TAIL BONE PAIN (COCCYDYNIA)

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About Coccydynia

Tailbone pain, also called coccydynia, is persistent pain at the coccyx, the small triangular bone at the very bottom of your spine. It usually feels like a dull ache that gets worse when you sit.

At Singapore Paincare, our specialists provide minimally-invasive treatments that relieve pain safely and effectively—offering an alternative to long-term medication or surgery, often with little to no downtime. Our goal is to help you get back to your daily life with comfort and confidence. 

Neck Lower Back Coccydynia

What Is Coccydynia?

Coccydynia is the medical name for pain in the tailbone. The coccyx is the last bone at the tail end of your spine. It is small, triangular and looks a little like a short tail.

Although we call it the “tail bone”, the coccyx is not one single bone. It is made up of 3 to 5 separate spinal segments joined together.

What Causes Tailbone Pain?

Coccydynia is persistent tailbone pain that is thought to involve inflammation of the coccyx. The most common causes are:

  • A fall that injures the tailbone
  • Childbirth
  •  Infection

However, about one in three people with coccydynia have no known cause. Some people feel pain without any fall or injury at all. In others, the original damage has healed but the pain continues. Between 20% and 40% of tailbone pain cases go on to become chronic pain.

Who Is More Likely to Get Coccydynia?

These factors can raise your risk of tailbone pain:

  • Being female
  • Obesity
  • Osteoarthritis or osteomyelitis (a bone infection)
  • Playing contact sports
  • Rapid weight loss

What Are the Symptoms of Coccydynia?

Tailbone pain

The pain is felt right at the coccyx. Most people describe it as a dull, achy pain that:

  • Gets worse when sitting
  • Can be made worse by cycling or standing
  • Ranges from mild to severe
  • Stays at the tailbone and does not spread to other areas

Other symptoms

You may also feel pain:

  • When changing position, such as moving from sitting to standing
  • During bowel movements
  • During sexual intercourse

Is a Curved Tailbone a Cause for Concern?

A message from our pain specialist

Not always. For most people, the tailbone is naturally curved. The sacrum, the bone just above the tailbone, follows the shape of the buttocks and curves gradually forward. The coccyx is attached to the sacrum by ligaments and tendons.

The angle between the tailbone and the sacrum is normal, and it varies from person to person. So a curved tailbone on its own is not necessarily abnormal.

Because this angle can also change after an injury or disease, X-ray results need careful review. An MRI is usually needed to rule out acute injuries such as bone abrasions, bruising (contusions) and swelling (oedema).

Many cases of coccydynia are caused by nerve hypersensitivity near the tip of the tailbone. Treatment therefore aims to reduce this nerve sensitivity, not to correct the angle of the tailbone

How Is Coccydynia Diagnosed?

At Singapore Paincare, our primary care doctors and pain specialists work together with an orthopaedic surgeon to assess your condition. We apply our Painostic® approach to evaluate the cause of your tailbone pain.

Your assessment may include:

Physical examination to check for the symptoms of coccydynia
Imaging tests, such as an X-ray, CT scan or MRI, if needed to understand the cause of your pain

What Are the Treatment Options for Tailbone Pain in Singapore?

Our goal is to treat your tailbone pain with the least invasive option, once we have identified its cause. We focus on removing the pain generators through specialised injections and minimally invasive procedures. These are combined with medication and cognitive and physical rehabilitation to help you regain function and reduce the chance of pain returning.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs are medicines with anti-inflammatory and pain-relieving effects. For coccydynia, your doctor may also offer a topical cream, which has fewer side effects.

Coccygeal Cushions

These specially designed cushions, often called “donut pillows”, relieve pressure on the coccyx when you sit.

Neurospan Radiofrequency Injections

Physical therapy sessions include resistance training to reduce pain. They also include stretching exercises to improve joint movement and minimise muscle loss. The type and intensity of exercise are tailored to your condition.

When Is Surgery Considered for Coccydynia?

Surgery is rarely needed. Non-surgical treatment has been effective in up to 90% of coccydynia cases. Surgery is usually only considered when pain does not respond well to conservative options.

All surgery carries risks, possible complications and downtime, so it may not be suitable for everyone. Weigh the pros and cons of non-surgical and surgical options carefully with your doctor before deciding.

Surgical options include:

  • Partial coccygectomy: removal of part of the coccyx
  • Total coccygectomy: removal of the whole coccyx

How Can I Prevent Coccydynia?

These simple steps can help lower your risk of tailbone pain:

  • Maintain a healthy weight
  • Avoid activities that worsen symptoms, such as cycling and sitting for long periods
  • Prevent falls by keeping floors and walkways clear of loose objects, debris and cords
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Frequently Asked Questions 

Coccydynia is persistent pain in the coccyx, or tailbone, the small triangular bone at the bottom of the spine. It is usually a dull, aching pain that gets worse when sitting. Common causes include a fall, childbirth or infection, although about one in three people have no known cause.

Sitting puts pressure directly on the tailbone, which is why coccydynia pain typically gets worse when seated. Many cases are also linked to nerve hypersensitivity near the tip of the tailbone, which makes you feel more pain than expected. Moving from sitting to standing can also trigger pain.

A coccygeal cushion, or “donut pillow”, can take pressure off the tailbone when you sit. Avoiding long periods of sitting and activities like cycling may also help. Your doctor may prescribe anti-inflammatory medicine, including a topical cream. Speak to a doctor if the pain persists.

Yes. Between 20% and 40% of tailbone pain cases progress to chronic pain. In some people, the original injury has healed but the pain continues. This is often due to nerve hypersensitivity, so treatment focuses on calming the nerves around the tailbone.

Not necessarily. Most people have a naturally curved tailbone, and the angle between the tailbone and sacrum varies between individuals. X-ray results need careful review, and an MRI is usually needed to rule out acute injuries such as bruising or swelling.

A doctor will carry out a physical examination to look for the symptoms of coccydynia. An X-ray, CT scan or MRI may be requested to understand the cause of your tailbone pain. At Singapore Paincare, our doctors apply the Painostic® approach to evaluate the cause.

Surgery is rarely needed. Non-surgical treatment has been effective in up to 90% of coccydynia cases. Surgery, such as a partial or total coccygectomy, is usually only considered when pain does not respond to conservative options. Discuss the risks and benefits with your doctor.