It is not clearly understood which portions of the anatomy can cause coccyx pain. In many cases the exact cause of the pain is not known (called idiopathic coccydynia), and in these cases the symptoms are managed.
In general, pain can by caused in the coccyx if an injury or some type of excess pressure on the area causes the bones to move beyond their normal very limited range of motion, resulting in inflammation and localized pain. An injury to either the ligaments or the vestigial disc may be a cause of pain. Rarely, the bones of the coccyx can fracture and cause pain. Also, in rare cases a tumor or infection in the coccyx can be a primary cause of tailbone pain.
Possible Underlying Causes of Coccydynia
Generally, a diagnosis of the cause of coccydynia will identify one of the following underlying causes of pain:
- Local trauma. A fall on the tailbone can inflame the ligaments or injure the coccyx or the coccygeal attachment to the sacrum. This is probably the most common cause of coccydynia.
- Childbirth. During delivery, the baby's head passes over the top of the coccyx, and the pressure created against the coccyx can sometimes result in injury to the coccyx structures (the disc, ligaments and bones). While uncommon, the pressure can also cause a fracture in the coccyx.
- Pressure. Certain activities that put prolonged pressure on the tailbone, such as horseback riding and sitting on hard surface for long periods of time, may cause the onset of coccyx pain. Tailbone pain due to these causes usually is not permanent, but if the inflammation and symptoms are not managed, the pain may become chronic.
- Tumor or infection. Rarely, coccydynia is due to a tumor or infection in the coccyx area that puts pressure on the coccyx.
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