The Coccyx: More Than Just a Primordial Tail

You may never think about your coccyx until you land hard on your bottom, then it will make sure you never forget it! Talk to anyone that has experienced pain in their tailbone, a diagnosis known as coccydynia, and they will recount tales of extraordinary pain and having to sit on a donut for what seems like forever. Dysfunction of the tailbone isn’t only caused by high impact trauma. Any parent will tell you when their babies are learning to walk, they fall on their bottom constantly. These little mini impacts will have an effect on the alignment of the coccyx.  All of these traumas have a great consequence on the collection of bones at the end of the tailbone that used to be seen as a useless primordial tail we no longer need. It is an important component of your pelvic girdle and nervous system.

Numerous muscles and ligaments of the pelvic floor and girdle attach directly onto the coccyx. This has an impact on the functions of theses soft tissues. A person with a coccyx dysfunction can experience problems with bowel and bladder function, pain with intercourse and low back pain to name a few. Muscles have an optimal length they need to be at to create an efficient contraction. When the coccyx is moved by trauma, then the functions of these muscles can become inhibited. The pelvic floor muscles act as a sling for your organs. If the sling is too tight or too loose, then it can cause pain and/or visceral dysfunction. These symptoms won’t necessarily appear immediately following the tailbone trauma. It can sometimes take months or even years for them to emerge. Often, when it takes a long time for the symptoms to develop, the coccyx is not considered to be a culprit for the symptoms. As Functional Manual Therapists, we are always assessing the coccyx for dysfunction when treating the lower half of the body.

The nervous system is highly impacted from dysfunction of the coccyx. Your dura, the continuous lining of the central and peripheral nervous system, attaches to the end of your tailbone. Dysfunction or trauma to this area can have significant ramifications to the mobility of your nervous system. In the hierarchy of the organ systems of the body, the nervous system reigns supreme. Think about it, without your nerves, nothing in your body would work. You couldn’t get your muscles to contract, your heart to beat and you wouldn’t have any higher-level thinking. So, it makes sense that your body would do anything and everything to keep your nervous system safe. When you sustain an injury to your coccyx there is now inflammation in and around your dura which is the safety wrapping of your nervous system. The body will send pain signals to your brain if the coccyx is affected because it’s trying to protect itself from further harm.

Eventually the inflammation naturally subsides and the pain starts to go away but the tension on the dura remains unless the coccyx alignment is fixed. We’ve seen numerous cases where limited range of motion of the neck and shoulders significantly improved with the mobilization and correction of the coccyx alignment. The nerves do not like being tugged on and when the dura is being tensioned in one direction because of the coccyx dysfunction, then the body will only move within a range where the nerves are not being stretched. Though we don’t mobilize the coccyx for all patients with upper extremity involved diagnoses, we will assess it if there seems to be an inhibition of motion due to tension through the nervous system, also known as neural tension.

Sadly, it used to be common practice to surgically remove the coccyx if someone had coccydynia but luckily research has revealed the importance of the tailbone. As trained manual therapists, we will be evaluating and treating the coccyx for dysfunctions to aid in your recovery and improve overall function and efficiency.

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