- The tailbone, a triangular bone located at the end of the spine, is medically known as the Coccyx. Coccydynia is usually felt as a localized dull and achy pain in and around the tail bone.
2. Coccydynia worsens with sitting, leaning back while seated, or when moving from a sitting to a standing position as it puts added pressure on the tail bone. The coccyx is painful during bowel movements, sexual intercourse, and menstruation in females.
3. Coccydynia is much more common in women than men because of the broader pelvis and in cases of difficult childbirth. Obese people are also more prone to have Coccydynia due to increased intrapelvic pressure. Even in underweight people with less weight around buttocks results in coccyx rubbing against the surrounding structures and gets inflamed.
4. Coccydynia is caused by trauma to the tailbone, like from a fall or during childbirth. Repetitive strains can also occur from frequent or prolonged sitting on hard or uncomfortable surfaces and frequently doing bike riding and rowing. It may also result from hypermobile tail bone. Rare causes may include infection or tumor. It may be idiopathic (No identifiable origin).
5. Majority of the coccydynia cases resolve with conservative treatments. The conservative treatment involves NSAIDs, Cold packs, Hot Packs, Activity modification, and Ergonomic adaptations to reduce stress on the coccyx. Use of Wedge-shaped cushions while sitting to take the pressure off the tailbone.
6. Also, injecting lidocaine, nerve block, manual manipulation of the coccyx, massage, specific stretches, pelvic floor rehabilitation, and TENS also helps. In rare cases, a coccygectomy (surgery to remove a part of the coccyx) is done.
7. A proper sitting posture ensures weight is taken off the coccyx. Avoid sitting for long periods. Lie on your side when resting to reduce the pressure on your coccyx.
8. Stretches for Coccydynia
- Knee to Chest Stretch-Lying on your back, pull one knee to the chest by grasping below the thigh. Keep the other leg straight. Hold for 10-15 seconds and repeat ten times on each side.
- Adductor Magnus Stretch-Sit upright on the floor with your legs outstretched outwards. Now bend forward from the waist till a stretch is felt on the inside of the groin on both sides. Hold for 5-10 seconds and repeat ten times.
- Piriformis Stretch-Lie on your back. Bend your right knee so that your right foot is flat on the floor. Cross your left leg over your right so that your left ankle rests on your right knee. Use your hands to grab hold of your left knee and pull it gently toward the opposite shoulder. You should feel the stretch in your buttocks and hips. Hold this stretch for 10 seconds, repeat ten times.
- Iliopsoas Stretch-Start with a kneeling position with both knees on the ground. Now bring your right foot forward so that your right knee is directly above your right ankle. Simultaneously extend your left leg behind such that top of your foot is on the ground. Place your hands on your right thigh and hold the stretch for 15 seconds and repeat two times on each side.
- Bridging-Start with supine lying with knees flexed together and pointing to the ceiling, arms by your side with palms facing down. Inhale and push through your heels, lift your lower back and hips, so that the whole body from knees to shoulder is aligned in a slanting line. Your body must be resting on your upper back and shoulders. Hold for 10-15 seconds, repeat ten times.
- Bird Dog exercise-Go on to your hands and knees, keeping your shoulders over your hands and your knees spaced hip-width apart. Simultaneously straighten and raise your left leg and right arm, keeping your pelvis and shoulders in a neutral position. Hold for 5-10 seconds and go back to the starting position. Repeat on the other side. Try to do 2-3 sets of 10 reps.
- Cat and Camel exercises-Go on to your hands and knees, keeping your shoulders over your hands and your knees spaced hip-width apart. Arch and hollow your back alternately, repeat 10-15times.
- Child Pose of Yoga-Get down on your hands and knees on the floor, with knees just under the hips. From this position, sit on your heels and then outreach your arms with hands and forearms touching the ground. Hold this stretch for 15-30 seconds and repeat three times.
- Pelvic Floor Muscle Relaxation– Relax the muscles of the pelvic floor with deep abdominal breathing.
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