The coccyx is the small bone (actually a few small bones fused together) at the very base of the spine. After the lumbar spine (lower back) is the large bone called the sacrum. At the very bottom tip of the sacrum is the coccyx. If we were still in our more primitive evolutionary state the coccyx would be our tail. Because humans no longer required a tail it gradually turned into what we now refer to as a “tailbone” or coccyx. Pain in the coccyx is known as “coccygodynia” or “coccydynia”. Because the coccyx is such a small bone and isn’t very well protected by muscle or fat, it is very vulnerable to injury. The most common injuries seen to the tailbone result from giving birth, slipping and falling, tobogganing, falling down stairs, riding a bumpy snowmobile or jet-ski, sitting on a hard chair or stool, riding on an uncomfortable bicycle seat, or participating in certain sexual positions that put the coccyx in a vulnerable position where it is prone to trauma. Sometimes there is no injury and coccyx pain is the result of stress. Coccyx pain is usually felt when sitting and when getting up from a sitting position. Sometimes bowel movements are painful. Sometimes the patient can’t ride in a car, or even lie in bed without terrible tailbone pain. Often sexual intercourse is painful or impossible. There are three major injuries that can result when the coccyx is injured. A fractured (broken) tailbone is where the bone actually breaks. Sometimes the patient will say they heard or felt a snap and knew instantly it was broken. A broken tailbone can take one year to fully heal, yet the pain and disability associated with it might last forever. Many medical doctors will tell a patient with a broken coccyx that there is nothing that they can do for the injury. The patient is told to rest and that the bone will eventually heal. This is true, however if the bone heals in an incorrect, or unnatural positon, the patient is likely to have pain for the rest of their lives.
Making sure that the fractured coccyx heals in a proper position is a very important and often overlooked fact. If your arm is broken wouldn’t you want to make sure it is in a proper position before the cast is put on? It’s the same thing with a broken coccyx. The second coccyx injury we often see is a dislocated coccyx. Where the sacrum joins the coccyx there is a joint called the sacrococcygeal joint. When you injure the tailbone this joint often is pushed into an abnormal position resulting in pain. When the coccyx is dislocated it is essential that the normal joint position be restored as soon as possible in order to allow for proper healing. The longer the tailbone is “out of position” the more chance it has of remaining that way forever. If you dislocated your shoulder you would want it put back into its “socket” as fast as possible. The longer the shoulder is out of its normal position the more soft tissue damage is occurring and the more long term damage will result. Its exactly the same for the coccyx. Proper position must be restored as soon as possible. A bruised tailbone is where the coccyx was damaged but not enough to dislocate or facture it. Its wrong to think that a broken tailbone is more painful than a bruised tailbone. Sometimes a simple bruised coccyx can be more painful than a bad fracture of the coccyx. Finally, stress is becoming a more well recognized cause of coccydynia. If one can understand the role of stress in the cause of headaches and stomach aches, then it should also be seen that stress can cause a tightening of the muscles in the pelvic floor. These small muscles attach to the coccyx and sacrum and when they are tight they will hold the tailbone in an abnormal way. This causes coccyx pain the same as if the person fell down a flight of stairs. Often patients are relieved to find out that there is nothing wrong with their tailbones that a bit of relaxation couldn’t help. Dr. Horowitz, at our Richmond Hill has been treating tailbone injuries since 1982. Patients come from all over North America to seek his advice and treatment for their coccyx pain. Many years ago tailbone pain was often treated by removing the tailbone. This surgery was rarely successful. It is not a surgery that is even performed anymore in most areas. It was found that the type of treatment that Dr. Horowitz performs is more successful and certainly much less traumatic and stressful for the patient than surgery. The success rate for full recovery is very close to 100%. The patients who do not have full recovery are often greatly relieved but might still have some slight discomfort from time to time, depending on how long their problem had been around before they started treatment. It is very rare that Dr. Horowitz will not help your tailbone pain, either completely or almost completely. It is very important to have your coccyx pain evaluated and treated as soon as possible. Don’t follow the “it will go away on its own” rule. It might go away on its own, but if it doesn’t then it might be too late to fully fix the problem the correct way. Our Richmond Hill clinic has 4 chiropractors and 1 physiotherapist. Dr. Horowitz is the chiropractor with the most expertise and experience in treating coccyx injuries and pain. Sometimes the treatment involves fixing the tailbone by giving the patient special exercises to do at home. Sometimes the tailbone must be repositioned back to its proper position. This can sometimes be achieved by a simple mobilization where the doctor moves the tailbone back to where it should be. This is not painful. Sometimes the tailbone must be repositioned and it can only be accessed internally, via the rectum. If this is necessary the doctor will insert a gloved and lubricated finger into the patient’s rectum and gently mobilize the coccyx back to its proper position. The muscles of the pelvic floor will then be “massaged” to relax them so they will lessen their hold on the tailbone. This whole procedure takes about 3 minutes. It is not painful, although some patients feel some slight discomfort, similar to having a slightly painful bowel movement. Sometimes one treatment is all that is needed, and sometimes multiple treatments are needed to completely remedy the situation. Dr. Horowitz is very experienced in the diagnosis and treatment of all coccyx problems. Your treatment options will be explained to you, often after x-rays are seen. Often treatment can begin on the day of your first consultation. Coccydynia is a painful and disruptive condition. Do not ignore the pain.