Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Coccygodynia ++ 724.7 Disorders of coccyx724.70 Unspecified disorder of coccyx724.71 Hypermobility of coccyx724.79 Other disorders of coccyx839.41 Closed dislocation, coccyx839.42 Closed dislocation, sacrum847.3 Sprain of sacrum847.4 Sprain of coccyx ++ M53.2X8 Spinal instabilities, sacral and sacrococcygeal regionM53.3 Sacrococcygeal disorders, not elsewhere classifiedS33.2XXA Dislocation of sacroiliac and sacrococcygeal joint, initial encounterS33.8XXA Sprain of other parts of lumbar spine and pelvis, initial encounter ++ 4B: Impaired posture4D: Impaired joint mobility, motor function, muscle performance, and range of motion associated with connective tissue dysfunction4E: Impaired joint mobility, motor function, muscle performance, and range of motion associated with localized inflammation4G: Impaired joint mobility, muscle performance, and range of motion associated with fracture +++ Description ++ Tailbone painPain often increases with sitting, defecation, transitional movements, and palpation of coccyx +++ General Considerations ++ Consider sacroiliac (SI) joint as potential cause of painAsk patient about history of falls; distant history can contribute to coccydyniaOccupations requiring prolonged sitting may contribute to coccydyniaPain may be referred from muscles, including obturator internus, levator ani, and gluteus maximus +++ Demographics ++ Five times more common in women than in men5Mean age of onset is 40 years5Three times more common in obese patients5 +++ Signs and Symptoms ++ Pain in sitting positionPain with transition from sitting to standingPain with standing, walking, forward flexionPain with defecation, coughingIncreased pain during menstruationInflammationPoor sitting postureFrequent shifts in sitting position, sitting down carefullyLuxation, hypermobility, hypomobility of coccyx +++ Functional Implications ++ Difficulty sitting, impacting ability to perform work and daily activitiesDifficulty or pain with defecation +++ Possible Contributing Causes ++ Vaginal deliveryPostpartumDirect trauma from fracture, fall, childbirthPoor sitting postureProlonged sittingAnorectal infectionLevator ani spasmTrigger points of obturator internus, levator ani, or gluteus maximusOveruse of levator aniNeoplasmPelvic asymmetryStretch or rupture of sacrococcygeal ligamentsSoft-tissue damage +++ Differential Diagnosis ++ Sacral chordomaTarlov cystPilonidal cystSacroiliac (SI) joint pain +++ Imaging ++ Dynamic radiograph of coccyx positionDynamic radiography (stand vs. sit) +++ Diagnostic Procedures ++ Joint injection at coccyx-sacral junction to determine reliefPhysical examinationDiagnostic joint injection +++ Medications ++ Muscle relaxantsOral analgesicsOral corticosteroids +++ Medical Procedures ++ Trigger point injectionsCorticosteroid injectionLocal anesthetic injectionCoccygectomy ++ To physician/interventional radiologist for trigger point injections ++ PainOveractive pelvic floor musclesPoor postureLimited joint mobilityObstructed defecation ++... Your MyAccess profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth