Postpartum Coccydynia

Coccydynia can result from a varying number of causes, parturition being one of them. As per the research about 50% of cases with forcep delivery will have postpartum coccydynia which cause luxation (partial or complete subluxation of coccyx bone or coccygeal joint) or fracture of coccygeal bone, the coccyx is pushed backward when head of the baby is emerged out.

Pain is felt or triggered after sitting for some duration and during transitions from sitting to standing positions.

Postpartum coccydynia is a painful and incapacitating condition in the early postpartum period and can interfere with the mother-baby bonding process. As a new mother will need a great deal of help to find a comfortable feeding position-sitting can be impossible. Sitting usually transfers the upper body weight to the pelvis which gives a direct pressure on coccyx bone.

Pain is felt or triggered after sitting for some duration and during transitions from sitting to standing positions. This makes it more difficult to perform their daily chores which impacts on the physical and psychological wellbeing of the women.

Anatomical Importance of Coccyx

Coccyx is the lower distal part of spine which is triangular in shape, composed of 3 to 5 coccygeal segments which are fused to form a single bone. Due to its anatomical significance as an attachment site for many muscles and ligaments. 

These muscles and ligaments together helps in supporting the pelvic floor, anus and contribute for voluntary bowel movement control. The primary function of coccyx is to provide support while the person is in a sitting position.

Pregnancy and Coccydynia

Pregnancy is a phase of a woman’s life where she gives birth to a newborn by nurturing it for nine months. During this span of nine months a lady undergoes a series of physical and physiological changes in the body.

During pregnancy progesterone, oestrogen & relaxing are going to give major changes like it reduces the tone of uterine muscle and replace collagen in pelvic joints and cervix with remodeled form with greater extensibility and pliability. Generalized increase in joint laxity and so in joint range which is hormonally mediated.

During pregnancy, a woman must adapt her posture to compensate for her changing centre of gravity due to distending abdomen. As a result of distending abdomen there is an increase in lumbar and thoracic lordosis. Also, there is an increase in body weight which gives more pressure on the spine and increases torsional strain on joints which is the one of the causes of giving a pull to tailbone muscles and joints.

Postural alignment during pregnancy also plays a role for the cause of Coccydynia. The overall equilibrium of the spine and pelvis alters as the pregnancy progresses. The centre of gravity no longer falls over the feet, increase in anteroposterior and medial-lateral sway, and women may need to lean backwards to gain equilibrium resulting in disorganisation of spinal curves. These changes may be still similar for 8 weeks after delivery.

As due to continuous pressure on the tailbone from prolonged periods and postpartum sitting for feeding also gives a tremendous pressure on coccyx, which is weak due to sustained pressure.

Clinical Presentation of Postnatal Coccydynia

  1. Pain in and around the coccyx while a lady takes sitting positions especially during feeding or driving.
  2. Tenderness over the coccyx area.
  3. Sharp pain when there are transitions from sitting to standing.
  4. Pain is unbearable when leaning backward in sitting position.
  5. Pain while or after defecation, unable to defecate completely.
  6. Pain and burning sensation over tailbone or coccyx while micturating.
  7. Severe pain while turning or rolling on bed.
  8. Pain while sleeping straight which makes sleeping impossible.
  9. Difficulty to perform activities like bending, turning & climbing steps.
  10. Exaggerated Pain during menstrual cycle and intercourse.

Evidence related to Rate Of Manifestation of Postpartum Coccydynia.

As per the research 60 -70 % of postpartum ladies will suffer with coccydynia, some of them will recover in a few weeks and rest will continue until they seek advice from specialists.

Diagnostic and Imaging:

● Dynamic coccyx / tailbone X ray. Sometimes CT coccyx may be helpful
● MRI bases on history or as decided by doctor
● For assessing the pelvic floor a pelvic exam is required
● For finding out the muscle related problem a rectal exam needs to be done.
● Some routine x-ray and MRIs should be done on the tailbone and spinal cord.
● Blood tests for finding out other internal causes.

Treatment Options:

Best Tailbone Treatment in India At Tailbone Treatment Women Clinic which focuses on treating tailbone pain by complete assessment of pelvis and core, managing symptoms and other post pregnancy related problems, preventing further damage and Postural correction.

We are a clinic that is solely dedicated for the wellness and health of all women. Our focus is on common women who face health issues related to their tailbone and pelvic region. We specialize in Tailbone Pain Non-surgical treatment called Coccygeal Internal Manipulation with Coccygeal Muscle Rehabilitation. We also deal with Pelvic Girdle Dysfunction, Diastasis Recti Dysfunction, Symphysis Pubis Dysfunction, Incontinence.

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Some common treatments are:

Tailbone pain is becoming common nowadays and the symptoms vary from patient to patient.Read more about these symptoms from the Best Tailbone Treatment in India.

  • The help of a physical therapist is very useful for tailbone pain. Physical therapists may support strengthening the surrounding muscles, supporting the pelvic floor. Also, they can help in finding out the proper way for sitting and movement so that it will less irritate the tailbone.
  • Prescribed medicines can help in healing the pain.
  • If pelvic floor prolapse or a herniated disc occurs when the last option is going through a surgery. It can also require the removal of some portion of the coccyx.
  • Injecting several anesthetics with or without steroids can often heal the pain, this may help in removing surrounding muscle tension and the underlying reasons of the tailbone pain.
  • Psychotherapy can help the patient to be psychologically strong. It will help them with pain tolerance and they should be able to tackle every barrier to healthy pain management for a better healthy lifestyle.
  • By giving less strain on the supporting ligaments or by going through several surgeries one can correct the hemorrhoids, which is one of the reasons for coccyx pain.

Required basic information for TailBone Diagnosis:

  • Previous pregnancies and childbirth experiences.
  • Gastrointestinal problems history.
  • Any other muscle problem.
  • Job profile.

These are the main things for Best Tailbone Treatment in India to know before starting the diagnosis.

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    Dr. Syeda Mubashira