Anatomy of the coccyx
(Keywords: coccyx pillow, coccyx removal, bruised coccyx, fractured coccyx
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.
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!
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. Best strengthened using the Kegel exercises ...
Can you see the coccyx in this picture (in tiny letters, see it?), and 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 down the stairs), may subluxate the coccyx and sprain its ligaments, and cause pain for months and even years.
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!
Mrs J, a young woman slipped and fell hard on her sacrum / 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 exam. Has there been fracture? Of the coccyx or even the sacrum? Black and blue? The SACROILIAC JOINT ANATOMY , the lumbar facet syndrome , the hips, and the superficial muscles.
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.
Update: 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% and at the fourth consult a month later had no coccyx pain at all.
It 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 ...
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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 is 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.
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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 X-rays, 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.