A Pain in the Butt
[originally published in KCN, April 1998]
No, I’m not referring to your spouse, your parent, your unruly child, or anyone else that comes to your mind. What I’m really referring to is taxes!… Seriously, what I am talking about is a condition known as coccygodynia — simply put in layman’s terms: tailbone pain. We doctors refer to the tailbone as the coccyx. This name originates from the Greek word meaning “cuckoo” because of its resemblance to the bird’s bill. The coccyx is formed by 3 to 5 fused caudal (tail) vertebrae at the very end of the spinal column and forms a joint with the triangular sacrum bone above. While most other animal tails are considerably longer than humans (the cat has about 20 caudal vertebrae) and have obvious functions such as offering locomotion (whale), maintaining balance (kangaroo), or expressing emotion (dog) — the human “tail” is nothing but a small cuckoo bill that serves only for the attachment of certain nearby muscles and ligaments.
While the causes of a painful coccyx can be many, invariably the most common cause comes from a trauma of some sort. A fall on the buttocks or even occasionally a difficult childbirth are typical events which can cause the tailbone to jam or displace slightly at the joint with the sacrum. A 1994 study out of the medical journal Spine, found that perhaps up to 70% of common coccyx pain can be attributed to a displacement or abnormal motion of the sacral-coccyx joint. This slight displacement or jamming of the joint is what we chiropractors refer to as a subluxation. The subluxation can provoke irritation and dysfunction of the nerves that stem from the central nervous system and exit at this level in the spine — namely the nerves that supply the rectum and the feeling sensation to the surrounding area of the tailbone.
Typically a person with this condition will have trouble sitting, especially on hard surfaces, due to pain. The tailbone area will be tender to the touch, as well as the surrounding muscles and ligaments that aid in its support. The person may also suffer from chronic bouts of hemorrhoids.
The chiropractic approach to this problem is aimed at realigning the coccyx in its proper relationship with the sacrum and/or restoring its normal motion. By doing this, the nervous irritation that was created can be reduced or eliminated, allowing proper natural healing to take place. Typically a patient who is a candidate for this type of treatment will show improvement in their symptoms within the first few visits.
The chiropractor may opt to utilize X-rays to aid in his or her diagnosis and to assist in making his or her care more precise. To facilitate healing in the initial phases, the chiropractor might recommend the use of ice to reduce inflammation and pain, as well as the use of a donut seat cushion designed to reduce the pressure that is placed on the tailbone while sitting.
Most of us probably don’t think much about our tailbones, but for those who suffer from coccygodynia — it truly is a “pain in the butt.” For these people, a visit to their chiropractor may prove to be helpful. Unfortunately, many cases of coccygodynia without any apparent “medical cause” are often passed off as psychogenic (ie. arising from the mind). Depending on the severity of pain, medical treatment usually range from rest and medication to complete surgical excision of the offending segment.
Your Doctor of Chiropractic is trained to diagnosis and evaluate disorders of the spine (including the coccyx) and determine if chiropractic care is an appropriate consideration.