The problem of the coccyx: the "coccydynia"


original article by dr. Roberto Amich




Posizione del coccige
Coccyx position



The coccyx is the set of the last vertebrae, it consists of 4 or 5 rudimentary vertebrae that are, perhaps, the remains of our coda.Anatomicamente coccyx describes a forward bend, a bow that can flex in a sitting position and is an articulation which falls within the synovial joints, with about thirty degrees of mobility.

The pain in the coccyx area is called "coccydynia", mainly attributed to a result of trauma, 60-70% of them because of a fall on the buttocks, worsened by continuous "compressions" on rigid seats or traumatic stress.

The pain is approximately 5 times more common in women than in men, because in the pelvis of the woman is the coccyx more exposed. 



Connessione pubococcigea
Connection pubo-coccygeal



Traumatic dislocation of the coccyx, may be a cause of imbalances in the autonomic pelvic area have important relationships with the surrounding visceral organs (rectum, prostate, bladder, Douglas Fund in women), can alter the physiological balance of the dural canal it can spread to other structures of the dura mater and even affect the intracranial membranes, as well as inhibiting the urinary bladder, resulting in functional incontinence or oddirittura, in men, generate premature ejaculation. This is because, the muscle that controls the urethra called pubococcygeus is a pelvic muscle that extends from the coccyx at the base of the penis, forming an arc.
This nervous connection entails the connection of the pelvic nerve to the bladder and prostate and is responsible for the interruption of urine flow during micturition, and the "pumping" of the seminal fluid that, in the case of alteration, could lead to an inadvertent premature ejaculation.
Furthermore, the alteration of the coccyx, may generate a "false" short leg, due to "draw" the muscles connected to it.



Pressione del coccige da seduto

coccyx pressure by sitting


Coccydynia can be a symptom (pain and burning) that can vary among people, describing a set of symptoms (pain induced or aggravated by sitting), made up of a number of conditions that may have different eziopatologie, resulting in the patient also pain bowel and sexual relationships. Even when the patient is in a sitting position, the coccyx tends to curve higher than the normal and the joint can sublussare, slipping back. The coccyx slip drag and tears apart the surrounding tissues, causing pain and inflammation.
Sometimes the coccyx pain may depend on imbalances of the spine, as a lumbosacral disease by repeated efforts (in sports), or by surgery and can be (in rarer cases), the consequence of anorectal infection or a tumor . Among the factors that predispose to coccydynia, in addition to the traumatic event, there are whole perineal muscle dysfunction of the small pelvis and relatively frequent muscle disorders, such as the great Syndrome gluteal and piriformis syndrome.

Manipolazione anale per lo sblocco coccigeo

anal manipulation to release the coccyx


Treating coccydynia is critical rectal manual examination of the muscles and the fascial system that make up the pelvic floor, to locate a muscle group or tense myofascial trigger points. The treatment of these points, includes a myofascial relaxation and muscular inhibition, through a manual treatment.
Dislocation of the coccyx, as well as creating a symptomatology in the lumbosacral area and the small pelvis, it may adversely affect the functioning of the craniosacral system and can be the cause of a number of symptoms and dysfunction of the autonomic nervous system.
The manual and osteopathic treatment of coccydynia must consider the algic symptom in a global scope and can predict, from case to case, an osteopathic technique direct anorectal, which often produces excellent results, due to the mechanism of action related to the interruption of a painful arc reflected at the local level. The maneuver, if necessary, can be repeated two or three times at a distance of a few days.
The effectiveness of the direct manipulation of the coccyx is due to a relaxation of the contraction of the elevator muscles, which are considered an important element of coccydynia. Also this manipulation acts secondarily on the articulation sacroiliac joint that plays a fundamental role in this disease.