Brief Answer:
Coccydynia cause and management

Detailed Answer:
Hi XXXX, thanks for asking from HCM.


I can understand your concern. Your description of pain is suggestive of "Coccydynia". It is tailbone pain. It can be due to following reasons

: Direct hit
: Prolonged sitting on hard bench
: Some mass lesion pressing over it
: Pregnancy leading to stretching of attached ligaments and tendons
: Lack of exercise and sudden exertion leading to degeneration of coccyx

It is confirmed by clinical history and tests. Pain usually presents as mild to severe, increases on prolonged sitting especially on hard surface/standing from sitting/toilet sit/leaning backward in sitting position. Now to confirm the cause, few investigations are needed like

X ray Coccyx or CT to know any destruction
MRI of Coccygeal region to know any tumor, soft tissue hematoma and degeneration

After ruling out these causes, it can be managed by medical treatment. Follow few tips like
: You can try over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, naproxen, Acetaminophen (Tylenol) after proper prescription.

: For more severe pain, your doctor can inject a local anesthetic like Xylocaine+lignocaine combination, nerve block, or steroid medicine like Prednisolone into the area. Some people get a combination of anesthetic and steroid injections.

:You can also take an antidepressant like Amitriptyline/Nortriptyline or anti-seizure like Gabapentine medicine after proper prescription.

: To ease discomfort, sit on a heating pad or ice pack, or go for a massage. The way you sit also matters. Poor posture can put too much pressure on your coccyx. Sit with your back against the chair and your feet flat on the floor to take the weight off your tailbone. Lean forward when you go to sit down. You can also sit on a special donut-shaped pillow or wedge-shaped cushion to relieve pressure on that sensitive area.

: A physical therapist can show you exercises to strengthen the muscles that support your tailbone. These include your stomach muscles and pelvic floor. You can also try a technique called coccygeal manipulation. This is when a doctor inserts a gloved finger in your rectum and moves the tailbone back and forth to shift it back into position.

: Most of the time, these treatments will relieve your pain until your tailbone heals. If no treatment has worked, your doctor might recommend surgery as a last resort to remove part of or the entire coccyx. This procedure is called a "coccygectomy".

Hope it will help you. If still in doubt, do let me know.

Thanks. Take care.

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