Pain in the tail bone can frustrate, irritate, and impair the quality of life. This condition can be curable and prevented if proper care is taken.
Any irritation (inflammation) of the bony area (tail bone) situated between the folds of the buttocks is referred to as Coccydynia. The usual complaint is pain at the bottom region of the back on sitting.
It is usually caused by injury, during pregnancy, chronic pressure on the tail bone due to sitting for long hours as in those involved in driving occupations. Many a times the injury is not direct, but an indirect one due to forceful contraction of pelvic floor muscles during the fall pulling relatively mobile coccyx violently forward. Sometimes tail bone pain occur in patients with chronic constipation. In one third of the cases, the cause is not known.
Coccydynia is usually diagnosed based on the typical complaints. Clinician can diagnose by examination and eliciting tenderness at the local region. It is necessary to directly visualize the tailbone region to rule out other causes and any infection. Sometimes infection of the hair follicles in that area and problems related to lower intestinal tract can mimic coccydynia.
Treatment is usually by activity modification, anti inflammatory medications and local injections. Surgery is rarely indicated in non responsive cases.
Since long hours of sitting may aggravate the condition, a modified padded cushion with cut out at the back could relieve the pressure on the coccyx. (Doughnut cushion). Pelvic floor exercises could help to get relief from pain. Use of stool softeners and laxatives in cases of constipated patients could help. Seitz bath by sitting in tub of hot water may also provide pain relief.
Oral anti inflammatory medications and local application of pain gels should be tried first. Local trigger injections with low dose steroid preparations will aid in complete relief in majority of cases. These local injections can be given by the doctor in the outpatient department.