Coccigodinia - pain in the occiput

It is a relatively common pain condition in women that is under-represented in the clinical practice of physiotherapy for women. Coccygodynia is a pain condition of the sacrum or a defect of the sacrum causing low back pain or low back pain.

A patient with coccygodynia usually describes severe pain in the occiput or low back pain but presents with caudal pain on diagnostic examination. Low back pain has a complex pathological picture and may also originate from a defect of the occiput. The physiotherapist should perform appropriate differential clinical tests to exclude the potential origin of low back pain from: herniation, spinal stenosis, spinal arthrosis or disc protrusion.

More than ¾ of lumbar spine disorders and pain occur in women and coccygodynia is 5 times more common in women than in men.

The sacrum

The sacrum is a small triangular-shaped bone made up of 3-5 overgrown vertebrae called the sacral vertebrae. The sacrum is an integral part of the lower spine and plays an important role in low back pain. The spine is attached to the sacrum by the articular surface. The femoral head is mainly a joint of the deep hip muscles, which play an important role in stabilising the pelvis and in childbirth in women

The female femoral head or tailbone is narrower and longer, and more often has an outward curvature. After childbirth, the stability of the femoral head and sacrum is characterised by micro-injuries and ligament stretching, which often leads to coccygodynia in women.

Symptoms

Coccygodynia is characterised by pain that is concentrated in the area of the occiput. The pain is often exacerbated by sitting with a backward tilt, running or more intense walking.

The pain is worse when getting up from a chair, and worsens if the chair is forced

Typically, the pain may spread to the sacrum and be recognised as general low back pain. Direct strain on the occiput is very painful, and if the patient falls on the buttocks, the pain is sharp and intense.

In general, two types of coccygodynia can be distinguished:

Acute coccygodynia (present for less than 10 weeks).

Chronic coccygodynia (present for several months or years)

Make an appointment for physiotherapy for coccyx pain

Physical therapy

This is a condition that should not be equated with disc herniation, spinal arthrosis, spinal stenosis or other spinal disorders. Therapy should be in the form of acute physiotherapy directly targeting the spine with TECAR therapy, LASER therapy and PERSIO therapy.

Acute coccygodynia requires a holistic instrumented approach, isolated manual therapy is not the leading method of treatment.

After 4-6 weeks, we usually achieve a complete absence of pain and enter the second phase of rehabilitation, where we stabilise the lower limb, sacrum and pelvis with special exercises.

The final part of physiotherapy also includes exercises to increase the weight-bearing capacity of the lower limb and to teach correct patterns of squatting, walking and running.