Differential Diagnosis for Tailbone Pain
- Single most likely diagnosis
- Coccydynia: This is the most common diagnosis for tailbone pain, often resulting from a fall onto the tailbone, childbirth, or prolonged sitting. The pain is usually localized to the coccyx and may be exacerbated by sitting or standing.
- Other Likely diagnoses
- Levator ani syndrome: A condition characterized by chronic pain in the region of the levator ani muscle, which is located near the tailbone. This pain can be exacerbated by sitting or straining.
- Pilonidal cyst or abscess: An infected cyst or abscess near the tailbone can cause significant pain in the area.
- Anal fissure: A tear in the lining of the anus can cause pain, especially during and after bowel movements, which may be mistaken for tailbone pain.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Cauda equina syndrome: A serious condition where the nerves in the spinal canal are compressed, leading to pain, numbness, and weakness in the legs. It requires immediate medical attention.
- Rectal cancer: Although rare, rectal cancer can cause pain in the tailbone area, especially if the tumor is large or has spread to nearby structures.
- Spinal infection (e.g., osteomyelitis, discitis): Infections of the spine can cause severe back pain, including pain in the tailbone area, and require prompt treatment.
- Rare diagnoses
- Tarlov cyst: A rare condition where fluid-filled cysts form in the nerve roots of the spine, which can cause pain, including in the tailbone area.
- Chordoma: A rare type of bone cancer that can occur at the base of the spine, including the coccyx, causing pain and other symptoms.
- Sacrococcygeal teratoma: A rare tumor that develops at the base of the coccyx, more commonly diagnosed in newborns but can occur in adults, causing tailbone pain among other symptoms.