Tailbone pain in women and men
Pain in the coccyx causes real torment: it hurts to walk, sit, and even lying down a person cannot find a place for himself. No need to think that this is an ordinary bruise, and soon everything will pass by itself. Sometimes the cause of tailbone pain can be much more serious.

Pain in the coccyx (or, in medical terminology, coccidogyny) prevents you from doing the most common things – sitting, lying down, walking, driving a car and playing sports. Sometimes pain is constant and haunts a person literally day and night. For many people, pain in the coccyx becomes chronic and worries for many years, then disappearing, then again reminding of itself1.

We asked our experts about the most common causes of tailbone pain in women and men. And at the same time, we found out what methods of treating pain in the coccyx are used by modern medicine, and what measures will help to avoid the development of this uncomfortable condition.

Physiology of women and men

In women and men, the coccyx is the final fragment of the spine, which consists of 4-5 vertebrae and is attached to the sacral region with the help of a cartilaginous disc. The gluteal muscles and muscles that are involved in the work of the pelvic organs are attached to the coccyx: the rectum, prostate gland, uterus, bladder.

Coccidogynia occurs with spasm and excessively high tone of these muscles or due to infringement of nerve endings in the coccygeal and sacral zone.

Pain in the coccyx worries women several times more often than men2. The fact is that the representatives of the weaker sex have a wider and more mobile pelvis, which is more easily injured. Pain in the coccyx in women may appear after difficult natural childbirth, for example, with a narrow pelvis of the mother and a large child. During childbirth, the coccyx shifts to allow for the expansion of the birth canal and may be injured2.

Causes of pain in the coccyx

The most common causes of pain in the coccyx in women and men are diseases of the spine and injuries of the sacrococcygeal zone. The injury is usually caused by a fall on the coccyx, but chronic injuries that can occur due to cycling and prolonged sitting on a hard surface are no less dangerous.

Less common is coccidogyny, which is provoked by diseases of the pelvic organs. Even less often, pain in the coccyx is caused by pathologies of the rectum – hemorrhoids, paraproctitis, anal fissure. We will tell you more about the most common causes of tailbone pain in women and men.

Coccyx injury

Injuries to the sacrococcygeal zone can be both “fresh” and quite old. With serious injuries (fractures and cracks), the pain is very sharp and increases with pressure on the coccyx.

If the injury is chronic, then the pains are usually aching, pulling and bursting. Doctors note that after a coccyx injury, pain disappears quickly, often within the first day.1. But after a few weeks, months, and sometimes years, coccidogyny again reminds of itself and can become a chronic disease.1.

Pathology of the lumbosacral spine

This is, first of all, osteochondrosis, hernias and protrusions in the lumbosacral region. Any of these pathologies can be accompanied by coccidogyny. Pain in the coccyx usually appears when the nerve endings located in this part of the spine are infringed. Pathologies of the spine are also manifested by other symptoms: stiffness of movements and burning pain in the lower back, on the inner and outer side of the thigh.

Spasm of the levator muscles

Pain in the coccyx can also cause spasm of the levator – one of the muscles that attaches to the coccyx and affects the function of the rectum3. If this muscle is compressed too much, there is pain in the coccyx, sacrum and anus.3. Painful sensations are repeated regularly, cause anxiety, increase in the sitting position and can be given to the perineum and buttocks. Sometimes the pain is accompanied by a feeling of “lump” in the rectum.

Prostatitis and prostate adenoma

Inflammation and congestion in the prostate gland can cause coccidogyny. With a disease in the chronic form, the pain is usually weak, aching, and radiates to the perineum and lower abdomen. Prostate problems can be indicated by such signs as frequent urination and erectile dysfunction.

Adnexitis

Inflammatory processes in the ovaries and fallopian tubes are a common female problem. Pain in the coccyx and anus often occurs with acute adnexitis, may be accompanied by general weakness, fever, intestinal disorders.

Treatment of tailbone pain

In 90% of cases, conservative treatment of pain in the coccyx is used, and only occasionally surgical intervention is used – removal of the coccyx. Methods of therapy are selected by the doctor after a comprehensive diagnosis. Treatment is usually handled by a neurologist, traumatologist or orthopedist.

Diagnostics

At the first stage of diagnosis, diseases are excluded in which the source of pain is organs that are not located in the sacrococcygeal zone.3. Such diseases include hemorrhoids, urinary tract infections, anal fissure, malignant tumors of the abdominal cavity and pelvic organs.3. Therefore, each patient with coccidogyny at the first visit to the doctor is referred to narrow specialists: gynecologist, andrologist-urologist, surgeon, coloproctologist3.

During an external examination, the doctor “probes” the coccyx from the outside and from the inside to fix pain3. Post-traumatic coccidogyny can be diagnosed with the “painful leaning syndrome”, where pain is exacerbated by leaning forward with arms outstretched3.

For instrumental diagnosis of coccidogyny, the following are usually used:

  • X-ray;
  • computed tomography;
  • MRI.

With the help of radiography and CT, bone structures can be examined, and MRI helps to assess the state of the ligamentous apparatus and muscles in the sacrum and coccyx3.

Modern treatments

Chronic coccidogyny is difficult to treat, so doctors advise seeking medical help as early as possible. For the treatment of pain in the coccyx in men and women, several methods are used:

  • drug therapy with non-narcotic analgesics, non-steroidal anti-inflammatory drugs, muscle relaxants, chondroprotectors, and, according to indications, tranquilizers and antidepressants3;
  • neurofrequency ablation of the sacrococcygeal disc1 – irradiation of nerve endings in the pain zone;
  • acupuncture1;
  • intrarectal massage1;
  • balneotherapy with therapeutic baths and mud1;
  • local darsonvalization1;
  • electrophoresis with novocaine1.

The best results are obtained by an integrated approach when several methods are used at once. Many patients with coccidogyny need the help of a psychotherapist to reduce anxiety and prevent the development of depression.

Prevention of tailbone pain at home

To prevent pain in the coccyx, doctors advise avoiding spinal injuries, lifting weights as little as possible and monitoring the correct body position during work and rest. Regular exercise will help keep your musculoskeletal system healthy. It is necessary to control weight and include foods rich in fiber in the daily menu to avoid constipation.

Popular questions and answers

Popular questions from readers we asked our experts: traumatologist-orthopedist Nikita Zaborovsky и neurologist Gleb Markelov.

How to sit properly so that the tailbone does not hurt?

– Pain in the coccyx is often aggravated by sitting. To reduce discomfort, people with coccidogyny take a forced position. For example, they lean forward more strongly or sit on one buttock. But such a decision cannot be called correct. Yes, the pain in the coccyx may become weaker, but with the wrong position of the body, the load on the spine increases. Therefore, it is better to use orthopedic pillows that help reduce pain and at the same time ensure the correct position of the body. One option is a donut-shaped pillow.

Which doctor should I contact if the coccyx hurts?

– After an injury, they usually turn to a traumatologist and a surgeon. In other cases, options are possible. Many men and women with coccidogyny first consult with an orthopedist and neurologist, and then, depending on the cause of the pain, they can get an appointment with a urologist, proctologist, gynecologist.

How to know if there is a crack or fracture in the coccyx?

With a crack or fracture, a person feels a sharp pain when pushing, or when pressing on the coccyx. Radiography and computed tomography help to “see” the injured area.

Sources:

  1. Coccidogyny. SBEE HPE “Bashkir State Medical University” of the Ministry of Health of Russia, Ufa. Medical Bulletin of Bashkortostan, Volume 8, No. 4, 2013. https://cyberleninka.ru/article/n/koktsigodiniya/viewer
  2. Coccidogyny. Belenky A. G. Russian medical journal. No. 6 dated March 26.03.2004, XNUMX. https://www.rmj.ru/articles/revmatology/Kokcigodiniya/
  3. Coccidogyny: etiology, diagnosis and treatment. Magazine “Doctor” from 04.01. 2021 https://disk.yandex.ru/i/AoQidmLdpbaGbg
  4. Vertebral lumbar pain: multifactorial origin, symptomology, principles of treatment. Journal “Attending Doctor” dated June 18.006.2008, 2008. Yu. V. Grachev, V. I. Shmyrev. https://www.lvrach.ru/05/5153167/XNUMX

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