Another term for coccydynia is tailbone pain or coccyx (this is the very bottom portion of the spine where three or more tiny vertebra are merged together but do have a limited movement –not completely fused) pain it is not very common and can cause persistent pain at the very bottom of the spine. The person will have increased pain with sitting position and with any movement that puts pressure on the bottom of spine. This is more often seen in women and is caused due to giving birth, trauma and/or infection. Treatment depends on how long the conditions has persisted as well as the amount of discomfort this has been causing.
Treatments that can decrease the pressure onto the tailbone area can alleviate pain but in very rare cases, surgery could be considered but only if the pain is extreme and changes in activity as well as non surgical treatment has been tried for a few months without relief. Surgery would involve taking coccyx out for which another name is coccygectomy.
Coccyx pain occurs when there is an injury to the ligaments or the disc (vestigial) in turn causing pain and irritation to the area but in unusual cases there can be fracture which would in turn cause severe pain and in worse case scenario there could be infection and/or tumor causing the pain.
First line of treatment is NSAIDs (non-steroidal anti-inflammatory drugs) which include ibuprofen, naproxen and COX-2 inhibitors all of which can decrease the inflammation and the pain. It is also beneficial to use heat and/or ice onto the area as well as trying to minimize sitting for long periods. Having a custom doughnut shaped pillow is ideal as well as pillows with U or V shape where the back portion is open and does not come into contact with the coccyx and if the constipation is a cause then it is ideal to increase fiber, drink more water as well as over the counter stool softener medication. Other options include a lidocaine with steroid injection under xray guidance (fluoroscopy) which can decrease pain up to few years as well as physical therapy provided stretching or ultrasound techniques, chiropractic manipulations. If none of the above are helpful then surgery to remove coccyx (coccygectomy) is indicated which is rare and involves lengthy recuperation. Some surgeons remove the entire coccyx and some remove just parts of it.