Coccydynia. (Coccyx Pain) Information for patients. Outpatients Physiotherapy Tel:

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1 Information for patients Coccydynia (Coccyx Pain) Outpatients Physiotherapy Tel: DPS ref: (RP) Issue 1: February 2013 Review date: January 2016 The Ipswich Hospital NHS Trust, All rights reserved. Not to be reproduced in whole, or in part, without the permission of the copyright owner.

2 Coccydynia is a term given to pain in the tail bone area. What is the coccyx? The coccyx is a small, triangular bone consisting of 3 5 vertebrae which are often fused. The name is derived from the Greek word meaning cuckoo due to its resemblance to a bird s beak. The coccyx is attached to the bottom of the spine (the sacrum) by a number of strong ligaments which reinforce the joint. The muscles of the pelvic floor are closely linked to the coccyx. The pelvic floor muscles attach from the pubic bone at the front of the pelvis, cover the underside of the pelvis (between the legs) and attach to the base of the spine / coccyx at the back. The muscles help to support the internal organs and control movement from the bladder and bowel. lumbar spine sacrum coccyx Page 2

3 Coccydynia can affect all ages and is five times more common in females. It can occur for the following reasons: an accident (fall onto coccyx); growth spurts; a large amount of weight loss; childbirth; or spontaneous onset with no known cause. The symptoms can vary from mild discomfort to acute pain which varies in intensity, frequency and duration between individuals. The pain is most commonly aggravated by: sitting, especially on hard surfaces with poor posture or for long periods; rising from a seated position; prolonged standing; climbing stairs; bending; lifting; and opening your bowels. The main treatment of coccydynia is physiotherapy. 1 Coccyx cushions are essential as they relieve the pressure off the painful area. They can be bought from the internet and need to be used every time you sit down. 2 Anti-inflammatory medication can help, please see your GP for advice. 3 Ice therapy wrap ice or frozen peas in a damp towel and place on the painful site for 20 minutes. Try to do this three times a day. Be careful not to get an ice burn. The skin should stay pink, not go white. 4 Avoid sitting for long periods. 5 Sitting and standing with good posture and good alignment allows muscles to work effectively. Page 3

4 6 Stool softening medication can be helpful. If you are concerned about this type of medication please see your pharmacist or GP. 7 Introduce exercises. Your physiotherapist will help you to decide which exercises are most suitable for you. Exercises a) Buttock squeezes Lie on your back. Tighten your buttock muscles. 30 seconds and then relax. b) Bridging Lie on your back with your knees bent up. Tighten your bottom and abdomen and lift your bottom. five seconds and then lower. Progress by straightening and bending one knee. Page 4

5 c) Pelvic floor exercises Lying on your back, slowly and gently draw up your pelvic floor muscles as if you were stopping a flow of urine. Breathe normally. d) Lie on your side with your knees bent and heels together Keep your back straight and pelvis still. Keeping your ankles together, lift the top knee away from the lower one. Go as far as is comfortable. If you start to feel yourself rolling backwards, lower your knee slightly. Page 5

6 e) Kneeling on all fours Kneeling on all fours, keep your shoulders still. Hollow your back down, then arch your back up gently. Repeat slowly. Concentrate on it being your lower back leading the movement. f) Lying on your back with your knees bent up Find the bony part on the front of your pelvis, move in one inch and feel the muscle under your fingers. Now slowly and gently tense your lower abdominal muscles. Breathe normally. g) Pilates Taking part in Pilates classes will help to progress your deep muscle strengthening and keep the area healthy. Page 6

7 Stretches a) Hamstrings stretch Sitting on chair, straighten one leg, lean forwards at your hip joint and pull your toes up. Repeat times, times daily. b) Lie on your back. Hold your leg behind your thigh and gently straighten your leg. c) Standing, lean forwards at the hip and stretch towards your toes. Pull your toes up. Repeat times, times daily. Page 7

8 Produced by: The Ipswich Hospital NHS Trust Heath Road, Ipswich, Suffolk IP4 5PD Hospital switchboard:

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