Tailbone pain, medically known as coccydynia, is a source of significant discomfort that makes simple activities like sitting nearly impossible. This localized pain at the very base of the spine can often be addressed effectively through non-invasive treatments. Chiropractic care focuses on restoring proper mechanical function to the spine and pelvis. Because the coccyx is delicate, even slight deviations can cause considerable pain, making targeted manual therapy a viable path toward relief.
Understanding Tailbone Pain (Coccydynia)
The coccyx, or tailbone, is a small, triangular bone consisting of three to five fused or semi-fused vertebrae located below the sacrum. This structure serves as an attachment point for various muscles, ligaments, and tendons, including the gluteus maximus and the muscles of the pelvic floor, and helps support the body when sitting. Pain arises when the coccyx becomes inflamed, bruised, or misaligned, leading to the condition known as coccydynia.
The mechanical causes of coccydynia often involve trauma or repetitive strain. An acute injury, such as a backward fall onto the buttocks, can result in a fracture, dislocation, or bruising of the coccyx. Chronic external trauma from prolonged sitting, especially on hard surfaces with poor posture, also places sustained pressure on the area and contributes to inflammation. Childbirth can also lead to internal trauma or hypermobility of the coccyx.
Chiropractic Assessment and Treatment Methods
A chiropractic approach to coccydynia begins with a thorough assessment, including a detailed patient history to understand the pain’s onset, location, and factors that worsen or relieve it. The physical examination involves palpation of the sacrum and coccyx to check for tenderness, misalignment, or abnormal movement, such as hypermobility or hypomobility. Chiropractors also determine if the pain is local to the coccyx or if it is referred pain originating from surrounding soft tissues, such as the gluteal or pelvic floor muscles.
Treatment focuses on restoring proper alignment and mobility to the sacrococcygeal joint. The most common techniques involve gentle external adjustments and mobilization of the coccyx and surrounding pelvic structures. These controlled manual forces, sometimes applied with specialized instruments like the Activator, aim to reduce joint stiffness and alleviate mechanical load. External manipulation involves mobilizing the coccyx through the skin just above the anus, which is appropriate for a coccyx that is displaced forward.
If the coccyx is severely misaligned or soft tissues attached to the bone are in spasm, internal manipulation may be considered and discussed with the patient. This technique involves the chiropractor inserting a gloved finger into the rectum to gently massage or stretch attached muscles, such as the levator ani, and manually reposition the coccyx. This internal approach allows for direct access to the ligaments and muscles that pull the coccyx out of position.
Adjunctive therapies are often integrated into the treatment plan to address the muscular component of the pain. Soft tissue techniques like myofascial release are used on the surrounding gluteal muscles, hamstrings, and piriformis to reduce tension and pressure on the coccyx. Patients are also instructed on therapeutic exercises, such as posterior pelvic tilts, to strengthen core stability and improve function of the muscles that impact the area.
What to Expect During and After Treatment
The duration of care for coccydynia varies depending on the severity and chronicity of the condition, though patients often notice improvement within a few weeks of consistent care. A typical course involves a series of sessions, where improvement is measured by a reduction in localized pain and an increased tolerance for sitting. The goal is to not only alleviate the immediate pain but also to achieve long-term relief by correcting the underlying mechanical dysfunction.
Supporting recovery at home is a significant factor in the success of chiropractic treatment. Chiropractors advise patients to use specialized seating, such as a wedge-shaped or U-shaped coccyx cushion, which offloads pressure from the tailbone while sitting. Patients also receive guidance on postural correction and body mechanics to prevent re-injury and undue strain.
Chiropractic care is primarily suited for mechanical causes of tailbone pain. A chiropractor will screen for “red flags,” which are signs that the pain may be due to a more serious non-mechanical cause requiring immediate medical referral. Symptoms such as unexplained weight loss, fever, severe unremitting pain not relieved by rest, or new-onset bowel or bladder dysfunction indicate that a referral to a medical specialist is necessary. If the pain is severe or persists for more than a month without improvement, further diagnostic imaging or interventions like injections may be warranted.