Coccydynia: Not Just Another Pain in the Butt

Coccydynia is a common condition experienced by writers and others who spend a great deal of time sitting, particularly on hard surfaces. Over time, the prolonged sitting can put pressure on the tailbone (coccyx), leading to inflammation and extreme pain. If you suspect you may have coccydynia, you will want to contact your family doctor and schedule an appointment - Many other conditions mimic this condition, so it's important to get a proper diagnosis.

What is Coccydynia?

Coccydynia (also known as coccygodynia) is a general term that is usually applied to pain in the area of the coccyx, or tailbone. This can range from a mild discomfort to an acute pain that makes sitting or moving to a standing position unbearable - the level of pain can vary from person to person and can also vary within the patient; some days, the pain may be nearly non-existent where, in other days, it can be agonizing. Fortunately, there are several treatments that can help to alleviate the pain of coccydynia.

Symptoms and Diagnosing Coccydynia

The first time I experienced the pain of coccydynia, I was in the hospital, where I was undergoing treatment for cellulitis in my left leg. I have lived with back pain for most of my life, so the sudden stab of pain was quickly dismissed as a typical muscle spasm. Laying in the semi-reclined position in a hospital bed seemed to be aggravating my lower lumbar region, or so I assumed. At one point, I literally gave a jerk of pain when the doctor was listening to my lungs but, still, I didn't realize it was a new problem until I returned home.

I soon learned that one of the best ways to aggravate coccydynia and the tailbone region was by sitting for prolonged periods of time. I was ordered to stay off my feet as much as possible with the cellulitis, so this meant either sitting or laying down. Needless to say, the increased time sitting put more pressure on my coccyx and I eventually found myself experiencing more frequent incidents of this sharp and stabbing pain. Oddly enough, I discovered that I could sit and remain relatively pain free, provided I didn't move. However, if I shifted my weight or leaned back, the stabbing pain would strike. Equally disturbing, trying to stand up was sheer agony. At times, the pain was so intense that I would have to take several minutes just to psyche myself up so that I could stand. I literally became afraid of the pain.

People experience different symptoms with coccydynia, but some of the more common ones are as follows:

- Pain during sitting or after having sat for a prolonged period of time. In many cases, the intensity of pain is directly proportional to how long the patient has been sitting.

- Acute pain that is experienced when moving from a sitting to standing position. This is believed to be do to a partially dislocated or abnormally-moving coccyx.

- Sharp pain that is more noticeable when the patient sits on a soft, rather than a hard, surface.

- Sensitivity to pressure around the coccyx

- Shooting pains that move down the legs

- Pain before or during bowel movements

- Pain during sexual intercourse

- Increased pain for women, during monthly menstruation

The pain of coccydynia can vary from a dull ache to a stabbing or knife-like pain. Some experience a foreign-body sensation, as if they were sitting on a marble, while others have even been known to describe it as "like being impaled on a garden cane, with or without chili peppers." Regardless how you choose to describe it, the pain of coccydynia is very real and can seriously affect the quality of one's life.

Diagnosis of coccyx pain can be a difficult thing sometimes. First off, many doctors are not experienced with coccydynia and are often quick to rule it out as a psychosematic condition stemming from depression or other conditions. Others attribute it to lower back pain and try to treat it as a lumbar region injury. One of the best ways to diagnose coccydynia is the Dynamic (sitting/standing) x-ray. Additionally, CAT scans, MRI scans and a colonoscopy may be administered in an attempts to diagnose this condition.

Treating Coccydynia

Fortunately, once you've been diagnosed with coccydynia, there are a wide variety of treatments that can be used to help alleviate coccyx pain. These include (but are not limited to) coccyx cushions (donut pillows and wedge pillows), applying ice or heat to the affected area, anti-inflammatory medications or suppositories, injections of anti-inflammatory medications into the affected area, manual manipulation of the coccyx (either externally or internally), surgical removal of the tailbone and, in some cases, psychological evaluation and treatment. In some cases, coccyx pain can be treated and alleviated through proper exercise, a good diet and resting the affected area. It's important to remember that coccydynia is usually the result of injury to the coccyx and, like any injury, it requires rest to heal. Unfortunately, while many of us realize that you need to rest a sprained ankle and not stress it further, we often forget this aspect when dealing with coccydynia. Much as jogging will cause further pain and damage to a runner's ankle, prolonged sitting can further damage the coccyx. Be careful to avoid further injury.

Sources:

Personal experience

http://www.coccyx.org/whatisit/index.htm - Informative article on coccyx pain

http://www.medicinenet.com/coccydynia/article.htm - Defining coccydynia and coccyx pain