Health Topics

Healthy Living

February 2012
Pain in the BUTT
Dr Somasekhar Reddy
Pain in the tailbone can frustrate, irritate and impair the quality of life. This condition can be curable and prevented if proper care is taken. Any irritation (inflammation) of the bony area (tail bone) situated between the folds of the buttocks is referred to as coccydynia. The usual complaint is pain on the bottom region of the back while sitting.

Causes of Coccydynia
  • Injury to the coccyx
  • Pressure on the tailbone during pregnancy
  • Chronic pressure on the tail bone due to sitting for long hours
  • Indirect injuries where the pelvic floor muscles are forcefully contracted
  • Chronic constipation
  • In one third of the cases the cause is not known.
Diagnosis is usually based on typical complaints. A clinician examines and elicits tenderness in the local region and diagnoses the condition. Infection in the hair follicles or lower intestinal tract problems can mimic coccydynia. In order to rule out infections or other causes, it is necessary to directly visualize the tailbone region.

  • Activity modification is the most commonly recommended treatment. Sitting for long hours at a stretch can aggravate the condition. Using a modified cushion (doughnut cushion) with a cut out relieves pressure on the coccyx.
  • Pelvic floor exercise can help in getting relief from the pain.
  • Stool softeners or laxative for those suffering from coccydynia due to constipation provides pain relief.
  • Sitz bath taken by sitting in a tub of hot water may also provide pain relief.
  • Oral anti-inflammatory medications and local application of pain gels also help.
  • Local trigger injections with low dose steroid preparations will aid in complete relief in majority of cases. These local injections can be given by the doctor in the outpatient department.
  • Surgery for coccydynia is rare and is done only in nonresponsive cases.

Dr Somasekhar Reddy is a Consultant Orthopaedic Surgeon, Apollo Hospitals, Hyderabad.
  • The information on this site does not constitute medical advice and is not intended to be a substitute for medical care provided by a physician.
  • See additional information.