Coccydynia – a real pain in the tailbone

By: Richard Staehler, MD
April 4, 2000

Introduction

Coccydynia, or tailbone pain, is a fairly rare and poorly understood condition that can cause persistent low back pain. It is felt as a localized pain at the very bottom of the spine (the coccyx) and will generally feel worse when sitting.

The condition is much more common in women than men. It is usually caused by local trauma (a fall) or giving birth. On rare occasions, an infection or tumor can also cause pain in the coccyx.

Local conservative treatments usually suffice to control or alleviate the pain. Rarely, surgical removal of the coccyx may be necessary if local conservative treatments are not effective in relieving the pain.

History

Coccydynia has a long history of being poorly understood. In the early 1900’s, coccydynia was a popular diagnosis for all types of low back pain. A fairly extreme treatment, the surgical removal of the coccyx (coccygectomy), was commonly undertaken to treat low back pain. At best, this operation had variable results.

Then the pendulum swung the other way, and the general opinion was that since the condition was mostly in women it was in some way related to "neurosis". The corollary was that operation did not work was because the pain was in the individual’s head, and the operation fell into disrepute and was no longer commonly performed. Subsequently, little research on the subject has been done.

Both extremes of opinion have long since fallen by the wayside. It is now known that that coccydynia does exist as a medical condition. However, it is fairly uncommon and probably accounts for less than 1% of cases of low back pain.

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