Coccyx Pain (Coccydynia)
Coccyx pain, also known as coccydynia, occurs when the coccyx or the surrounding soft tissues become irritated or damaged. This leads to pain and discomfort at the base of the spine, particularly when sitting or moving from sitting to standing.
The coccyx can be affected in a number of ways. In approximately one third of cases, however, no clear cause can be identified.
Causes of Coccydynia
The most common causes of coccyx pain are outlined below.
Childbirth
Childbirth is thought to be the most common cause of coccydynia. During the later stages of pregnancy, hormonal changes increase the flexibility of the coccyx and the lower spine to allow the pelvis to widen during delivery.
In some cases, childbirth can overstretch the muscles and ligaments surrounding the coccyx. These structures may then be unable to hold the coccyx in its normal position, leading to ongoing pain and instability.
Injury to the Coccyx
The coccyx may be injured following a direct impact to the base of the spine. This can occur during contact sports or as a result of an accidental fall.
Examples include:
- Falling while skiing or ice skating
- Falling from height, such as from a horse, and landing on the coccyx
Although uncommon, coccyx injury may also occur following rectal or prostate surgery in men and gynaecological procedures in women.
Most coccyx injuries result in bruising. In more severe cases, the coccyx may become partially dislocated or fractured. When this occurs, the bones of the coccyx may move abnormally, causing pain that is often worse when sitting.
Repetitive Strain Injury
Repetitive strain to the lower spine can lead to coccydynia. Activities such as cycling or rowing involve repeated forward-leaning movements that place stress on the coccyx and surrounding soft tissues.
Over time, repeated strain may stretch and weaken the supporting muscles and ligaments. If these structures can no longer stabilise the coccyx effectively, pain and discomfort may develop.
Poor Posture
Sitting in awkward or unsupported positions for prolonged periods, such as at a desk or while driving, can place excessive pressure on the coccyx. Pain may gradually worsen the longer the position is maintained.
Body Weight
Being overweight or obese can increase pressure on the coccyx when sitting, potentially causing coccydynia or worsening existing symptoms.
Conversely, individuals who are very slim may have insufficient padding over the coccyx. This can allow the coccyx to rub against surrounding tissues, leading to irritation and pain.
Ageing
With increasing age, the small cartilage structures that help support the coccyx may wear down. In addition, the bones of the coccyx may become more rigid or fused. These changes can increase stress on the coccyx and contribute to pain.
Cancer
A less common cause of coccyx pain is cancer. This may include primary bone tumours such as chordoma or cancer that has spread to the coccyx from another part of the body, such as the bowel.
Assessment by a Spine Surgeon in Nottingham can help determine the cause of coccyx pain and guide appropriate management, particularly when symptoms are persistent or worsening.