Coccydynia & Coccygectomy ( Tail bone Pain)
Coccyx also known as Tail bone is the triangular vestigial bone that forms lowermost tip of our spine. It is attached to sacrum through Sacrococcygeal Joint. Normally this Joint is immobile, that is there is no movement. Whenever you sit , the pressure of sitting goes to this bone but since there is no movement in this joint, patient does not feel anything.
Due to fall on buttocks, trauma while diving or travelling, or after long sitting on hard surface and Child birth, this joint gets sprained. This results in instability or hypermobility of the joint leading to micromovements which leads to pain on long sitting and on getting up from sitting position. In some cases pain is so severe that patient is not able to sit straight for more than few minutes. They lean forward while sitting or keep on shifting weight on alternate buttocks and are more comfortable standing and walking.
Diagnosis is based on clinical history, Physical examination and Investigations like Xary and MRI. Xrays are special Dynamic Xrays done in sitting and lying position to check for any movement in coccyx with change of Posture. MRI is done to rule out other causes of pain like Infection and tumours.
Treament includes Pain killers, ice or Hot packs, rest, physiotherapy and most important is Soft cushion or special Coccydynia rings. Some patients benefit from local injections and Pars Impar block. Few patients with severe symptoms not responding to medical management benefit from Surgery - Coccyx Excision or Coccygectomy.