Coccygodynia is a painful condition of the tailbone which occurs more commonly in females. The association of coccyx pain with pelvic floor symptoms and the prevalence of coccyx pain in women with pelvic pain has not previously been reported.
To identify the prevalence of coccygodynia in women with pelvic pain and to describe the association of coccygodynia with pelvic floor examination findings and symptoms.
Retrospective cohort analysis SETTING: Tertiary medical institution PARTICIPANTS: 127 women presenting for outpatient pelvic floor physical therapy treatment who underwent vaginal and rectal pelvic floor examination.
Prevalence of coccygodynia, pain scores, association of coccygodynia with other co-morbidities and diagnoses, and association of coccygodynia with physical examination findings.
Sixty three (49.6%) of 127 women with pelvic pain presented with coccygodynia and 64 (50.4%) did not. Women with coccygodynia had significantly higher rates of muscle spasm (50.8% vs 31.2%, p=0.025) higher visual analog scale (VAS) pain scores (median 5 vs 3, p=0.014), higher rates of outlet dysfunction constipation (31.7% vs 10.0%, p=0.032), and higher rates of fibromyalgia (15.9% vs 3.1%, p=0.014). On pelvic exam, women with coccygodynia were significantly more likely to have sacrococcygeal joint hypomobility (65.1% vs 14.1 %, p<0.001), coccygeus muscle spasm (77.8% vs 17.2%, p<0.001), anococcygeal ligament pain (63.5% vs 9.4%, p<0.001), external anal sphincter pain/spasm (33.3% vs 13.1%, p<0.001), and impaired pelvic floor muscle (PFM) coordination (77.8% vs 57.8%, p=0.016).
Almost 50% of women seeking pelvic floor physical therapy for pelvic pain had co-existing coccygodynia. These women had higher pain scores, increased pelvic floor dysfunction, and significantly greater abnormal physical exam findings. This study demonstrates a strong link between coccygodynia, pelvic floor symptoms, and pelvic pain, and highlights the importance of screening for and identifying coccyx pain when evaluating women with pelvic pain. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.