This page offers the answers to some of the most common questions related to pain occurring within the tailbone area, as well as the procedures used to diagnose and treat it effectively. Click on the questions to reveal the answers. Additional questions and answers about spine-related pain and our procedures are featured in the Ask the Doctors section.

1. What makes up my tailbone?

   The tailbone is the last bone of the vertebral column. It is a tiny triangular bone which is usually made up of three to five vertebrae that are fused together. There is a joint that connects the tailbone to the rest of the sacrum.

2. What are the usual causes for coccydynia or tailbone pain?

   Coccydynia usually occurs due to local posttraumatic pain of the coccyx or it is “referred” from a different part of the body.

3. What are the most common areas of the body that refers pain to the coccyx?

   The most common areas of the body that refers pain to the coccyx is the lower lumbar spine. The pain is due to a herniated disc or narrowing of the spinal canal. These two conditions create an inflammation of the sacral nerves that innervate the coccyx.

4. How do you determine the cause of my tailbone pain?

   After a history and physical exam which helps determine the possible source of the pain, we will obtain an x-ray or MRI of the tailbone area. This is to make sure that there is no obvious lesion of the tailbone. We will use a continuous x-ray machine and place a small amount of local anesthetic and anti-inflammatory medication on the nerves that are under the coccyx. This group of nerves is called the “ganglion of impar.” If the pain goes away, then we know that the pain was coming from the coccyx. If the pain does not go away we know that the pain is being “referred” from another source.

5. What is the next step to determine the cause of my tailbone pain if the “ganglion of impar” block is negative?

   We will obtain an MRI of the lumbar spine and determine if there is either a disc herniation or a narrowing of the spinal canal that may be inflaming the nerves that pass by these areas on the way down to the coccyx. We can do a diagnostic block to determine the problem as well as treat it at the same time.