Coccydynia

Coccydynia is a painful condition of the terminal portion of the spine.

• specific patient factors have been previously associated with coccydynia patients, including female gender, history of recent fall on the buttocks, obesity and a possibility of psychological disorder (1)
  • the increased occurence of coccydynia in women has been attributed to the more posterior location of sacrum and coccyx and the characteristics of the ischial tuberosities that leave a woman's coccyx more exposed and susceptible to trauma both in common situations (sitting position) and during child deliveries (2)
• radiographic studies of patients with symptoms of coccydynia have revealed the sacrococcygeal joint and the second intercoccygeal joint are generally fused, whereas the first intercoccygeal joint is mobile
  • it has been proposed that stretching of the ligamentous structures of the first intercoccygeal joint may be partially responsible for the symptoms of coccydynia (1)
• management of coccydynia
  • initial management is via conservative methods, including medication such as non-steroidal antiinflammatory drugs, local steroid injections and manipulation
  • surgical treatment (coccygectomy) may be indicated if conservative management is unsuccessful

Reference:

1. Hodges SD et al. A treatment and outcomes analysis of patients with coccydynia. The Spine Journal 2004; 4 (2):138-140
2. Andrés JD, Chaves S. Coccygodynia: a proposal for an algorithm for treatment. Journal of Pain 2003;4 (5): 257-266