Coxalgia: Causes, Symptoms, Diagnosis and Treatment

The coccyx is the lower part of the spine.

It represents a vestigial tail (hence the common term “coccyx”) and consists of three or more tiny bones fused.

The coccyx is formed by between three and five separate or fused vertebrae.

Coxalgia is a coccyx pain, a little-known condition that can cause persistent pain in the lower part of the spine, also called coccyx.

It is a localized pain usually exacerbated when sitting or doing any activity that may pressure the coccyx.

Causes of coxalgia

This condition is more common in women than in men.

Generally, it is caused by a trauma such as a fall, which causes an injury to the vestigial disc and ligaments, due to childbirth, due to excessive pressure in the area.


Rarely the presence of an infection or a tumor can also cause coxalgia.

While it was initially thought that the coccyx is permanently fused (without movement between the coccygeal vertebrae), it is now known that the entire coccyx is not a solid bone. Still, there is often limited movement between the bones allowed by the fibrous joints and ligaments.

The coccyx bones rarely can fracture and cause pain.

Pain in the hip can be the result of several factors.

Sometimes, diseases that affect other joints in the body, such as arthritis, can cause hip pain.

Trauma, including bone fracture, is also a cause of pain in the hip.

Pain in the hip area can also be caused by painful infections or skin conditions, such as shingles.

Hip pain can also occur due to a problem with the back or spine.


Symptoms may include:

  • Pain that gets worse when you’re sitting.
  • Local pain in the coccyx area that gets worse when touched or when pressure is applied to it.
  • Pain worsens when you move from a sitting position to a standing position.
  • Pain that gets worse with constipation and feels better after a bowel movement.

Diagnosis of coxalgia

Coxalgia is diagnosed with diagnostic tests, such as X-rays, MRIs, and CT scans.

These tests can present images of coccyx injuries such as fractures, masses, tumors, or other damages.

One finding is usually local sensitivity in the coccyx palpation examination. If this sensitivity to palpation does not manifest, the pain is derived from another structure.


Treatments for coxalgia are usually not invasive. The first line of treatment generally includes:

  • Apply ice or a cold pack to the area several times a day for the first few days of pain.
  • I am applying heat or hot compresses to the area after ice therapies.
  • Perform stretching therapies: Exercises are performed to stretch the muscles and tendons present in the joints. A good exercise routine should be established for as long as the physiotherapist indicates.
  • Physiotherapy: Physical therapy is essential for treating almost all orthopedic conditions. Physiotherapists use different modalities to increase strength, regain mobility and help patients return to their pre-injury activity level.
  • Administration of nonsteroidal anti-inflammatory drugs: The naproxen and ibuprofen, selective cyclooxygenase – 2 inhibitors reduce inflammation around the coccyx, which usually causes pain.
  • Avoid sitting for prolonged periods of putting pressure on the area as much as possible.
  • The use of orthopedic cushions or a personalized pillow to avoid the pressure exerted when sitting in the coccyx. Some patients use a donut-shaped pad that can put pressure on the coccyx.
  • Suppose the coccyx pain is caused or increased with the force of the intestines due to constipation. In that case, stool softeners and increased fiber and water intake are recommended to achieve soft and periodic bowel movements.