What it is

Coccydynia, or tail bone pain, refers to any type of persistent tail bone pain. It is typically localized pain that is made significantly worse with sitting. Patients with this condition typically find a lot of relief with seat cushions with a cut out for the coccyx, or tail bone.

View of inside of female pelvis looking down

How it is treated with physical therapy

The coccyx is attached to the sacrum with an amphiarthrodial joint, meaning there is a disc between the two surfaces. There are two primary muscles assisting with the joint’s mobility: the coccygeus and pubococcygeus. When the coccyx suffers any trauma, e.g. falling on your bottom, these muscles can go into spasm. If one or both of these muscles it tight, then it can pull the joint out of alignment. Therapy can completely eliminate your pain by releasing this muscle tension and mobilizing the joint.
Therapist will use manual therapy techniques, using a gloved finger, to work directly on the tissue. This work is done primarily rectally for both women and men for more direct access to the joint and attaching muscles. Therapist will also work externally in the hips/glutes as well. This condition responds very well to trigger point dry needling.

Your Homework

Often times, there is not much homework other than specific stretching or strengthening based on your presentation. You will also be coached through how to avoid your triggers while healing and how to prevent this from happening again in the future.

How many sessions

Coccydynia is typically a quick recovery, requiring as few as 2 visits and up to 8 visits depending on the severity.
I typically like to see this patient once per week so the muscle tension is less likely to return between sessions.

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