson, MD
Mark D Aronson, MD
- Editor-in-Chief — Primary Care (Adult); Hospital Medicine
- Section Editor — General Medicine
- Professor of Medicine
- Harvard Medical School
Coccydynia is pain at the coccyx. It is also referred to as coccygodynia or tailbone pain. Though coccydynia resolves with supportive care in the majority of patients, symptoms can persists for months and years. Intractable coccydynia is relatively uncommon, but when it occurs, it can dramatically decrease a patient's quality of life. This topic will provide an overview of coccydynia, including diagnosis and management.
The coccyx is the lowest region of the vertebral spine, located inferior to the sacrum (figure 1). Typically, the lower coccyx curves anteriorly, into the pelvis (figure 2 and figure 3). The coccyx, along with the two ischial tuberosities, bears weight when a person is sitting, with an increased weight load on the coccyx when a person leans back, partly reclining, in the sitting position (figure 4).
The coccyx typically has three to five vertebral segments, with fibrocartilaginous joints between the sacrum and coccyx and between coccygeal segments. These joints are comparable with those seen in higher intervertebral spaces, but may be fused in the coccyx. Muscles and ligaments that insert on the sacrum and coccyx (including the levator ani and its component parts) support the pelvic floor and participate in voluntary control of the bowel.
PREVALENCE AND RISK FACTORS
Coccydynia is five times more prevalent in women than men [1,3]. The higher prevalence is thought to be due to injuries that occur during childbirth and the coccyx being located more posteriorly in women (figure 3), and thus more susceptible to external trauma .To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- PREVALENCE AND RISK FACTORS
- CLINICAL FEATURES
- Clinical diagnosis
- Additional evaluation
- DIFFERENTIAL DIAGNOSIS
- Initial management
- Persistent symptoms
- - Imaging
- - Local injection
- - Other treatments
- Intractable coccydynia
- SUMMARY AND RECOMMENDATIONS