Anatomy of the coccyx
Keywords: coccyx pillow, coccyx removal
There's a need to take the pressure off a bruised or fractured coccyx in the acute phase after injury. Coccydynia is one of the most debilitating conditions. If not managed correctly it leaves the victim unable to sit for months and even years.
Where exactly is the coccyx? Slide your finger down between the buttock crease and eventually, deep, just before you reach the anus, you will feel a hard bony prominence. That's it. A normal coccyx is not at all tender.
The coccyx lies at the end of the vertebral column, consisting usually of four bones lying below the sacrum. It’s incorrectly been considered a vestigial tail that has no real function in the human, which is far from the case.
There are many muscles that have their origin on the coccyx; muscles that are vital in bearing down on the toilet, child birth, orgasm, sneezing. Coccyx removal, I think you'll agree, should be the very last option.
So what are the causes of coccygeal pain and why is a coccyx pillow so
useful? About the only time the coccyx seems to give trouble is after
direct trauma, and sometimes after child birth. And then it certainly
let’s you know of its presence. It hurts, and prevents us doing what
first comes to hand, namely sitting. When a person can’t sit, they are supremely miserable.
So, how many muscles might be affected by a bruised or fractured coccyx? Nine muscles, including one of the largest muscles in the body, the gluteus maximus, and numerous ligaments are attached to the coccyx.
These muscles are used during defecation, urination, orgasm, childbirth,
walking and running. The coccyx is important.
These deep pelvic muscles are vital part of stabilising the pelvis and lower back too. They can be best strengthened using the updated Kegel exercises.
Can you see the coccyx in this picture; it's written in tiny letters, see it? And I'm sure you then can see the levantor ani and the coccygeus muscles attached to it. Well there are seven other muscles, all attached to the coccyx.
The coccyx is only rarely fractured as it is fairly mobile, able to flex forwards and backwards. But a violent force directly to the coccyx like falling on the lip of a stairs may subluxate the coccyx and sprain its ligaments, and cause pain for months and even years.
Here's an important tip. Make sure your child knows that pulling a chair out from under someone about to sit, is a very mean trick to pull. I have patients who have suffered from coccyx and low back pain for the rest of the lives. Intended as a joke, it has caused a lifetime of misery. Mind you, knowing some kids, perhaps you will be putting ideas into their heads. Some people's children. Not yours, of course.
Owing to its attachment to so many muscles, the coccyx, when injured, can have a detrimental effect on movement, sitting, bearing down on the toilet may be painful and urinating may also be affected.
Some women may even experience pain during sexual intercourse. The coccyx is not without some importance.
A young woman slipped and fell hard on her sacrum and coccyx. Apart from the bruising it was a terrible injury. She has a hairline fracture through the coccyx, serious sacroiliac joint sprain and a L4 lumbar spine slipped disc.
Whilst this is a worse case than one would normally see on an average day at the chiropractic coalface, three separate injuries, all impacting on each other, it was gratifying this morning, six weeks after the fall, to examine her and find that she has almost no pain or disability. She is faithfully doing her lower back exercises and is more than happy, no longer needing the coccyx pillow, though her coccyx is still tender on palpation.
Now we have made a start with chronic severe migraines obviously eminating from TMJ anatomy ... the jaw joint is a major cause of facial pain and severe headaches. Often there is also upper cervical pain since the sensory nucleus of the nerve supplying the jaw joint (the Trigeminal nerve) is found in the neck. Often it is a chicken-and-egg situation. Does the TMJ anatomy cause the Atlanto Occipital joint subluxation, or vice versa. In her case it's clearly the former - she grinds her teeth at night (bruxism), a major cause of migraine headache migraine headache ...
So much for the doom and gloom. The good news is that this little tailbone responds well to chiropractic, and the treatment is not particularly painful. Coccyx pain relief is at hand. It's only very rarely that coccyx amputation is indicated.
The first phase of chiropractic care is no different to any other
acute joint injury. It needs to be iced to reduce any swelling and
inflammation, the subluxations should be reduced as soon as possible,
and you need to avoid sitting directly on it for a few weeks.
Fortunately there are several aids in the form of a coccyx pillow that
take direct pressure off the offended dignity of this little group of
The bruised coccyx (and a fracture coccyx of course) causes " coccydynia ". Sitting in the car is often painful, but this little coccyx pillow does wonders.
Really this injury should be considered as a syndrome, as trauma to the coccyx often affects the sacrum, the sacro-iliac joints and the myriad of muscles around the coccyx. And of course, the trauma may well have affected the spinal joints as well.
So, chiropractic begins with a thorough examination. Has there been fracture of the coccyx or even the sacrum? Is it black and blue?
The sacroiliac joint anatomy,
the lumbar facet syndrome,
the hips, and the superficial muscles all need to be considered. A piriformis syndrome in particular as it's origin is the sacrum and often during a fall on the buttocks there is direct trauma to the piriformis and the sciatic nerve.
Fortunately, the skin is very tight around the coccyx, and can be used in most cases to correct the subluxated coccyx. The treatment is not usually particularly painful, despite the fact that the general area is so sore - as your chiropractor uses the skin away from the joint to correct the subluxation.
Occasionally, it has to be done rectally. This also is not painful, but obviously awkward and embarrassing. I have never seen research, but on the odd occasion when I have had to do an internal rectal correction of the coccyx, I have been of the opinion that it can be corrected even more quickly. This is perhaps because at the same moment one can do cross friction of the adjacent ligaments and muscles. Thereafter a coccyx pillow is usually a good idea for a few weeks.
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I recently had a patient referred by another chiropractor, because it's generally known that when necessary I will do an internal coccyx treatment. The man had had two years of unremitting coccyx pain that had not responded to medical or an external chiropractic treatment.
Within three treatments he was 90 percent and at the fourth consult a month later had no coccyx pain at all.
made me wonder why it is that I, and others, are so reluctant to do an
internal coccyx treatment; perhaps we should start there. It's the only
way to address the local muscles associated with coccyx pain.
Suggestion: If you are male, and over 45, ask your chiropractor to check your prostate at the same time. It's right there. Prostate cancer is the most common serious cancer in men; and, talking of prostates, it's obligatory that every man eats a tomato a day. More, a phytosterol called beta sitosterol prevents an enlarged prostate. It's particularly high in avocado.
For an interesting case history from the Chiropractic Coalface,
click here: CHIROPRACTIC COALFACE
Before removal, don't you think it might be an idea to pay your local chiropractor a visit? Reducing the subluxation together with a coccyx pillow is far less misery. The arrow below points to the coccyx. Or, what remains of it.
Do you have a question about your coccyx? Share it. Perhaps we can contribute to your dilemma.
Click below to see contributions from other visitors to this page...
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The solution sometimes to chronic pain is to take up something new. Something that will engage your mind and body. Another sport, like gliding perhaps, or just a good walk every day.
One of my diversions on going into semi-retirement was to go solar. Not because I suffer from chronic pain, nor because I'm bored with Chiropractic Help, but simply because I'm hyperactive. Born in the this the twenty first century I would certainly have been put on Ritalin for the rest of my life! Hobbies like solar, beekeeping, gardening are simply put of my philosophy of healthy living and preserving the planet for our children's children.
There have been few things more satisfying in my life that getting most of our energy from the sun. SOLAR POWER ENERGY ...
Or, how about writing a book? I've just finished my fourth book,
A FAMILY AFFAIR ...
this my first non-chiropractic book. A bit saucy, not for the
faint-hearted! But as an ebook that you can read it on your computer for
only 99 cents, a snip. I guarantee you will finish it! How do I know?
It's a trilogy, and Book I is available for free on the web. Just as
many people are reading chapter one,
as the naughty last chapter,
MISSION UNACCOMPLISHED ... so you can get a taste before purchasing.
Did you find this page useful? Then perhaps forward it to a suffering friend. Better still, Tweet or Face Book it.
Interesting challenges of the day
1. Mr B has the trophy for the most acute neck in February. He has quite advanced lower neck arthritis for a forty year old, thanks to a severe fall on the head from a trampoline. But this is upper cervical pain. Right rotation is simply impossible. Luckily he is improving rapidly, eighty percent better he says after three treatments. See cervical facet syndrome.
2. Mrs C is a new patient with a long history of lower back pain, hip pain and pain in both feet. We'll see how we get on, Rome wasn't built in a day.
3. Miss U sprained her ankle two months ago, wearing high heels. She still has severe mid foot pain. Xrays and perhaps a CT scan.
4. Mr V is 86 years old and hurt his back helping his wife into the car. Just one treatment of the sacroiliac joint and he's eighty percent better. It's not always like that.
5. Mr W lay on his back knocking down a pillar. Turning his head causes severe vertigo. He needs the Epley exercises, not pills, research shows. Update, he's fine.
6. Mrs X, a young mother has severe lower back pain, with numbness down the posterior thigh, calf and side of foot. It started after a long drive in the car. Update, she's forty percent less painful after four treatments, but the leg is still numb. Update two; she 60% better, but it's slow and is going to take the full 6 weeks to heal. Further update; a setback, after lifting her child she now has leg pain. It's going to the be difficult.
7. Mrs Y, a 70 year old woman is on maintenance care fo a nasty lumbar stenosis despite having to do everything at home. Her husband has a hospital acquired infection in the shoulder. After 4 operations he is incapacitated and going rapidly down hill.
8. Mrs Z, an 78 year old woman is doing remarkably well with a bad sciatica. But at over 200 lbs she is not losing weight, in fact gaining despite my suggestions. She's high risk for a stroke. Referral to a dietician to crack the whip.
9. Mr A, a 73 year old engineer, still working, is doing fine after a long episode of lower back pain. Some pain on the side of the hip remains after five treatments. Reassured him it's not hip arthritis.
10. Mrs B, a 64 year old woman has had Scheuermanns disease; it's left with a spinal kyphosis and chronic middorsal pain. She responds well to chiropractic treatment, provides she come every six weeks or so for treatment.
11. Mr C, a young engineer fell off his mountain bike injuring his cervical spine and pelvis. Luckily both responded very quickly to a few chiropractic adjustments. Update: his neck is sore again. It all goes back to a whiplash injury ten years ago when he was rammed by a fully laden truck carrying a load of stone. Time for Xrays.
12. Mrs D, a middle aged woman with hip pain of one year duration, despite other treatment. Xrays reveal an impingement syndrome and early hip arthritis. There's much to be done.
13. Both Mrs E and I can't believe how much better her lower back and leg pain are. Surgery for a scoliosis and spondylolysthesis three years ago helped greatly for one year. But then her leg went lame and weak. He was responded extremely well despite all expectations.
And so the day goes. Chiropractors shouldn't be treating the elderly? Bunkum.
Have a problem that's not getting better? Looking for a different slant on your pain? Want to pose a question?
Greetings, Dr B.
You helped me quite some time back with a soothing and professional
response which turned out to be exactly correct. I now consult a local chiropractor.
You write a superb newsletter, too.
Your own unresolved problem. Pose a question
Knowing that up to 70% of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there's a fair chance I can add some insight to your unresolved problem. But at least 30% of the time, I may be quite wrong! Give plenty of detail if you want a sensible reply.
You visited this chiropractic help site no doubt because you have a problem that is not resolving and want to know more about what chiropractors do.
The quickest and most interesting way is to read one of my ebooks of anecdotes. Described by a reader as gems, both funny and healthful, from the life and work of a chiropractor, you'll love them. Priced right at $2.99, though Kindle fiddles the price without telling me.