Coccydynia
(Tailbone Pain)

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Medical Author:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

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.

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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.

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.

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 scan).

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.