Sacroiliac Joint and Tailbone Pain

The sacroiliac joints sit between the wing of the pelvis and the spine. It makes up the rear part of the pelvic girdle. The exact placement varies from person to person, but injuries are common due to the unique role it plays in movement and body support.

Pregnancy is a common source of sacroiliac pain, as the ligaments of the pelvis are relaxed in preparation for childbirth. The same hormones are secreted prior to menstruation, and the pain in this joint can be lumped into general cramps. Other sources of injury are sports, or any movement that interferes with the torsional movement of the joint and lower extremities. Arthritis, especially in women who have had multiple pregnancies, is a common cause of pain later in life. However, referred pain to the joint from another part of the spine is the most common culprit.

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Typically the pain will be a dull ache, except when performing movements that use the joint (ie, walking, climbing stairs, rising from a seated position). The pain is often lateral (on one side or the other) but may be bilateral. Referred pain may continue down the leg, and is often mistaken for sciatica.

Sacroiliac joint and tailbone pain relief is obtained through over-the-counter medications, local anesthetics, or steroids. Specific exercises may be prescribed as well. A special support belt may be indicated to provide support to the area while inflammation subsides.

Pain in the tailbone, or coccydynia , is usually brought on by prolonged sitting. Other conditions that can lead to coccyx pain include pregnancy, childbirth, or trauma, such as fall or blow to the end of the spine. Any activity that jostles a person, such as horseback riding, roller coasters, or bicycling are also indicated as sources of coccyx pain.. Tailbone pain may also be referred pain, caused by injury to the lumbar spine, pelvic floor muscles, or the buttock muscles.

What is referred to as the tailbone is actually made up of three to five small vertebrae, surrounded by muscles and ligaments. It joins the sacral bone. The difference between pain in the tailbone and pain in the surrounding muscles is commonly determined with a simple test. Local anesthetic is injected into the area - if the pain is immediately relieved, then it is not a referred type of pain, and treatment progresses from there. X-rays can help determine the presence of fracture, as can MRI scans.

Passive treatment of coccyx pain includes alleviating pressure on the area while sitting. A cushion with a hole cut in the back is helpful for use while sitting. Using an over-the-counter anti-inflammatory or pain reliever is useful. If the source of the pain is from the lumbar paraspinal muscles, spinal manipulation and massage can help relieve pain. If the pain is persistent, a local nerve block or steroidal injections may be used. Very rarely, removal of the tailbone may be indicated, but this is usually reserved for patients with malignant cancer. Coccyx pan can be stubborn and is notoriously difficult to treat, so multiple approaches are often used.