The tailbone, or coccyx, is a small bone at the very end of your spine. Many individuals experiencing pain in this area wonder if arthritis could be the underlying cause. While less common than other factors, it is possible for arthritis to affect the tailbone, leading to chronic pain and impacting daily activities.
Understanding the Coccyx and Arthritis
The coccyx is a small, triangular bone located at the base of the spinal column, just above the buttocks. It is typically formed from three to five fused vertebrae. This bone serves as an attachment point for various muscles, tendons, and ligaments that support the pelvis and pelvic floor. When sitting, the coccyx works with other pelvic bones to bear and distribute body weight, providing stability.
Arthritis refers to the inflammation of a joint, which is where two or more bones meet. There are over 100 different types of arthritis. Common symptoms across various types include joint pain, stiffness, swelling, and a reduced range of motion.
Does Arthritis Affect the Tailbone?
While not the most common cause of tailbone pain, arthritis can affect the coccyx. The most frequent type of arthritis to impact the tailbone is osteoarthritis, often called “wear-and-tear” arthritis. This condition develops as the cartilage cushioning the sacrococcygeal joint—the joint connecting the coccyx to the sacrum—gradually breaks down over time, leading to bone-on-bone friction and pain.
Inflammatory types of arthritis can also involve the coccyx, though less frequently. Conditions like ankylosing spondylitis or psoriatic arthritis can cause inflammation in the joints of the tailbone. Rheumatoid arthritis, another autoimmune disease, has been reported to cause coccydynia. Factors such as aging, previous injury, prolonged sitting, and even being overweight or underweight can increase the risk of developing arthritis in the tailbone.
Common Causes of Tailbone Pain Beyond Arthritis
Coccydynia, the medical term for tailbone pain, typically stems from causes other than arthritis. Direct trauma is the most common culprit, often resulting from a fall directly onto the buttocks, which can bruise, fracture, or dislocate the coccyx. This injury can lead to inflammation around the coccyx, contributing to pain.
Repetitive strain from activities that put prolonged pressure on the tailbone, such as long-distance cycling or rowing, or prolonged sitting, can also trigger coccydynia. Poor posture can further exacerbate this pressure. Childbirth is another frequent cause, as the coccyx may be bruised, fractured, or dislocated due to the pressure exerted during delivery.
Coccygeal instability, where the tailbone moves excessively or too little during sitting and standing, can also cause pain. This instability may result from trauma or weakened ligaments. Bone spurs, small bony growths near the tailbone tip, can irritate surrounding tissues, leading to localized pain, especially when sitting or leaning back. Less commonly, tailbone pain can be referred from other areas of the spine or pelvis, such as a herniated disc or sciatica. Rarely, infections or tumors in the coccygeal area can also be a source of pain.
Diagnosing and Managing Tailbone Pain
Diagnosing tailbone pain typically begins with a thorough medical history and physical examination. During the exam, a healthcare provider may palpate the coccyx area to check for tenderness, swelling, or bone spurs. Sometimes, a rectal exam assesses the coccyx’s mobility and rules out other internal issues.
Imaging tests can provide further insight. X-rays may be used to check for fractures or dislocations, while MRI or CT scans can help identify issues like tumors, infections, or significant joint changes. Dynamic X-rays, taken while sitting and standing, can reveal excessive or limited coccyx movement, indicating instability. Blood tests might be ordered to rule out inflammatory conditions or infections.
Management of tailbone pain often starts with conservative treatments. Over-the-counter pain relievers, such as NSAIDs, can help reduce pain and swelling. Specialized coccyx cushions, often U-shaped or wedge-shaped, can alleviate pressure while sitting. Applying heat or ice packs may also provide relief.
Physical therapy can be beneficial, focusing on exercises to strengthen pelvic floor muscles, improve posture, and stretch surrounding tissues. If conservative measures are insufficient, injections of local anesthetics and corticosteroids directly into the area can provide temporary pain relief and reduce inflammation. In rare cases of persistent and severe pain unresponsive to other treatments, surgical removal of the coccyx (coccygectomy) may be considered as a last resort.