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 very small bones fused together.

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

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

It is a localized pain that is usually exacerbated when sitting or doing any activity that may put pressure on 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 originally thought that the coccyx is always fused (without movement between the coccygeal vertebrae), it is now known that the entire coccyx is not a solid bone, but 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 a number of factors.

Sometimes, diseases that affect other joints in the body, such as arthritis, can be the cause of 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 other 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 that gets worse 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 with coccyx injuries such as fractures, masses, tumors or any other injury.

One finding is usually local sensitivity in the coccyx palpation examination. If this sensitivity to palpation does not manifest itself, then 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.
  • Applying heat or hot compresses to the area after ice therapies.
  • Perform stretching therapies: Exercises are performed to stretch the muscles and tendons that are present in the joints. A good exercise routine should be established, for as long as the physiotherapist indicates.
  • Physiotherapy: Physical therapy is an important aspect of the treatment of almost all orthopedic conditions. Physiotherapists use different modalities to increase strength, regain mobility and help patients return to their pre-injury level of activity.
  • Administration of nonsteroidal antiinflammatory drugs: The naproxen and ibuprofen, selective cyclooxygenase – 2 inhibitors reduce inflammation around the coccyx, which usually causes pain.
  • Avoid sitting for prolonged periods or putting pressure on the area, as much as possible.
  • The use of orthopedic cushions or a personalized pillow to avoid the pressure that is exerted when sitting in the coccyx. Some patients use a donut-shaped pillow, but can put pressure on the coccyx.
  • If the coccyx pain is caused or increased with the pressure of the intestines due to constipation , then stool softeners and increased fiber and water intake are recommended to achieve soft and periodic bowel movements.