Coxalgia: Description, Causes and Risk Factors:
The coccyx is the very bottom portion of the spine. It represents a vestigial tail (hence the common term "tailbone") and consists of three or more very small bones fused together. The coccyx is made up of between three and five separate or fused vertebrae.
Coxalgia commonly called tailbone pain or coccyx pain is a fairly rare and relatively poorly understood condition that can cause persistent pain at the very bottom of the spine. This part of the spine is the coccyx or tailbone. Coxalgia is felt as a localized pain and will generally feel worse when sitting or with any activity that puts pressure on the bottom area of the spine.
The condition is much more common in women than in men. It is usually caused by local trauma (e.g. a fall) or giving birth. On rare occasions, an infection or tumor can also cause pain in the coccyx.
While it was originally thought that the coccyx is always fused together (with no movement between the coccygeal vertebrae), it is now known that the entire coccyx is not one solid bone but often there is some limited movement between the bones permitted by the fibrous joints and ligaments.
It is not clearly understood which portions of the anatomy can cause coccyx pain. In many cases the exact cause of the pain is not known (called idiopathic coxalgia), and in these cases the symptoms are managed.
In general, pain can by caused in the coccyx if an injury or some type of excess pressure on the area causes the bones to move beyond their normal very limited range of motion, resulting in inflammation and localized pain. An injury to either the ligaments or the vestigial disc may be a cause of pain. Rarely, the bones of the coccyx can fracture and cause pain. Also, in rare cases a tumor or infection in the coccyx can be a primary cause of tailbone pain.
Pain in the hip can result from a number of factors. Abnormalities of the skin, nerves, bones, joints, blood vessels, and soft tissues of the hip can all result in pain. Sometimes diseases that affect other joints in the body, such as arthritis, can be the cause of pain in the hip. Trauma, including bone fracture, is also a cause of hip pain. Pain in the hip area may also originate from painful infections or other conditions of the skin, such as shingles. Hip pain may also occur because of a problem with the back or spine.
Symptoms may include:
- Pain that is markedly worse when sitting.
- Local pain in the tailbone area that is worse when touched or when any pressure is placed on it.
- Pain that is worse when moving from a sitting to standing position.
- Pain that is worse with constipation and feels better after a bowel movement.
A health professional diagnoses coxalgia by taking a thorough medical history from the patient and completing a physical examination. Diagnostic tests, such as x-ray or MRI, are also commonly performed in order to rule out other potential causes of the pain.
A thorough physical examination for coccyx pain should include:
Pelvic and rectal exam to check for a mass or tumor that could be a cause of the pain.
- Palpation to check for local tenderness.
The most striking finding on examination is usually the local tenderness upon palpation of the coccyx. If the coccyx is not tender to palpation, then the pain in the region is referred from another structure, such as a lumbosacral disc herniation or degenerative disc disease.
Treatments for coxalgia are usually noninvasive and local. The first line of treatment typically includes:
Applying ice or a cold pack to the area several times a day for the first few days after the pain starts.
- Applying heat or a hot pack to the area after the first few days.
- Stretching: Stretching the muscles and tendons that surround the joint can help with some causes of hip pain. A good routine should be established, and following some specific suggestions will help you on your way.
- Physical Therapy: Physical therapy is an important aspect of treatment of almost all orthopedic conditions. Physical therapists use different modalities to increase strength, regain mobility, and help return patients to their pre-injury level of activity.
- Non-steroidal anti-inflammatory drugs (NSAIDs). Common NSAIDs, such as ibuprofen, naproxen and COX-2 inhibitors, help reduce the inflammation around the coccyx that is usually a cause of the pain.
- Avoiding sitting for prolonged periods, or placing any pressure on the area, as much as possible.
- A custom pillow to help take pressure off the coccyx when sitting. Some find a donut-shaped pillow works well, and for others it is not the right shape and still puts pressure on the coccyx. Many prefer a foam pillow that is more of a U-shape or V-shape (with the back open so nothing touches the coccyx). Any type of pillow or sitting arrangement that keeps pressure off the coccyx is ideal.
- If the tailbone pain is caused or increased with bowel movements or constipation, then stool softeners and increased fiber and water intake is recommended.
NOTE: The above information is for processing purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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