Coccygodynia

Last reviewed: 1 May 2023
Last updated: 31 Dec 2019

Summary

Definition

History and exam

Key diagnostic factors

  • coccyx pain
  • coccygeal tenderness
  • spasm of pelvic floor musculature
  • relief of symptoms after corticosteroid injection
More key diagnostic factors

Other diagnostic factors

  • guarding
Other diagnostic factors

Risk factors

  • female sex
  • history of trauma to the coccyx
  • obesity
More risk factors

Diagnostic investigations

1st investigations to order

  • lateral sacrococcygeal x-ray
  • dynamic lateral sacrococcygeal x-rays
More 1st investigations to order

Investigations to consider

  • MRI lumbosacral spine with contrast
  • CT lumbosacral spine
  • WBC count
  • erythrocyte sedimentation rate
More investigations to consider

Treatment algorithm

ACUTE

new diagnosis: acute or chronic disease

symptoms ≥2 months and failed acute management

Contributors

Authors

Rudolph J. Schrot, MD, MAS, FAANS
Rudolph J. Schrot

Neurosurgeon

Sutter Medical Group

Sacramento

CA

Disclosures

RJS declares that he has no competing interests.

Peer reviewers

Birender Balain, MBBS, FRCS, FRCS (Tr and Orth)

Specialist Registrar

Robert Jones and Agnes Hunt Orthopaedic and District Hospital

Oswestry

UK

Disclosures

BB is the author of some studies referenced in this topic.

Stephen Esses, MD

Professor of Orthopedics

Brodsky Chair of Spinal Surgery

Baylor College of Medicine

Houston

TX

Disclosures

SE is the author of a study referenced in this topic.

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