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Coccydynia 

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About Coccydynia

The coccyx is the last bone located at the tail of the spine, it is a small triangular-shaped bone and resembles a primate’s tail. Despite the term “tail bone”, the coccyx is made up of 3 to 5 separate spinal bodies. This tailbone pain is known as coccydynia.

What Causes Coccydynia

Coccydynia is persistent pain in the tailbone. It is implied that there is an inflammation of the coccyx and it is usually caused by trauma to the tailbone such as in a fall or childbirth, and/or infections. However, about one-third of those with coccydynia has no known causes. Still, 20% to 40% of the tailbone pain progresses to chronic pain. Sometimes the original damage may have healed, but the pain persists. In many cases, the patient will feel pain without any cause or trauma. Some of the risk factors are as follows:

  • Female
  • Obesity
  • Osteoarthritis/ Osteomyelitis
  • Contact Sports
  • Rapid Weight loss

What Causes Coccydynia

Coccydynia is persistent pain in the tailbone. It is implied that there is an inflammation of the coccyx and it is usually caused by trauma to the tailbone such as in a fall or childbirth, and/or infections. However, about one-third of those with coccydynia has no known causes. Still, 20% to 40% of the tailbone pain progresses to chronic pain. Sometimes the original damage may have healed, but the pain persists. In many cases, the patient will feel pain without any cause or trauma. Some of the risk factors are as follows:

  • Female
  • Obesity
  • Osteoarthritis/ Osteomyelitis
  • Contact Sports
  • Rapid Weight loss

Symptoms Of Coccydynia

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Pain
The pain is felt at the coccyx (tail bone), it is described as a dull and achy pain, which typically gets worse while sitting and is exacerbated by cycling or standing. The pain can range from mild to severe, but it does not radiate to other regions.
Other Symptoms
Some other symptoms include pain from positional changes such as sitting to standing, bowel movement or sexual intercourse.

A Message About Coccydynia

The tailbone at the end of the spine is usually curved, which is the normal body structure for most people. The sacrum above the tailbone follows the shape of the buttocks and has a progressively forward curve. At the end of the spine, the coccyx connects the sacrum through various ligaments and tendons. There is a normal angle between the tailbone and the sacrum, and the angle varies from individual. Hence not all curved corner tailbones are abnormal.

Since this bending angle can be inconsistent in the case of injury and pathology, X-ray examination needs to be carefully evaluated. Magnetic resonance examination (MRI) is usually necessary to rule out acute injuries such as bone abrasions, contusions and edema.

Many cases of coccydynia are due to nerve hypersensitivity causing increased pain perception near the tip of the tailbone. The treatment is targeted at reducing nerve hypersensitivity and not correcting the angle of the tailbone.

Diagnosing Coccydynia

At Singapore Paincare clinics, our team of experienced primary care doctors and pain care specialists together with an orthopaedic surgeon will evaluate your condition. Our doctors will also carry out physical examinations to look out for the above symptoms of coccydynia. An X-ray, CT scan or MRI may be requested to understand the cause of coccydynia.

What Treatments Are Available for Coccydynia

Our goal at Singapore Paincare is to treat your pain with the least invasive option after accurately identifying the cause of your pain. Our approach to pain resolution focuses on the removal of pain generators via specialised injection and minimally invasive procedures. Combined with pharmacological treatments and cognitive and physical rehabilitative therapies, we help patients improve their functions and prevent pain from recurring.

Non-Surgical Treatments for Coccydynia

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Non-Steroidal Anti-Inflammatory drugs
Prescriptions of varying medications such as NSAIDs have anti-inflammatory and analgesic effects. These drugs help to relieve pain. For coccydynia, topical cream may also be offered by our clinics and specialist as it has fewer side effects.
Coccygeal Cushions
Modified and specifically designed cushions often referred to as “donut pillows” can relieve the pressure off the coccyx when sitting.
Neurospan Radiofrequency Injections
Our Neurospan injection aims to reduce the nerve hypersensitivity of the coccyx by using radiofrequency waves to desensitise the respective nerves of S2 – S4. Furthermore, a mix of local anaesthesia and steroids is given concurrently at the correct location and level, which helps to break the pain cycle, reduce inflammation, and improve healing. This treatment aims to provide long-lasting relief.
Physical Therapy
The therapy sessions by our specialists involve resistance training to reduce pain. It also consists of stretching exercises to increase motion in the joint and minimize loss of muscle. However, the intensity and type of exercise may differ based on the conditions of the patient.

Surgical Treatments for Coccydynia

Non-surgical treatment has been effective for up to 90% of coccydynia cases, it is rarely required unless the pain does not respond well to conservative options. As surgery always comes with associated risks, complications and downtime, it may not be suitable for everyone. You should carefully weigh the decision before deciding to go under the knife by considering the pros and cons of both non-surgical methods and surgical reconstruction.

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Partial Coccygectomy
A partial coccygectomy is a surgery to remove a part of the coccyx.
Total Coccygectomy
A total coccygectomy is a surgery to remove the entire coccyx.

How Can I Prevent Coccydynia?

The following tips can help you reduce the risk of tailbone pain:

  • Maintaining a healthy weight
  • Avoid activities that worsen symptoms, like cycling and sitting for extended periods
  • Keeping yourself safe from falling by making sure your floors and pathways are free of loose objects, debris and cords

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