Case history
Case history
A 35-year-old woman presents with chronic disabling coccygeal pain for 3 years. The pain intensified 3 months after a snowboarding accident and is worse when sitting down, and standing from sitting. The pain is described as pulling and lancinating, and occasionally radiates to the hip and lumbosacral spine. Physical examination reveals tenderness at the tip of the coccyx, which is hypermobile and painful on rectal examination.
Other presentations
Patients with less common causes of coccygodynia (e.g., rectal tumours) do not typically present with a history of trauma, and onset is insidious and unrelated to sitting. Patients with referred pathology (e.g., disc herniation) would not have coccygeal tenderness on examination and/or would not have relief from diagnostic coccygeal injection.
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