Pelvic rehabilitation providers commonly treat a variety of conditions associated with peripartum pelvic girdle dysfunction. This list of conditions includes coccyx pain, and a recent study aimed to identify risk factors which may lead to coccyx pain in the postpartum period. Dr. Jean-Yves Maigne, who is well known for providing foundational research on the topic of coccyx pain, and colleagues completed a case series of 57 postpartum women presenting to a specialty coccydynia clinic. Dynamic x-rays were taken to assess mobility of the coccyx, and data about delivery methods were collected. (A control group of 192 women were comprised of women who also presented to the clinic but who had coccyx pain from other causes.)
The authors found that the women reported immediate postpartum pain in the coccyx with sitting. Instrumentation was a common finding in regards to the patients’ deliveries. 50.8% of the deliveries utilized forceps while 7% were vacuum-assisted. An additional 12.3% of the deliveries were spontaneous and were described as “difficult.” A subluxation of the coccyx was observed in 44% of the women who developed coccyx pain after childbirth as compared to 17% of the controls. A fractured coccyx occurred in 5.3 % of the women. Body mass index (BMI) of more than 27 and having 2 or more vaginal deliveries was also associated with a higher prevalence of a subluxation of the coccyx.
Being unable to sit comfortably following childbirth could make a new parent’s life very difficult with limitations in activities such as sitting to feed the baby. Socially, being unable to sit comfortably can also limit many activities. The women in this study reported immediate tailbone pain with sitting, which can alert providers to a condition requiring both immediate and follow-up attention. Risk factors such as having a difficult delivery or use of forceps may also signal a patient history that may lead to coccyx pain.
If you are interested in learning more about managing coccyx pain, join Lila Abbate at Coccyx Pain Evaluation and Treatment in Bay Shore, NY on October 25-26! You may also be interested to learn more about treating patients during the postpartum period, in which case Care of the Postpartum Patient is right up your alley!