Coccygodynia Clinical Presentation

Updated: Oct 31, 2022
  • Author: Deepak Gautam, MBBS, MS(Orth); Chief Editor: Jeffrey A Goldstein, MD  more...
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Most patients with coccygodynia (coccydynia) give a history of a fall or an antecedent childbirth. In 1950, Schapiro described this disorder as "television disease" because most of the patients had followed poor postural adaptation while watching television, [19]  and this poor adaptation was thought to be an important predisposing factor for coccygodynia. Prolonged sitting while using a computer likewise can be a harbinger of coccygodynia.

Patients usually complain of pain that is aggravated by sitting on hard surfaces. Some patients may complain of experiencing pain during defecation and sexual intercourse or while riding a bicycle or a motorbike.

From the 1930s through the late 1960s, George Thiele published several articles relating to coccyx pain, [8]  as a consequence of which coccygodynia is still sometimes referred to as Thiele syndrome. Thiele's description of the clinical features continues to hold true today. The main symptoms include pain in the lower sacrum or coccyx or in the adjacent muscles or soft tissues. The patient usually points to the coccyx as the site of pain. [3]  The severity of pain depends on the amount of time spent sitting.


Physical Examination

On examination, there is tenderness over the localized region. [1] In fact, absence of local tenderness over the coccyx should lead the examiner to consider other diagnoses, such as lumbar disk disease or herniated disk. A rectal and pelvic examination also should be performed to check for any masses (tumors).