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Coccygodynia

Last reviewed: 23 Nov 2024
Last updated: 11 Apr 2024

Summary

Definition

History and exam

Key diagnostic factors

  • coccyx pain
  • coccygeal tenderness
  • spasm of pelvic floor musculature
  • relief of symptoms after corticosteroid injection
Full details

Other diagnostic factors

  • guarding
Full details

Risk factors

  • female sex
  • history of trauma to the coccyx
  • obesity
Full details

Diagnostic tests

1st tests to order

  • lateral sacrococcygeal x-ray
  • dynamic lateral sacrococcygeal x-rays
Full details

Tests to consider

  • MRI of the sacrum and coccyx
  • CT lumbosacral spine
  • WBC count
  • erythrocyte sedimentation rate
Full details

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 has been an expert witness for personal injury defense, is a primary investigator on two industry sponsored studies, and has given medical lectures.

Peer reviewers

Patrick M. Foye, MD

Professor and Director of the Coccyx Pain Center

Rutgers New Jersey Medical School

Newark

NJ

Disclosures

PMF is the author of references cited in this topic.

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.

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