See Sacrum Sacral Region. The coccyx connects with the sacrum through the sacrococcygeal joint, and there is normally limited movement between the coccyx and the sacrum. The coccyx usually moves slightly forward or backward as the pelvis, hips, and legs move.
When a person sits or stands, the bones that make up the pelvis including the coccyx rotate outward and inward slightly to better support and balance the body. See Sacroiliac Joint Anatomy. Although the tailbone is considered vestigial or no longer necessary in the human body, it does have some function in the pelvis.
For instance, the coccyx is one part of a three-part support for a person in the seated position. Weight is distributed between the bottom portions of the two hip bones or ischium and the tailbone, providing balance and stability when a person is seated. The tailbone is the connecting point for many pelvic floor muscles. These muscles help support the anus and aid in defecation, support the vagina in females, and assist in walking, running, and moving the legs. Because of the number of pelvic floor muscles attached to the coccyx, certain bodily functions, including sex or defecation, can lead to pelvic pain after trauma to the coccyx.
Idiopathic pain of the coccyx is pain caused for no discernible reason. It is more common in females than in males. This is a diagnosis of exclusion, meaning that it can only be diagnosed after all other possible causes have been ruled out. Not every coccyx gets completely fused. In some people, the coccyx remains mobile and can continue to move as the person sits and moves. There is some evidence that a rigid coccyx is more likely to cause a certain type of pain due to the fact that it is constantly irritating surrounding soft tissues as the person changes positions.
Sacrococcygeal teratomas are the most common type of neonatal tumor and develop on the sacrum or coccyx. Teratomas generally appear when the patient is very young.
Treatment options depend on which condition is causing pain in the coccyx. In the case of trauma, the most common treatment is a conservative mix of therapies.
It is probably a good idea to give conservative treatment a long leash. If a conservative approach is not working, your healthcare provider might suggest surgical removal of the coccyx, known as coccygectomy. There is not a standard timeline for how long you should wait to consider surgery.
Some healthcare providers will consider it in as little as two months if nothing seems to be working. Other healthcare providers might want to continue to try other options for as long as a year.
Even though it is more aggressive than nonsurgical treatment options, complete or partial coccygectomy is considered to be very safe and relatively effective. Patients that have the procedure have good outcomes.
The most common predictor of a poor outcome or failure to relieve pain in all coccydynia patients is whether or not the surgical removal was complete or partial. Evidence suggests that complete coccygectomies lead to better outcomes than partial removal of the coccyx. Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Tague RG. Fusion of coccyx to sacrum in humans: prevalence, correlates, and effect on pelvic size, with obstetrical and evolutionary implications.
Am J Phys Anthropol. CT morphology and morphometry of the normal adult coccyx. Eur Spine J. Coccygectomy as a surgical option in the treatment of chronic traumatic coccygodynia: a single-center experience and literature review.
Asian Spine J. Coccydynia: an overview of the anatomy, etiology, and treatment of coccyx pain. Ochsner J. Children's Hospital of Philadelphia. Sacrococcygeal teratoma. Updated March An evaluation of two different methods of coccygectomy in patients with traumatic coccydynia.
J Pain Res. Influence of adequate pelvic floor muscle contraction on the movement of the coccyx during pelvic floor muscle training. J Phys Ther Sci. The filum terminale, an extension of the meninges at the inferior end of the spinal cord, is attached to the coccyx and uses the coccyx as an anchor for the spinal cord.
Finally, the coccyx extends posteriorly during childbirth to provide more space for the fetal head to pass through the birth canal.
This flexion explains the sexual dimorphism seen between the male coccyx, which points anteriorly, and the female coccyx, which points more inferiorly to provide extra space for the fetus. By: Tim Taylor. Last Updated: Oct 24, All Rights Reserved. Innerbody Research does not provide medical advice, diagnosis, or treatment.
You must consult your own medical professional.
0コメント