When does your pain occur?
Coccyx pain can also be caused by lying in the same position for too long or repeatedly. This can simply cause tension in the affected area or be accompanied by damage to the tissue in the coccyx region. This is especially the case with older, bedridden people who lie in one position for a long time.
Since the coccyx is not as well padded with fatty tissue and muscles as the buttock region, the bone presses vertically on the resting tissue, depending on its position when lying down. The weight of the affected person is not important. As a result, there is often a pressure point on the coccyx, which causes pain.
If you are still mobile and in good general health, you can react quickly and take countermeasures that will allow the pressure point to heal. The problem with older people, however, is that they already have poor tissue perfusion and a concomitant disease that also does not promote healing of the pressure sores caused by lying down. In addition, sometimes there are also bad nerves, so that the person does not even notice that there is tissue damage to the coccyx.
If the pressure point is not noticed, it can become an open area and possibly become infected. In the worst case, the tissue may be destroyed, the coccyx itself may be damaged or the area may no longer heal. For this reason, extreme caution is required when lying down for a long period of time, in order to avoid greater damage or pain to the coccyx.
When sitting, the human coccyx is often under greater strain than in other postures. Nowadays, many complaints of the back, coccyx, neck and other parts of the body are caused by incorrect sitting postures and unhealthy habits. This is caused by longer and longer sitting activities at work, hard surfaces, poor chairs and lack of movement in between.
Sitting on hard surfaces for long periods of time can be the cause of pain in the coccyx. The nerve plexus, which emerges from the spinal canal deep in the back and supplies the leg, can be squeezed and affected by long sitting. Initial symptoms are tingling in the legs, up to slight numbness.
Together with the nerves, the supplying blood vessels can also be affected. If these are squeezed while sitting, pain can occur in affected areas of the body. In addition, even small injuries to the bone matter in the coccyx can occur due to permanent pressure when sitting.
When sitting, the body shifts a large part of its weight to the relatively small coccyx, which in the long term can lead to chronic damage to the bone. The therapy of pain in the coccyx caused by sitting consists mainly of a change in sitting habits. An ergonomically adapted office chair can provide long-term relief.
Especially movement and alternation of sitting, walking and standing strengthens the back and the coccyx. If the surface is too hard, a seat cushion is recommended which takes some of the pressure off the coccyx. Since the coccyx is closely connected to the spine and hips, it is also stressed by movements in the joints.
Almost all movements of the upper body and legs are accompanied by movements in the hip joints and between the vertebrae. Thus, when the coccyx is impaired, movements such as standing up, sitting down, bending, jumping and others are directly affected. When standing, the pain often subsides slightly, but the movement itself is painful.Gentle treatment should be observed in case of pain.
Even though sports play a very important role in the well-being of the musculoskeletal system, certain sports also cause their typical injuries and pain. The coccyx can, of course, always be affected by the shear forces that occur after sport as a result of violent and powerful movements in the hips and legs. This can lead to tension in the ligaments and muscles of the coccyx or even to dislocation of the coccyx bone, which should be repositioned therapeutically.
There are also sports in which the coccyx is used more often and therefore pain can occur after exercise. For example, when cycling or rowing, the predominantly seated posture and the friction generated by the repeated same movements lead to irritation of the tissue around the coccyx. This happens very quickly due to the reduced padding of the coccyx.
In addition, when doing sports in a sitting position, pressure is exerted on the coccyx, which stretches the ligaments and thus provokes pain in the coccyx again. But this is among other things a matter of exercise. Usually such pain occurs after sport for beginners or after overexertion or incorrect loading and subsides with time.
If the coccyx still hurts repeatedly after the same sport, this can also be due to the sport itself, which is very stressful for the coccyx. Many strength athletes regularly suffer from pain in the coccyx. The pain is not always directly attributable to incorrect posture or incorrect loading.
Many exercises that are performed in weight training result in strong pressure and tension on the hips, back and coccyx. The coccyx is more heavily loaded, especially when bending over and applying force in the hip. In weight training, the already natural, stressful movement is made more difficult with additional weights.
If pain persists for a long time, a herniated disc must also be considered. Initially, the sport should be avoided until the pain subsides. Painkillers, which additionally inhibit inflammation, from the group of NSAIDs (e.g. Ibuprofen, Diclofenac), accelerate healing.
In the future, it may be necessary to reduce weights and to analyze and correct incorrect loads. Pain in the coccyx usually occurs with every type of movement. Most patients experience the pain symptomatology when lying, walking, standing and sitting.
Particularly in the case of pain in the coccyx, which occurs when bending over or is intensified by bending forward, a so-called pain radiation must be tested. Pain does not always have its cause in the area in which it is felt by the affected patient. It often seems that problems in the buttocks area in particular are caused by the coccyx, although no direct disease of this bony structure can be proven.
A possible cause for pain in the coccyx is a herniated disc in the area of the lumbar spine. Due to the nervous interconnection, patients may experience pain in the coccyx in addition to the typical back pain. Especially in the presence of a herniated disc in the L5/S1 region, coccyx pain occurs when bending down.
In addition, irritation in the area of the ligamentous or muscular apparatus can also lead to pain in the coccyx, which occurs when bending down or is intensified by bending forward. Many women also suffer from pain in the coccyx during pregnancy. This pain phenomenon usually occurs mainly during early (1st trimester) and late (3rd trimester) pregnancy.
Explanations for coccyx pain in pregnant women are mainly found in the hormonal changes the body undergoes. During pregnancy, the pelvic ring becomes loose. For this reason, the distance between the rear edge of the pubic bone and the upper edge of the sacrum increases by about one centimeter.
Due to the gradual stretching of the ligaments, pain may occur in the coccyx. Furthermore, the growing child in the womb exerts additional pressure on the bony pelvis, muscles and tendons. This also provokes a stretching of the pelvic ring.
Which could also be of interest to you: Pain in the sacrum In most cases, the pain only lasts for a short period of time, but in some pregnant women, this change in the anatomical structures can lead to longer-lasting pain.There are many treatment options available, especially for pain in the coccyx that occurs during pregnancy. For most women, seat rings and the use of a pelvic belt help to relieve the discomfort. In addition, the so-called TENS electrotherapy can be used for pain treatment.
Many women with coccyx pain respond very well to targeted physiotherapy and manual applications. For severe or untreatable pain in the coccyx, the local infiltration of an anesthetic is the method of choice. However, due to the potential risks of this procedure, it represents one of the last therapeutic options.
Women who frequently suffer from pain in the coccyx during pregnancy can help themselves in the acute situation with painkillers (analgesics) such as paracetamol. This medicine can also be taken during pregnancy without hesitation. There is no risk of damage to the unborn child.
During the 2nd trimester aspirin, ibuprofen, diclofenac and naproxen can also be used. However, ibuprofen, diclofenac and naproxen should not be used after the 3rd trimester of pregnancy. Taking them may cause premature occlusion of the fetal blood circulation in the area of the heart (so-called ductus botalli).
At this time, aspirin should be taken as sparingly as possible, as this painkiller can also induce premature closure of the ductus botalli. Furthermore, treatment with aspirin (ASA) must be discontinued at the end of the 37th week of pregnancy at the latest. Since aspirin inhibits blood clotting, there is a risk of severe blood loss if this period is not observed during the birth.
Abdominal pain associated with pain in the coccyx is not uncommon, especially during pregnancy. Abdominal pain can be due to the hormonal processes of the uterus. During pregnancy, muscles are loosened, which above all also affect the stability of the pelvis.
With the pressure of the growing child on the pelvis and back, pain can also occur in the coccyx. In men, abdominal pain can also be accompanied by coccyx pain. Here the intestine is often affected.
For example, an intestinal loop may be trapped in the abdominal wall, which is called a hernia. It can occur more quickly in strength athletes, as can pain in the coccyx due to strain. Light pain medication (caution during pregnancy) and protection are the primary treatment methods.
If a hernia is suspected, a doctor must be consulted urgently. The intestine plays a very important role in the development of pain in the coccyx. Anatomically, the rectum together with the anus is close to the coccyx.
Therefore, this section of the intestine in particular influences the coccyx. On the one hand, a banal constipation, diarrhea or flatulence can increase the pressure in the intestine and consequently also on the pelvic floor muscles and the coccyx. As a result, the tissue around the coccyx is stretched, such as the levator muscles or the ligamentum anococcygeum, and the nerves there are irritated.
On the other hand, people with a chronic inflammatory bowel disease such as ulcerative colitis or Crohn’s disease often also have pain in the coccyx region. In ulcerative colitis, only the superficial mucous membrane in the bowel is damaged in comparison to Crohn’s disease. Nevertheless, it begins in the rectum, i.e. near the coccyx, whereas Crohn’s disease can occur anywhere in the bowel.
The chronic inflammation of the bowel can also spread to the surrounding tissue and then cause pain there as well. This can be explained by a phenomenon of nerve connections to the spinal cord. Here again, pathological patterns of intestinal movement play a role in irritating the coccyx.
Diverticulitis is another clinical picture related to the coccyx. Here the intestinal wall is bulging, which can fill with feces and become inflamed. The inflammation can lead to perforation of the intestine.
This allows intestinal contents to escape unhindered into the abdominal cavity and leads to extensive inflammation with peritoneal involvement. The coccyx can also be affected, as it is the deepest point in the pelvis and the inflammation likes to spread there.Fistula ducts, i.e. connecting ducts of two previously unconnected body cavities, can also form between the intestine and the coccyx, which also cause pain due to inflammatory reactions. Ultimately, in the case of coccyx pain through the bowel, one must distinguish between direct pain originating at the coccyx itself (i.e. through fistulae, direct coccyx inflammation or pressure increase in the abdominal cavity) and transmission pain caused by the pain being switched and transferred via the intestinal nerves to the spinal cord (which can lead to crossing with other nerves). Transmission pain is found, for example, in the listed chronic intestinal diseases.
