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Last updated: September 28, 2025View editorial policy

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Differential Diagnosis for Sudden Coccyx Pain

  • Single Most Likely Diagnosis
    • Coccydynia (tailbone pain) due to trauma: This is the most common cause of sudden coccyx pain, often resulting from a fall onto the buttocks or a direct blow to the coccyx. The pain can be severe and is usually localized to the coccyx area.
  • Other Likely Diagnoses
    • Coccygeal fracture: A fracture of the coccyx can occur from a fall or direct trauma, leading to sudden and severe pain in the coccyx area.
    • Levator ani syndrome: This condition involves spasms of the levator ani muscle, which can cause pain in the coccyx area, often worsening with sitting.
    • Pilonidal sinus or abscess: An infected pilonidal sinus or abscess near the coccyx can cause sudden pain in the area, especially if it becomes infected.
  • Do Not Miss Diagnoses
    • Cauda equina syndrome: Although rare, this condition involves compression of the nerves in the spinal canal and can present with sudden onset of coccyx pain, along with other neurological symptoms such as numbness, weakness, or bladder and bowel dysfunction. It is a medical emergency.
    • Rectal cancer: Although less common, rectal cancer can cause coccyx pain if the tumor is large enough to press on the coccyx or surrounding nerves.
  • Rare Diagnoses
    • Tarlov cysts: These are rare, fluid-filled sacs that can form on the nerve roots in the spine, including near the coccyx, and can cause pain if they compress nearby nerves.
    • Infection of the coccyx (osteomyelitis): A rare infection of the coccyx bone itself, which can cause sudden onset of pain, fever, and other systemic symptoms.
    • Chordoma: A rare type of bone cancer that can occur at the base of the spine, including the coccyx, and cause pain in the area.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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