Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Inflammation of the bony area (tailbone
or coccyx) located between the buttocks is referred to as
coccydynia. Coccydynia is associated with pain and tenderness at the tip
of the tailbone between the buttocks. The pain is often worsened by sitting.
What causes coccydynia?
Coccydynia is often caused by an injury, but it may occur
seemingly spontaneously. There are many causes of tailbone pain which
can mimic coccydynia, including sciatica, infection, pilonidal cysts,
and fractured bone.
How is coccydynia diagnosed?
Coccydynia is commonly diagnosed based solely on the symptoms and the
examination findings of local tenderness. Other conditions can be excluded
by the examination (such as shingles, which typically would be associated
with local rash) and other testing (to exclude bone or tissue disorders,
such as with CAT scan or MRI
Patients with coccydynia are advised to use a well-padded
seat when sitting and avoid long periods of sitting when
possible. If the condition becomes severe or persistently troublesome, then medical attention should be sought to
accurately evaluate the cause of the pain.
Rest, avoiding re-injury to the affected area, antiinflammation and pain medications can
relieve symptoms. Some patients with persistent coccydynia are
treated with local cortisone injection. This injection is simply
performed in the doctor's office and can potentially dramatically
relieve the pain and even resolve the symptoms for many. Rarely, when
patients have unrelenting pain, a surgical resection of the coccyx
can be performed to remove the irritated bony prominence.