Tailbone pain, or coccydynia can have a multiplicity of causes. Some cases simply referred to as idiopathic coccydynia, because the origin can’t be ascertained, but in most cases, it falls into a few simple anatomical sub-categories
- Direct trauma to the lower back is the most common cause. It gives rise to inflammation in the surrounding tissue which is what causes all the pain and discomfort
- Hypermobility is another anatomical origin. Excessive movement can put a dangerous level of stress on the joint between the coccyx and sacrum, damaging the tailbone and causing pain. Additionally, excessive movement can stress the muscles of the pelvic floor, resulting in pain.
- Interestingly enough, Hypomobility is also something to look out for, as this can cause the coccyx to jut out and place pressure on the joint. This jutting again puts pressure on the pelvic floor muscles, which goes hand in hand with discomfort in that region of the body.
- It is also possible for the sacrococcygeal joint to dislocate, resulting in pain. This can happen at either the front, or the back of the tailbone.
Now that we’ve understood the underlying anatomical mechanisms, let’s take a look at some of the ways one can damage their tailbone.
- Falling on one’s bottom is arguably the most likely way one injures their tailbone. This local trauma can damage not only the ligaments, but also the coccyx itself. Apart from bruising the area, it could result in a fracture of the tailbone. Ouch.
- One can wear away at the mobility of the sacroiliac joint by engaging in activities that put pressure on the tailbone for extended periods of time. Sitting on hard surfaces for too long, for instance, is a common cause. Another thing to watch out for is horse-riding. Polo players, and others who ride for extended periods of time often come down with chronic coccygeal pain. This isn’t overly worrying, because the inflammation can be rolled back by being more careful. Getting a comfier seat, for instance. If you ignore this pain for too long, though, it can give rise to longer-term issues.
- This next point goes to all the moms out there. Did you experience lower back, or coccygeal pain during, or shortly after, delivery? That was, because as the baby’s head passes through the birth canal, it puts pressure on the top of the coccyx. In rare cases, this can lead to a coccygeal fracture, but far more likely is that it will simply irritate or inflame the coccygeal structures – the bones, ligaments and disc – by virtue of the pressure.
- It is possible that the pain you might be experiencing in your lower back is simply referred pain (i.e. pain originating from tissue damage in one part of the body but felt in another part. This pain can be referred from a lumbar herniated disk or a degenerated spinal disk. It’s worth noting that is a fairly rare phenomenon.
- Coccydynia can also be caused by infection in the coccygeal bone (osteomyelitis) or a tumor in that particular region that compresses the coccygeal structures.
Risk factors which increase the chance of developing coccydynia include obesity and female gender. One particular study concluded that a BMI of greater than 27.4 in women and 29.4 in men predisposed to a greater likelihood of developing pain after a one-time-injury.
