Coccygodynia can be divided into different categories:

1. **Traumatic Coccygodynia:** Pain caused by bruises, fractures, or dislocations of the coccyx after an accident.

2. **Functional Coccygodynia:** Pain due to poor posture, muscular imbalances, or misalignments of the pelvis.

3. **Inflammatory Coccygodynia:** Pain due to inflammatory diseases such as periostitis in the area of the coccyx.

4. **Psychosomatic Coccygodynia:** Pain without detectable organic cause, which is exacerbated by stress or emotional strain.

The main causes of coccydynia can be divided into several categories:

- Traumatic causes:

- Falls on the buttocks leading to bruises, fractures, or dislocations of the coccyx.

- Mechanical stress:

- Prolonged sitting on hard or unsuitable surfaces, which can lead to microtraumas and chronic pain.

- Birth complications:

- Mechanical overload of the coccyx during childbirth can cause pain.

- Inflammatory diseases:

- Periostitis (inflammation of the periosteum) or abscesses in the coccyx area.

- Tumors:

- In rare cases, benign or malignant tumors in the coccyx area can cause pain.

- Psychosomatic factors:

- In some cases, no organic cause is found, and the pain is exacerbated by psychological stress.

The symptoms of coccygodynia vary depending on the cause and severity, but typically include:

- **Pain when sitting:** Discomfort that worsens with prolonged sitting on hard surfaces and may increase when standing up.

- **Discomfort during bowel movements:** Pain that occurs during or after bowel movements.

- **Pain during physical activity:** Discomfort when bending or lifting heavy objects.

- **Sensitivity in the coccyx area:** Tenderness or local sensitivity when touched.

- **Radiating pain:** In some cases, the pain radiates to the lower back or pelvis.

The diagnosis is made through a combination of medical history, physical examination, and imaging techniques:

- Medical history: The doctor inquires about the patient's medical history, possible injuries, and existing symptoms.

- Physical examination: Examination of the coccyx area for tenderness, swelling, or misalignments.

- Imaging techniques:

- X-ray: Visualization of fractures, dislocations, or degenerative changes.

- MRI: Identification of inflammations, tumors, or other soft tissue structures.

- Ultrasound: Examination of abscesses or fluid accumulations in the coccyx area.

Conservative Therapy In most cases, coccygodynia can be treated without surgery:

• Pain relief:
  • Taking anti-inflammatory medications such as ibuprofen or diclofenac.
  • Local application of heat or cold therapy to relax the muscles.
• Seating aids:
  • Use of special seat cushions to reduce pressure on the coccyx.
• Physiotherapy:
  • Exercises to improve posture and strengthen the core muscles.
  • Manual therapy to mobilize the coccyx.
• Injections:
  • Local infiltration of cortisone or anesthetics for pain relief.

Surgical Therapy Surgery is only considered in rare cases and with persistent symptoms:

• Coccygectomy: Removal of the coccyx in severe chronic pain that does not respond to conservative measures.

To prevent coccygodynia, the following measures are recommended:

1. Avoiding falls: Caution during activities that carry an increased risk of injury.
2. Ergonomic sitting positions: Use of suitable seating and cushions to minimize pressure on the coccyx.
3. Regular exercise: Promoting core stability through targeted exercises and avoiding long periods of sitting.
4. Early treatment of injuries: Immediate therapy after a fall or overstrain of the coccyx.
5. Stress management: Psychological support to reduce psychosomatic complaints.