In most cases the only way to access this angle on the tailbone is internally. This involves putting pressure on the front of the tailbone to move it back into place. Why does this only work internally? Since the most common dysfunction of the tailbone is to be pushed forward by a fall to the buttocks, it needs to be mobilized in a posterior direction. Pelvic floor physical therapists can do this, and some chiropractors and osteopaths may be trained to do it as well. This is most directly done rectally, but sometimes can be accomplished vaginally. The only way to treat most tailbone dysfunction is to work internally to mobilize the soft tissue around it and the joint itself. Chronic nagging pain or tightness in these areas that shifts but never resolves despite care may be traced down to misalignment of the tailbone. The most common two places I see this are the lower back and the suboccipital region, or area just below the skull on the back of the neck. Since the spine and its contents are continuous from the skull to the tailbone, a tailbone out of place can affect alignment all the way up to the head. Pain or tightness further up the spine is often a secondary symptom that patients don’t realize is connected. Bladder leaking may be aggravated by the inability of the pelvic floor to contract optimally. Problems may include pain with intercourse, sensation of “tightness,” or pain with bowel movements. Their ability to function optimally is affected by the positioning of the bones around them. Pelvic floor dysfunction is common, as the pelvic floor muscles attach around the tailbone. Often patients find themselves shifting from buttock to buttock in search of a comfortable position. This symptom may manifest as an inability to be comfortable in sitting. However often patients have no pain at the tailbone until it is directly touched, and occasionally have no pain around it at all. The most obvious symptom is coccydynia, or pain at the tailbone. What Are the Problems Associated With Tailbone Misalignment? Whether the fall was 2 months ago or 20 years ago, the tailbone may still be out of alignment. As they heal the ligaments may scar down around the misaligned tailbone, effectively holding it rigidly out of place. In many cases, a fall to the buttocks jams the tailbone forward, spraining the ligaments surrounding. And yet the tailbone is out of alignment and causing dysfunction.īecause the tailbone is attached to the rest of the spine by ligaments, it can be sprained just like any other joint. They recall a multitude of childhood falls, none of which were particularly notable. Usually, though, patients arriving with tailbone dysfunction cannot pinpoint a particular time that it was severely injured. It is often a slip and fall, resulting in pain in sitting, and requiring the use of a donut pillow for some time until the irritation subsides. Some patients know the moment they injured their tailbone. It may feel like it “points” deep into the body, rather than continuous with the rest of the spine. However in a dysfunctional alignment it may be painful to touch it or the tissue around it, immobile, and even noticeably off-center. In a healthy alignment it is mobile (moves slightly when pressed upon), center line, pain free, and continuous with the sacrum. To find your tailbone, just feel down your back, between the buttocks, until just above the opening of the anus. It is shaped like a triangle, and attaches to the sacrum by ligaments that run front, back, and both sides. The coccyx, or tailbone, is the last piece of the spine. Once injured it can cause pain in sitting, pain with bowel movements, pelvic floor dysfunction, such as pain with intercourse, or even cause reactions up the spine, all the way to the neck and head. What is the connection?Īlthough it is a common site of injury, often taking the brunt of our many childhood and adult slip and falls, the tailbone is unfortunately an under-evaluated source of pain and dysfunction in both men and women. These are symptoms I see commonly grouped together in patients coming for treatment. Inability to sit squarely or for long periods of time. Pelvic floor dysfunction such as pain with intercourse or urinary incontinence.
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