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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Tailbone Disorders

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The tailbone is the small bone at the bottom of backbone, or spine. Tailbone disorders include tailbone injuries, pain, infections, cysts and tumors. Tailbone rarely breaks. Instead, most injuries cause bruises or pulled ligaments. A backward fall onto a hard surface, such as slipping on ice, is the most common cause of such injuries. Symptoms of various tailbone disorders include pain in the tailbone area, pain upon sitting, pain or numbness in the arms or legs due to pressure on nerves in the tailbone area, and a mass or growth you can see or feel.

 

The tailbone is the small bone at the bottom of backbone, or spine. Tailbone disorders include tailbone injuries, pain, infections, cysts and tumors. Tailbone rarely breaks. Instead, most injuries cause bruises or pulled ligaments. A backward fall onto a hard surface, such as slipping on ice, is the most common cause of such injuries. Symptoms of various tailbone disorders include pain in the tailbone area, pain upon sitting, pain or numbness in the arms or legs due to pressure on nerves in the tailbone area, and a mass or growth you can see or feel.

Causes

  • Chordoma
  • Coccydynia
  • Levator Syndrome
  • Pilonidal Cyst
  • Pilonidal Disease
  • Sacral Dimple

 

Among the above mentioned causes most common cause encountered in the clinical practice is Pilonidal Cyst/Sinus and Coccydynia.

Coccydynia is the inflammation of the bony area i.e. tailbone or coccyx which is located between the buttocks. Coccydynia is associated with pain and tenderness at the tip of the tailbone between the buttocks. The pain is often worsened by sitting.

Coccydynia is often caused by an injury, but may generally occur spontaneously. There are many causes of tailbone pain which can mimic Coccydynia, including sciatica, infection, Pilonidal cysts, and fractured bone.

Pilonidal cysts are pockets of skin in the crease of the buttocks near the end of the tailbone. This condition is caused due to pushed ingrown hairs into the folds of the skin, which results in irritation and inflammation of the skin.

There are several well-known facts about Pilonidal cysts. Men are affected two to three times more often than are women, and the cysts typically affect those younger than 40. This disease has preponderance to male sex.

Pilonidal cysts often cause discomfort when there is infection, which can result in a painful abscess. Treatment includes removing hair from the area and surgery to open and drain the cyst. A Pilonidal cyst may remain harmless. If it becomes infected, however, it will cause pain, inflammation and usually drainage of fluids. If the condition becomes chronic it will result into Pilonidal Sinus. A Pilonidal sinus may appear as a tract, a passage below the surface of the skin that connects the infected Pilonidal cyst to the opening on the skin's surface. More than one sinus tract may form to drain a single infected cyst.

Signs of Pilonidal Sinus

  • Slight lump that can be felt over the tailbone in the buttock crease
  • If the Pilonidal cyst becomes larger and inflamed there can be pain which may further worsen with continued sitting
  • Infection can result in a painful abscess
  • Pain, localized swelling, redness, fever and drainage of pus.
  • Hairs may come out of a Pilonidal sinus
  • Foul smell from draining pus

Risk Factors

  • Male sex
  • Obesity
  • Inactive lifestyle
  • Occupation requiring sitting
  • Excess body hair
  • Poor hygiene
  • Excess sweating
  • Stiff or coarse hair

Treatment

  • Antibiotic therapy
  • Hot compresses
  • Application of depilatory creams
  • Surgery - This usually consists of a small operation, in which, under anesthesia, the infected skin tracts are laid open and the wound is generally left wide open, with pack dressings to keep it so, the aim is to let the wound heal up from its base. If it heals by bridging across the surface there is a danger of the whole problem occurring again. The operation may therefore be followed by six or more weeks of dressings while the wound heals, but the final result is generally good.

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