From the Research
Coccydynia after weight loss should be managed with conservative treatments, prioritizing pelvic floor physical therapy, as it has been shown to be a safe and effective method in reducing pain levels, with a mean percent global improvement of 71.9% 1. To manage coccydynia, start with conservative treatments including:
- NSAIDs like ibuprofen (400-600mg three times daily with food) or naproxen (500mg twice daily) for pain relief
- Use a donut-shaped cushion or coccyx pillow when sitting to reduce pressure on the tailbone
- Apply ice packs for 15-20 minutes several times daily during acute pain phases, then transition to heat therapy for chronic discomfort
- Physical therapy focusing on pelvic floor exercises and stretching can help relieve tension, as shown in a study where 79 patients who completed treatment had a mean average pain rating decrease from 5.08 to 1.91 (P < .001) 1
- Avoid prolonged sitting, and when you must sit, maintain good posture with weight distributed evenly For persistent pain, consider a local injection of corticosteroids and anesthetic administered by a pain specialist. Weight loss reduces the natural cushioning around the coccyx, exposing it to increased pressure during sitting. Most cases resolve within weeks to months with conservative management, though some may require more specialized interventions if pain persists beyond 2-3 months, as suggested by a review of current treatment options for coccygodynia 2. It's essential to note that surgical intervention, such as coccygectomy, is typically reserved for patients with evidence of advanced coccygeal instability or spicule formation, and should only be considered after conservative treatments have failed, as indicated by a study on the treatment and outcomes of patients with coccydynia 3.