Can Tailbone Pain Be a Cancer Symptom?
Medically reviewed by Doru Paul, MDMedically reviewed by Doru Paul, MD
Tailbone pain, or coccydynia, occurs below your hips at the end of your spine. It affects the coccyx (tailbone).
Tailbone pain can result from causes that range from prolonged sitting to injuries and falls. While uncommon, it can also involve tailbone cancer. This cancer can include primary cancers such as a chordoma tumor, a cancerous tumor that grows along your spine. It can also include cancers, such as prostate cancer, that metastasize or spread to bone from their primary site.
Most causes of tailbone pain can be relieved with home treatment. However, pain that persists may require medical treatments such as injections or surgery. Pain related to cancer involves treatment to counter the effects of malignant cells.
This article explains tailbone pain and how it can be related to cancer. It also describes treatments, triggers, and therapies used for tailbone pain.
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Describing Tailbone Pain
Tailbone pain occurs at the base of your spine, near the top of your buttocks. It typically causes tenderness and discomfort that often feels achy and dull. Occasional sharp pain may also occur.
Tailbone pain can last from a few days to a few months. It can interfere with your ability to perform daily activities. Tailbone pain can also disrupt normal, restful sleep. The discomfort can often feel worse under the following circumstances:
Being seated
Leaning back while seated
Sitting down or standing up
Bending forward
Passing a bowel movement
Having sex
Menstruation (period bleeding)
The Connection Between Tailbone Pain and Sacroiliac Joint Pain
The two sacroiliac joints (one on either side of your lower spine) connect your sacrum (the bone that connects your spine to your pelvis) to your hip bone. Your tailbone is attached to the bottom of your sacrum. Dysfunction or inflammation of the sacroiliac joints can radiate to your tailbone, causing pain.
When Is Tailbone Pain a Cancer Symptom?
Though rare, tailbone pain can be a sign of some types of cancer. These cancers typically develop near your tailbone. They can also involve cancer that has metastasized (spread) from another part of your body.
Tailbone pain can be linked to the following types of cancer:
Chordoma: This rare type of malignant (cancerous) tumor can develop in the bones of your spine. While a chordoma can occur anywhere along your spine, it usually forms at the sacrum (the base of your spine), the tailbone, or the base of your skull. Chordomas are difficult to treat because of their proximity to your brain and spinal cord. When possible, surgery is the preferred option.
Ovarian cancer: Lower back pain can be a sign of ovarian cancer. The pain can occur as discomfort that you feel consistently on most days without the pain resolving.
Cervical cancer: Lower back pain can occur as an early sign of cervical cancer. It can feel like a sharp pain or pressure.
Colon cancer and rectal cancer: Back pain can occur with colon and rectal cancer. This type of pain typically does not worsen with movement. It may hurt at night or early morning, then dissipate. The pain may also occur with tingling, weakness, or numbness in your arms and legs.
Lung cancer: Bone cancer is a common site for lung cancer metastasis. Pain in your hips or back are key indicators of lung cancer.
Prostate cancer: When prostate cancer metastasizes, it typically spreads to your bones first. The bones most commonly affected include those in your spine, hips, and ribs.
Breast cancer: The bones are the most common site for breast cancer metastases. Symptoms can occur as pain or a fracture due to a bone weakened by cancer cells.
While tailbone pain typically does not indicate a need for emergency treatment, tailbone pain that may be related to cancer requires immediate assessment. Contact your healthcare provider if you have tailbone pain accompanied by any of the following symptoms:
A sudden increase in swelling or pain
Long-term constipation
Sudden weakness, numbness, or tingling in either or both legs
Loss of bowel or bladder control
A noticeable mass in your tailbone area
Ovarian Cysts and Other Medical Causes of Tailbone Pain
The source of tailbone pain isn't always obvious. Tailbone pain can sometimes occur as a symptom of the following non-cancerous medical conditions:
Osteoarthritis (degenerative joint disease)
Joint hypermobility (unusually large range of movement) or hypomobility (limited range of movement) of the sacrococcygeal joint
Infection
Variants of the coccygeal structure, such as scoliosis (an abnormal curve in your spine)
Referred or radicular pain from another injury or condition
Compressed or irritated nerves in the tailbone
Treatments to Manage Tailbone Pain Before Diagnosis
Treatment to manage tailbone pain before diagnosis involves several conservative (non-medical) options. Research indicates that conservative treatment is successful in treating 90% of tailbone pain. In most cases, the following treatments can resolve the problem:
Sit on an over-the-counter coccygeal cushion. These wedge-shaped cushions relieve the pressure on your tailbone while you are seated.
Practice proper sitting posture to correct poor sitting positions that can contribute to tailbone pain. Sit completely upright, keeping your back firmly against the chair. Your knees should be level with your hips, feet on the floor, and your shoulders relaxed.
Lean forward slightly when seated to adjust the distribution of your weight.
Apply heat and/or cold over the site of your pain. Since neither is more effective than the other, try both treatments to determine which one works best.
Take oral nonsteroidal anti-inflammatory drugs (NSAIDs) such as Motrin, Advil (ibuprofen), or Aleve (naproxen) to reduce pain and inflammation.
Use topical NSAIDs at the site of the pain to avoid oral NSAID side effects.
Practice pelvic floor exercises, which may be especially beneficial during pregnancy.
Lie on your side to reduce pressure on your tailbone.
Take stool softeners to reduce pain and straining during bowel movements.
Possible Pain Triggers
Avoiding possible triggers for tailbone pain can help reduce the incidence and frequency of discomfort and allow the affected area to heal. These triggers include:
Sitting for long periods: Sitting for long periods, especially on hard, narrow, or uncomfortable surfaces, can exert extra pressure on the tailbone.
Sitting with improper posture: Positions that involve leaning back or reclining while seated can force your body into unnatural positions that can add pressure to your tailbone.
Straining during a bowel movement: Sitting for long periods on the toilet and straining can exert extra pressure on the tailbone.
External or internal trauma: This type of injury can occur as a result of a backward fall or vaginal childbirth.
Rapid weight loss: Losing weight at a fast rate can result in a loss of natural mechanical cushioning
Obesity: Depending on the distribution of extra body weight, obesity can throw off natural body alignment and exert extra pressure on the tailbone.
Repetitive motions: Activities like cycling and rowing require you to lean forward and exert extra pressure on your tailbone.
Treatments for Tailbone Pain and Related Cancers
When debilitating tailbone pain persists despite conservative treatment, your healthcare provider may advise the following therapies:
Manual manipulation and massage
Intrarectal manipulation to identify and correct a dislocated sacrococcygeal joint
Injections of a local anesthetic with steroids around the coccyx
Ganglion impar local anesthetic block
When other treatments fail, surgical amputation of the coccyx may be advised. This procedure, called a coccygectomy, is reserved as a last resort for extreme cases.
When tailbone pain occurs as a result of bone metastasis of related cancers, the following therapies may be successful in treating the bone metastasis and the problems that it causes:
Systemic therapy: Certain drugs work by slowing the growth of cancer cells, strengthening bones, and helping delay fractures in affected bone. They include Zometa (zoledronic acid) and other bisphosphonates, Xgeva, Prolia (denosumab), a monoclonal antibody (man-made antibody), and corticosteroids such as prednisone and dexamethasone.
External radiation therapy: This involves directing radiation treatment at tumors on the spine, which can help relieve pressure and sometimes prevent paralysis.
Radiopharmaceuticals: These drugs contain radioactive elements. They are injected into a vein and settle in bones affected by cancer. The drugs emit radiation to kill cancer cells.
Ablative treatments: These treatments use extreme heat or cold to ablate (destroy) bone tumors.
Kyphoplasty: This minor surgery is used to stabilize a painful collapsed bone in a spine weakened by cancer.
Pain medication: When used as prescribed, these medications can be safe and very effective.
Chemotherapy, immunotherapy, targeted agents, and hormonal therapy may also be possible treatment options.
Learn More: Bone Metastases Treatment and Prognosis
Summary
Tailbone pain can hamper your ability to perform daily routines. It can prevent you from normal sitting, standing, and movement. While it can affect your quality of life, it is often a short-term problem.
Rarely tailbone pain can be a symptom of a more severe issue, such as cancer. Tailbone pain caused by cancer can result from a primary tumor at the site. It can also occur from cancer that has spread from a primary site to your tailbone, though its symptoms may not differ from other types of tailbone pain.
Contact your healthcare provider for tailbone pain that does not resolve with conservative home treatments. Don't delay if tailbone pain occurs with feelings of numbness in your limbs, a lump in your tailbone, or loss of bladder or bowel control. If cancer is involved, getting a prompt diagnosis can help you achieve the best outcomes.
Read the original article on Verywell Health.
