History
Historically, the coccyx is probably a functionless remnant (rudiment) from old times. It is assumed that humans had a kind of tail in former times, which then regressed. What remained were the few vertebrae of the coccyx.
Possibility of movement
The movement possibilities in the coccyx vertebrae are exclusively forward or backward, rotations are normally not possible. This is especially important during birth, but also in cases of difficult bowel movements (constipation), since the coccyx can shift backwards due to muscle traction, thus increasing the pelvic exit plane (conjugata recta). Only then is it possible for the child to fit through the pelvic exit plane at birth.
Function
The coccyx serves primarily as a base for the muscles of the pelvic floor. Since the pelvis is open at the bottom and has no bony occlusion, these muscles have a special significance as they not only hold the organs in place but are also responsible for continence. The coccyx vertebra is therefore of crucial importance, especially as the point of attachment for muscles.
However, due to the variable number of vertebrae and the minimal supporting surface of the vertebral bodies, the coccyx cannot help to stand upright. Nevertheless, the coccyx is important. If there is osteoporosis in the coccyx, fractures can occur here more easily, which are not only associated with severe pain, but also result in restriction, especially when sitting.
Diseases
Inflammations of the coccyx in particular are more frequent due to the connection to the many muscles. A dislocation (luxation) of the coccyx is rarer. However, if such a painful dislocation occurs, the doctor has to pull the coccyx downwards (caudally) via the rectum in order to move it to its correct position.
Immediately afterwards, the symptoms should improve. Also rare is a coccyx fracture, which is associated with enormous pain and a hematoma in the anal region.Such a fracture can occur when skiing, for example, if you “sit properly on your bottom”. In most cases, however, the coccyx must already have been damaged beforehand, through osteoporosis or an inflammation, for a fracture to occur.
Since it is not possible to put a plaster cast on the coccygeal vertebra, in extreme cases it must be removed (resection of the coccygeal os). In most cases, however, a therapy with painkillers (analgesics), cooling and longer protection of the coccyx is sufficient. Especially in younger patients, the coccyx should heal after some time.
