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Dr Hitesh Patel is Consultant – Pain Management & Palliative Care he recieved his M.D. from B.J. Medical College Ahmedabad, Asia’s largest hospital, Civil Hospital, Ahmedabad. He earned his F.I.P.M. (Fellow In Pain Management) at Daradia Pain Hospital in Kolkata, which is affiliated with the Aesculap Academy in Germany. He received his C.C.P.P.M. (Certificate Course in Pain and Palliative Medicine) from Gujarat Cancer Research Institute Ahmedabad, the state’s largest cancer hospital.

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back pain

COCCYDYNIA

Tailbone pain, called “coccydynia,” is a pain in and around the small triangular bone at the very bottom of your spinal column, above the cleft of your buttocks.

The coccyx is made up of three to five fused vertebrae (bones). It lies beneath the sacrum. Several tendons, muscles, and ligaments connect to it. Both the coccyx and the ischial tuberosities bear your weight when you sit down.

CAUSES

  • For one-third of those with coccydynia, the cause is unknown.
  • Women are five times more likely than men to develop coccydynia. 
  • Falling – can bruise, break (fracture) or dislocate (knock out of place) coccyx.
  • Repetitive Strain Injury (RSI)
  • Sports like bicycling and rowing 
  • Pregnancy/Childbirth
  • Obesity
  • Underweight
  • Sitting – sitting on a hard or narrow surface.
  • Cancer
coccydynia

SYMPTOMS

  • Achy or piercing pain in the tailbone.
  • Severe pain when changing from sitting to standing up.
  • Severe pain when sitting for long periods of time.
  • Pain during bowel movements.
  • Pain during sex.
  • Poor sleep.
  • Painful buttocks.

DIAGNOSIS

  • Clinical History
  • X-ray.
  • CT scan.
  • MRI.
  • Bone scan.

TREATMENT

Most people recover without undergoing any sort of treatment. 90% just need to use at-home remedies.

  • NSAID to reduce pain and swelling.
  • Decreasing sitting time. Lean forward if you have to sit.
  • Taking a hot bath to relax muscles and ease pain.
  • Using a wedge-shaped gel cushion or coccygeal cushion (a “donut” pillow) when sitting.
  • Taking stool softeners to reduce pain during bowel movements.
  • Stretching and strengthening the muscles of your lower back and pelvis.
  • Applying hot or cold packs to your lower back. 
  • Wearing loose-fitting clothing.
  • Physiotherapy

PROCEDURE:

  • Coccygeal nerve block — using numbing medications and steroids to decrease the inflammation.
  • GANGLION IMPAR BLOCK
  • Radiofrequency Ablation

Surgical options include:

  • Partial coccygectomy (removal of part of the coccyx — extremely rare).
  • Total coccygectomy (removal of the entire coccyx — extremely rare).
Treatment