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Pain from the sacro-coccygeal joint can result from a fall or can be of insidious onset. Due to the pain when sitting, patients tend to sit on either buttock to try and offload the painful area. Sometimes a coccygeal cushion is tried as this has a cut out to offload the coccygeal area.
After assessment and examination occasionally an MRI scan would be advised in order to look more closely at the sacro-coccygeal area to assess whether there are one or two mobile joints as well as any inflammatory change around them. It also excludes any sinister pathology.
Treatment involves a coccygeal cushion, normal analgesics and physical therapy. If symptoms are not improving, then an injection into the sacro-coccygeal joint can be done and this can be done either using x-ray or under local or general anaesthetic.
Surgery, namely a coccygectomy is reserved for failure of conservative treatment.

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