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What is Coccydynia and why it’s a pain in a butt

Coccydynia refers to pain in the coccyx, known as the tailbone. This type of pain can be a debilitating condition that hinders your ability to perform simple activities such as sitting, standing, using the toilet, or engaging in sexual intercourse.

This affects women five times as much as men and is more prevalent in obese persons (Fogel, Cunningham & Esses 2004). It can develop on its own or be linked to trauma, such as childbirth or a fall.

The coccyx can be highly sensitive to touch, yet the pain might originate from surrounding structures, including the lower spine, muscles, ligaments, or soft tissues (Patel, Appannagari & Whang, 2008). If the pain persists for more than 3 months, central sensitisation may be a contributing factor (refer to this link for an explanation).

WHY IS IT IMPORTANT TO UNDERGO A PELVIC FLOOR ASSESSMENT IF I HAVE TAILBONE PAIN?

Women experiencing this overactivity may also report difficulties with bowel movements or painful intercourse. Overactive pelvic floor muscles can exert tension on the coccyx, leading to pain. This, along with numerous factors, makes it important to manage coccydynia comprehensively. It extends beyond a mere coccyx examination. It is important to consider factors such as spinal health, tummy muscles, and sitting and movement postures, along with understanding history and conducting a pelvic floor examination.

It’s common for women to continuously focus on the sharp pain, akin to a child persistently poking to assert their presence. However, it’s important to recognise that this self-poking behaviour is counterproductive.

Remember that not all physiotherapists offer the same expertise—a women’s health physiotherapist can conduct a thorough pelvic floor assessment for you.

I’VE JUST GIVEN BIRTH AND CANNOT SIT TO FEED MY NEWBORN. WHAT SHOULD I DO?

If you experience coccyx pain preventing you from sitting to feed your child, please consult your doctor, especially if you underwent a challenging delivery requiring forceps. A study by Maigne, Rusakiewicz, and Diouf (2012) reported a 50.8% incidence of postpartum coccydynia in 57 patients, with ‘luxation and fracture of the coccyx’ being the most characteristic lesions.

As a mother, it’s common to find yourself slumping on the couch while feeding your baby or simply wanting to relax. However, continuously adopting this posture over time can aggravate coccyx-related discomfort, as it is not intended to be a primary weight-bearing structure.

WHAT CAN I DO TO EASE MY COCCYX PAIN?

Applying ice packs to the area may help with pain management in the initial stages of discomfort. Instead of going for expensive shaped cushions, try using two rolled-up towels positioned like train tracks, as demonstrated on this video here. Arrange them to provide support to the sit bones and upper thighs, lightening the pressure from the coccyx. This will alleviate pain, and help to normalise your sitting position.

Managing coccyx pain is comprehensive, personal to you, and takes time to heal with the right assessment and management. In many cases, conservative approaches are effective, with 90% of instances managed successfully. This may involve interventions such as NSAIDs or steroid injections (Lirette et al., 2014), while a minority may necessitate surgical intervention.

If you are experiencing a never-ending pain in the butt, please call or WhatsApp us at 9780 7274, or get in touch by email help@embracephysio.sg and let’s discuss how we can help you.

Feel free to look through our website, where you can learn about other women’s health conditions we treat. This is a safe space where we can discuss how we can help you with physiotherapy.

Note: While I am a physiotherapist, I am not your personal physiotherapist. The contents of this website are for informational purposes only and are not intended to serve as personal medical advice.

References:

  1. https://www.painscience.com/articles/sensitization.php
  2. https://pubmed.ncbi.nlm.nih.gov/14753797/
  3. https://pubmed.ncbi.nlm.nih.gov/19468909/
  4. https://pubmed.ncbi.nlm.nih.gov/22820826/
  5. https://pubmed.ncbi.nlm.nih.gov/24688338/
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