Differential Diagnosis for Tailbone Pain
Single most likely diagnosis
- Coccydynia: This condition is characterized by pain in the tailbone (coccyx) area, often exacerbated by sitting and relieved by leaning forward or standing. The patient's symptoms align closely with this diagnosis, making it the most likely explanation.
Other Likely diagnoses
- Pilonidal cyst or abscess: These conditions can cause pain in the tailbone area, especially when sitting. Leaning forward may help alleviate the pressure on the cyst or abscess, providing temporary relief.
- Levator ani syndrome: This condition involves pain in the pelvic floor muscles, which can radiate to the tailbone area. Sitting can exacerbate the pain, while leaning forward may help reduce the discomfort.
- Anal fissure: A tear in the lining of the anus can cause sharp pain, especially when sitting. Leaning forward may help reduce the pressure on the fissure, providing some relief.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Cauda equina syndrome: This is a rare but serious condition where the nerves in the spinal canal are compressed, causing pain, numbness, and weakness in the lower back and legs. Although unlikely, it is crucial to consider this diagnosis due to its potential for severe and permanent damage if left untreated.
- Rectal cancer: Although rare in a 38-year-old female, rectal cancer can cause pain in the tailbone area, especially if the tumor is large enough to exert pressure on the surrounding structures.
Rare diagnoses
- Tarlov cyst: A rare condition where a cyst forms on the nerve roots in the spine, causing pain and discomfort in the tailbone area.
- Sacrooccygeal teratoma: A rare tumor that develops at the base of the tailbone, which can cause pain and discomfort in the area.
- Infectious sacroiliitis: A rare condition where the sacroiliac joint becomes infected, causing pain and inflammation in the area, including the tailbone.