The coccyx, or as we call it the tailbone, is at the lower end of the spine, below the sacrum.
The coccyx is a very small bone and most of the doctors are not familiar with it. The coccyx provide important attachment to the tendons, ligaments and muscles.
Lumbosacral spine x-rays and MRI will not show the coccyx. If you want to view the coccyx, order coccyx views or MRI. Dynamic views of the coccyx with the patient sitting and leaning backwards is the best to image the coccyx.
Doctor will compare these x-rays to a non weight-bearing films with the patient standing or lying to the side.
Excessive movement of the coccyx is abnormal.
The coccyx is a shock absorber. When sitting, it shifts slightly forward. The coccyx bear more weight when the person is sitting and leaning backwards compared to when leaning forward.
Coccyx pain symptoms (coccydynia) includes:
– pain during sitting or when getting up from sitting
– pain above the anus in the middle
– pain improves when leaning forward or leaning to the side
– local tenderness just above the anus
The most frequent causes of coccyx pain include:
– falling on the buttocks or backwards
– fracture or dislocation due to trauma or injury
– pregnancy and labor
– idiopathic without any apparent cause
Falling on the tailbone can lead to coccyx pain. We call it coccydynia with chronic inflammation of the sacral coccygeal joint.
Dislocation of the coccyx occurs when there is a separation of the coccyx from the sacrum.
These are the published types of coccyx injuries:
– anterior dislocation
– posterior dislocation
– anterior angulation
– hooked coccyx (a lot of people think it’s a big deal in causing the pain in the tailbone)
The side bend deformity of the coccyx is another type that causes pain.
Dural tension causing sacrococcygeal syndrome, low back pain and the other symptoms is an unproven theory but I’m going to try to explain it to you.
The normal dural tension occurs because the filum terminale is connected to the dural tube and there is a smooth movement of the dural tube as the coccyx moves normally.
Excessive curving of the coccyx causes increased dural tension by the pole on the dural tube. And if the coccyx is extended, the dural tube will be relaxed and the tension will be relieved, so as the back pain.
This is just a theory, an unproven theory.
Treatment of coccyx injuries include:
– surgery as the last resort
Surgery includes incision at the end of the spine to expose the coccyx, detachment of the muscles inserted into the coccyx, the fractured coccyx is removed and care should be taken to avoid injury to the rectum.
The wound is irrigated and closed and the patient is given antibiotics for few days.
This article is for educational purposes only. Please consult your doctor before you make any decision about your medical care.