Question

I have a problem when I sit on hard surfaces. My tailbone hurts when I sit. I'm not skinny or fat. I'm in relatively good shape. What's my problem?

Answer

If you have pain while sitting the most common cause is something known as coccydynia, pain in the coccyx, or tailbone. The coccyx is made up of three to five vertebrae and is triangular in shape.

Coccydynia may be due to a number of causes, such as from a fall or problems at childbirth. It is more often seen in women than in men, and researchers theorize that it's due to the shape of the female pelvis causing the coccyx to protrude more. It can be also be hereditary in origin.

The coccyx can cause pain while sitting, because it causes the joint to be out of position, and prolonged pressure can cause pain and inflammation. Symptoms of coccydynia vary. Descriptions include 'like sitting on marble', 'shooting pains down the leg', 'like sitting on a knife', or 'like being impaled on a garden cane'. Some sufferers have pain while having intercourse or having bowel movements.

Coccydynia is often diagnosed based on clinical evaluation of the patient. X-rays and MRIs are used to determine other causes of pain in the spine, such as muscle strains. Pain from that area can also be due to cancer, which, although rare, makes it important to see a physician to rule this out.

Treatment of coccydynia usually involves injections of an antiinflammatory medication to the area. Sometimes in severe cases, surgical fusion of the vertebrae may be needed.