title: Coccydynia: an overview of the anatomy, etiology, and treatment of coccyx pain.
abstract: BACKGROUND
  Despite its small size, the coccyx has several important functions. Along with being the insertion site for multiple muscles, ligaments, and tendons, it also serves as one leg of the tripod-along with the ischial tuberosities-that provides weight-bearing support to a person in the seated position. The incidence of coccydynia (pain in the region of the coccyx) has not been reported, but factors associated with increased risk of developing coccydynia include obesity and female gender.
  
  
  METHODS
  This article provides an overview of the anatomy, physiology, and treatment of coccydynia.
  
  
  RESULTS
  Conservative treatment is successful in 90% of cases, and many cases resolve without medical treatment. Treatments for refractory cases include pelvic floor rehabilitation, manual manipulation and massage, transcutaneous electrical nerve stimulation, psychotherapy, steroid injections, nerve block, spinal cord stimulation, and surgical procedures.
  
  
  CONCLUSIONS
  A multidisciplinary approach employing physical therapy, ergonomic adaptations, medications, injections, and, possibly, psychotherapy leads to the greatest chance of success in patients with refractory coccyx pain. Although new surgical techniques are emerging, more research is needed before their efficacy can be established.
authors.affiliation: Department of Pain Management, Ochsner Clinic Foundation, New Orleans, LA.
authors.forename: Lesley Smallwood
authors.initials: LS
authors.lastname: Lirette
authors.affiliation: Department of Pain Management, Ochsner Clinic Foundation, New Orleans, LA.
authors.forename: Gassan
authors.initials: G
authors.lastname: Chaiban
authors.affiliation: Department of Pain Management, Ochsner Clinic Foundation, New Orleans, LA.
authors.forename: Reda
authors.initials: R
authors.lastname: Tolba
authors.affiliation: Department of Pain Management, Ochsner Clinic Foundation, New Orleans, LA.
authors.forename: Hazem
authors.initials: H
authors.lastname: Eissa
keywords: Coccyx; pain–intractable; sacrococcygeal region