Diagnosis and Treatment of Coccygodynia or Coccygeal Pain
Tests to Diagnose Coccygodynia or Coccygeal Pain
The tests to diagnose the cause of coccygodynia or coccygeal pain is done by a complete medical history together with an examination of the body done by health professionals. The expert will examine the latest injuries in the areas and find out the factors how to enhance the situations in the way of either curing the pain or making it better. It is most often done with help of imaging studies like X-rays etc.
- The spinal areas or the vertebral column is examined in order to diagnose the causes of redness, tenderness, bruising or swelling for coccygodynia or coccygeal pain. A neurologic examination and a rectal examination are also done. The rectal exam is done by inserting a finger through the rectum to sense the coccyx areas to find out any fracture or dislocation in the area or if the patient feels pain for the direct stress in opposition to the coccyx.
- If there is any record of injury or trauma, imaging studies or X-rays are done in order to diagnose the extent of fractures or displacement of the coccyx if any. Sometimes, these examinations are not enough to ascertain the injuries. Some experts suggest standing and sitting postures X-rays for determining if there is any dislocation or fracture.
- If this doesn't help in detecting the problem, some doctors recommend MRI, CT scan, or Bone scans later. These tests are also suggested if there is any doubt about infection or tumor that might cause the coccygodynia or coccygeal pain.
Treatment for Coccygodynia or Coccygeal Pain
Early Treatment for Coccygodynia or Coccygeal Pain
Coccygodynia or coccygeal pain normally disappears within a short time. It takes a month maximum. In the meantime, the tailbone pain can be lessened following a few simple things:
- While in sitting posture, try to lean forward to avoid getting coccygeal pain.
- Be seated on V-shaped wedge cushion or doughnut shaped pillow as a part of conservative treatment measure to deal with Coccygodynia or coccygeal pain.
- Get your affected areas remain cold or heated as necessary.
- Get pain relievers that are purchasable without doctor's prescriptions, such as Aspirin, Ibuprofen group of medicines like Mortrin IB, Advil etc, or acetaminophen like Tyleon etc…
Even if you do feel relieved of the pain, it is necessary to consult with the doctor.
The coccygodynia or coccygeal pain treatment is normally local and noninvasive. The primary treatment of the problem includes:
- The drugs of the non-steroidal anti-inflammatory group (NSAIDs) type, such as naproxen, ibuprofen, and COX-2 inhibitors are great help for curing the painful coccygodynia or coccygeal pain.
- Application of cold pack or ice pack to the affected areas for the first few days of the starting of coccygodynia or coccygeal pain, and also after first few days after that.
- Avoiding of prolonged sitting postures, and any stress on the affected areas.
- Customized pillows like a donut shaped or other shaped that keep the coccyx areas free from pressure and pain. Some again prefer U or V shaped foam pillow with back open so that it does not touch the painful areas of coccygodynia or coccygeal pain.
- If bowel movement or constipation causes coccygodynia or coccygeal pain, the stool softeners and fiber intake can be increased together with the intake of sufficient water, so drinking water is recommended.
Further Non-Surgical Treatments for Coccygodynia or Coccygeal Pain
In case the pain persists or it is severe, further nonsurgical treatments can be suggested for the coccygodynia or coccygeal pain. These treatments for coccygodynia or coccygeal pain include:
- Injection: Pushing numbing agent to anesthetize the local areas, and steroid for remission of coccygodynia or coccygeal pain. Fluoroscopic guidance is necessary. The relief that is brought by the injection lasts for one week to a few years. More than three injections per year are not allowed.
- Massage or Manipulation: Some patients again bring relief of Coccygodynia or coccygeal pain through manipulation, for example, chiropractic treatment etc.
- Stretching of the Coccyx: The ligament attached to the coccyx can be stretched, but advices of the physiotherapist, chiropractor or other health experts are important. They can only advise you how far you can stretch your ligaments.
- Ultrasound Therapy for Coccygodynia or Coccygeal Pain: Ultrasound therapy of the body also brings relief from coccygodynia or coccygeal pain.
If the possibility of tumor and infection are ruled out after examination with the help of X-ray, tests and MRI, then extended non-surgical treatment is a logical recommended option.
After getting relief of the pain, if your movement is not so painful, try to supply nutrients to the healing areas by doing some light aerobic activity. It will help to enhance the body's natural ability to heal. Additionally, the aerobic workout releases endorphin with analgesic properties to relieve the pain.
Surgical Treatment for Coccygodynia or Coccygeal Pain
If non-surgical treatment fails for coccygodynia or coccygeal pain, to ease or control the persistent pain a coccygectomy is the only option where a part of coccyx is removed by surgery. Though this kind of surgery is the direct option for the recovery from the uncomfortable pain, yet it is performed rarely as most of the spine surgery books have not included this surgery.
Different surgeons approach the operation differently for coccygodynia or coccygeal pain. The most important difference is that some prefer to remove the whole coccyx, and other prefers partial removal of it.
Generally, the surgery for coccygodynia or coccygeal pain is done by following a few steps:
- Firstly, 1-2 inches of cut is made just above the coccyx. It is just below the skin of subcutaneous fat tissues. No muscles are there to cut apart.
- Secondly, the periosteum, the covering of the bone is dissected away out of the bone at the start of the back, and it is carried around at the front. The tissues in this plane are safe. It allows the coccyx to be separated from the sacrum.
- Thirdly, after the exclusion of coccyx, it is sent to the pathology to ascertain if it includes any tumor.
The operation is a very simple process and can be done in 30 minutes. But it takes 3 months to 1 year to heal to get complete relief of the pain and symptoms. Throughout the healing process, the sitting is, of course, not very easy.
The Success Rates of Coccygodynia or Coccygeal Pain (Coccygectomy) Surgery
The success of coccygodynia or coccygeal pain operation is mostly dependent on two things:
- Preoperative condition of the patient.
- Surgeon's experience of coccyx surgery.
If the above criterion is met, the success rate can be 80 to 90 percentages.
Complications in Coccygodynia or Coccygeal Pain Surgery
The primary risk of coccygodynia or coccygeal pain surgery involves surgeon's unplanned moving out the sub periosteal plane surrounding the bone during the coccyx removal. It might cause severe infection as the rectum stretches out just in front of it. Though not likely, if something happens, a redirecting colostomy might necessary to heal rectum.
These are the wound healing or the local infection in prospective risks. This is not like the spine surgery where the surgeon is to manage large number of local nerve roots.
The biggest risk, indeed, is the persistent post-operative pain in the coccyx areas. Once this happens, it suggests that the patient might suffer a long therapeutic process. Even it may not show any improvement.