coccydynia, coccalgia, coccygeal neuralgia or tailbone pain. The majority of cases were found to be aggravated by pregnancy and childbirth (postpartum).

1. coccydynia

2. ococcydynia, coccalgia, coccygeal neuralgia or
tailbone pain.
oThe coccyx serves as an attachment site for
several muscles and ligaments:
o Anteriorly, the coccyx is bordered by the levator
ani muscle and the sacro-coccygeal ligament.
othe lateral border of the coccyx serves as an
insertion point for the coccygeal muscles, the
sacrospinous ligament, the sacrotuberous
ligament and the gluteus maximus.
oInferiorly, the tendon of the iliococcygeus muscle
inserts onto the tip of the coccyx.
oTogether, these ligaments and muscles contribute

3. CAUSES:
Falls.
Repetitive strain injuries (RSI). Sports like
bicycling and rowing require you to lean
back and forth. Too much of that repeated
motion can strain the tissues around your
tailbone.
Pregnancy or childbirth.
Carrying extra weight.

4. WHY SPECIFICALLY IN POSTPARTUM
PATIENTS?
1. Trauma during childbirth: especially in cases of prolonged or
difficult deliveries.
2. Hormonal changes: Postpartum hormonal changes can affect
ligaments and muscles in the pelvic region, potentially leading to
increased sensitivity or discomfort around the coccyx.
3. Posture changes: Changes in posture and the strain on the
lower back and pelvic area during pregnancy can persist
postpartum, contributing to coccyx pain.
4. Tissue inflammation: Inflammation around the coccyx or in the
surrounding tissue can occur due to trauma or hormonal
changes, leading to pain.
5. Tension on pelvic floor muscles: Pregnancy and childbirth can
cause changes in the pelvic floor muscles, which may contribute
to coccyx pain.

5. During pregnancy, the coccyx will be relaxed and
loosened to facilitate childbirth; this condition
may sometimes result in coccygeal pain or
coccygeal injury. During vaginal delivery the
sacrococcygeal ligaments may be damaged, and
the acute trauma of the coccyx may appear during
the passage of the fetus through birth canal. An
intrapartum coccygeal fracture or dislocation also
supposed to be the cause for postpartum
coccydynia.

6. SYMPTOMS :
Dull (achy) or sharp (piercing) tailbone pain.
Tailbone pain that worsens when you go from sitting to
standing.
Pain when you poop.
Pain during sex.
Other related symptoms that may occur in people with tailbone
pain include:
•Back pain.
•Sciatica.
•Sleep disorders.
•Depression.
•Anxiety.

7. PT TREATMENT:
Ice to your Coccyx
Glute Stretches
Bridge
Lumbar Rotation with Contr
Spikey Ball on your Piriformis

8. MACHINES(PT):
 extracorporeal shockwave therapy (ESWT)
 Lin SF, Chen YJ, Tu HP, Lee CL, Hsieh CL, Wu WL, Chen CH. The
effects of extracorporeal shock wave therapy in patients with
coccydynia: a randomized controlled trial. PloS one. 2015 Nov
10;10(11):e0142475
Marwan Y, Husain W, Alhajii W, Mogawer M. Extracorporeal shock
wave therapy relieved pain in patients with coccydynia: a report of
two cases. The Spine Journal. 2014 Jan 1;14(1)
Effects of extracorporeal shock wave therapy on pain in patients
with chronic refractory coccydynia: A quasi-experimental study.
Anesthesiology and pain medicine. 2016 Aug;6(4).