Tailbone pain /coccydynia , coccyx

Dr. Ebraheim’s educational animated video describing anatomy of the coccyx (tailbone) as well as treatment of specific injuries associated with the coccyx.
The coccyx is commonly referred to as the tailbone. It is the final segment of the vertebral column comprising of two to four separate or fused vertebrae (the coccygeal vertebrae below the sacrum) below the sacrum.
The coccyx is a very small bone which most doctors are not very familiar with. The occyx provides an important attachment for tendons, ligaments and muscles.
Lumbosacral spine x-rays and MRI will not show the coccyx. If you want to vies the coccyx, order coccyx views or MRI. Dynamic views of the coccyx while the patient is sitting leaning backwards is needed for imaging of the coccyx. These x-rays should then be compared to non-weight bearing films with patient standing or lying to the side.
Excessive movement of the coccyx is abnormal. When sitting, the coccyx shifts forward and acts as a shock absorber. The coccyx bears more weight when the person is sitting and leaning backwards compared to when leaning forward.
Coccyx pain symptoms (coccydynia)
•Pain during sitting or when getting up from sitting.
•Pain originating in the middle just above the anus.
•Pain improves while leaning forward or to the side.
•Local tenderness over the area.
The most frequent causes of coccyx pain:
•Falling on the buttocks or backwards.
•Fracture/dislocation due to trauma or injury
•Malignancy
•Infection
•Pregnancy/labor
•Idiopathic
Falling on the tailbone can lead to coccygeal pain, known as coccydynia, resulting in chronic inflammation of the sacrococcygeal joint.
Dislocation of the coccyx occurs when there is a separation of the coccyx from the sacrum.
Types of coccyx injuries
•Anterior dislocation
•Posterior dislocation
•Anterior angulation
•Hooked coccyx
In addition to hooking and dislocation casuing pain, there may be a side bend deformity causing the coccyx to be angled sharply. Side bend deformity is usualy to the left.
Dural tension causing sacrococcygeal syndrome, low back pain and other symtpoms is a non-proven theory. Curving of the coccyx cause increased dural tension. Coccygeal extension releaves tension and back pain.
Treatment of coccyx injuries include:
•Manipulation
•Therapy
•Cushion for sitting: doughnut, balloon, etc.
•Injections
•Surgery as a last resort.