Muscle Spasm and
Coccyx Pain
Coccyx Pain
Muscle spasm or tightness causing coccyx pain
A possible factor in persistent coccydynia is muscle dysfunction. It is common
to find taut bands that are very painful when pressed. Taut bands are strongly
contracted muscle fibers within an otherwise relatively normal muscle.
Rectal examination of the pelvic floor muscles is necessary to locate these
contraction knots or myofascial trigger points. They are often found in the
levator ani, sphincter ani and coccygeus muscles. Patients with these trigger
points may complain of painful bowel movements and dyspareunia [painful
sexual intercourse]. Other muscles that can cause coccydynia are the obturator
internus, gluteus maximus and adductor magnus. Trigger points in the
adductor magnus often cause pain in both the thigh and the pelvic floor.
Treatment of trigger points may include compression, dry needling, injection
with procaine, manual stretching or myofascial release.
[The paragraphs above are adapted from a reply by Jan Dommerholt to a
question on the NOI message board].
Gluteus maximus syndrome
The gluteus maximus muscles are the powerful muscles in the buttocks that
raise you from sitting to standing, and also lower you into a sitting position.
The gluteus maximus is attached to the coccyx as well as to other bones. A
spasm or tightness of this muscle can pull on the coccyx and cause pain when
you move into a sitting position or raise yourself. It doesn't cause pain while
you are sitting. The spasm, and the pain, is normally just on one side.
Diagnosis
The features that distinguish gluteus maximus pain are:
it hurts while raising or lowering yourself, even into a squatting position
the pain doesn't depend on whether you actually put pressure on the coccyx
by sitting - it goes away while you are sitting, instead of getting worse
If you have gluteus maximus pain, a manual practitioner who examines you
will find muscle spasm, joint stiffness and tenderness at the lumbo-sacral joint
on the same side as the pain. If the practitioner puts pressure on the point
where the gluteus maximus is attached to the side of coccyx, this will
reproduce the patient's pain.
Treatment
Manual treatment of the back and buttock muscle with massage should solve
the problem, usually in 3 to 5 treatments, with clear improvement felt after
the first treatment.
The information on gluteus maximus syndrome is based on information kindly
supplied to me by Adrian Good, an osteopath and physiotherapist in
Melbourne, Australia (email: agood@brightonspinal.com.au), and author of
Pain Relief - Manual Therapies Can Help, Lothian Books, ISBN: 0734403240.
Piriformis syndrome
One muscle which is often thought to be the cause of pain when sitting is the
piriformis. You have two piriformis muscles, running horizontally from the lower
spine to the top of each thighbone (femur). The piriformis runs over the sciatic
nerve, and piriformis syndrome is thought to develop when the muscle
becomes tight or spasms and places pressure on the sciatic nerve. This can
cause pain in the lower back and/or pain that radiates to the buttocks and
down the leg. Pain is often made worse by sitting.
According to one doctor, "Piriformis syndrome can cause pain in the low back,
groin, perineum, buttock, hip and other areas, and can also cause
dyspareunia (painful intercourse) and pain in the rectum during defecation.
Piriformis problems are very diverse and very common, and fortunately
respond very well to treatment in massage therapy".
Diagnosis
Piriformis syndrome is usually diagnosed on the basis of the pattern of
symptoms. One website, Neurography.com, says that special MRI scans can
show up piriformis problems.
Trying to stretch the piriformis muscle has been suggested as a way of
diagnosing the problem - if it hurts to stretch it, you may have piriformis
syndrome. The instructions for stretching it are: Lie flat on your face on a bed.
Bend your legs 90 degrees at the knee, lifting your feet in the air. Let the feet
spread apart from each other, keeping the knees together and bent at 90
degrees.
Treatment
Treatments include stretching the muscles, Massage therapy, injections of
corticosteriods.
More information
There is detailed information on piriformis syndrome on the Spine-Health web
site, and more general information on the International Society for pelvic pain
site, and the OrthoDoc Massage Therapy site.
Updated 2003-01-12
Coccyx Org
A possible factor in persistent coccydynia is muscle dysfunction. It is common
to find taut bands that are very painful when pressed. Taut bands are strongly
contracted muscle fibers within an otherwise relatively normal muscle.
Rectal examination of the pelvic floor muscles is necessary to locate these
contraction knots or myofascial trigger points. They are often found in the
levator ani, sphincter ani and coccygeus muscles. Patients with these trigger
points may complain of painful bowel movements and dyspareunia [painful
sexual intercourse]. Other muscles that can cause coccydynia are the obturator
internus, gluteus maximus and adductor magnus. Trigger points in the
adductor magnus often cause pain in both the thigh and the pelvic floor.
Treatment of trigger points may include compression, dry needling, injection
with procaine, manual stretching or myofascial release.
[The paragraphs above are adapted from a reply by Jan Dommerholt to a
question on the NOI message board].
Gluteus maximus syndrome
The gluteus maximus muscles are the powerful muscles in the buttocks that
raise you from sitting to standing, and also lower you into a sitting position.
The gluteus maximus is attached to the coccyx as well as to other bones. A
spasm or tightness of this muscle can pull on the coccyx and cause pain when
you move into a sitting position or raise yourself. It doesn't cause pain while
you are sitting. The spasm, and the pain, is normally just on one side.
Diagnosis
The features that distinguish gluteus maximus pain are:
it hurts while raising or lowering yourself, even into a squatting position
the pain doesn't depend on whether you actually put pressure on the coccyx
by sitting - it goes away while you are sitting, instead of getting worse
If you have gluteus maximus pain, a manual practitioner who examines you
will find muscle spasm, joint stiffness and tenderness at the lumbo-sacral joint
on the same side as the pain. If the practitioner puts pressure on the point
where the gluteus maximus is attached to the side of coccyx, this will
reproduce the patient's pain.
Treatment
Manual treatment of the back and buttock muscle with massage should solve
the problem, usually in 3 to 5 treatments, with clear improvement felt after
the first treatment.
The information on gluteus maximus syndrome is based on information kindly
supplied to me by Adrian Good, an osteopath and physiotherapist in
Melbourne, Australia (email: agood@brightonspinal.com.au), and author of
Pain Relief - Manual Therapies Can Help, Lothian Books, ISBN: 0734403240.
Piriformis syndrome
One muscle which is often thought to be the cause of pain when sitting is the
piriformis. You have two piriformis muscles, running horizontally from the lower
spine to the top of each thighbone (femur). The piriformis runs over the sciatic
nerve, and piriformis syndrome is thought to develop when the muscle
becomes tight or spasms and places pressure on the sciatic nerve. This can
cause pain in the lower back and/or pain that radiates to the buttocks and
down the leg. Pain is often made worse by sitting.
According to one doctor, "Piriformis syndrome can cause pain in the low back,
groin, perineum, buttock, hip and other areas, and can also cause
dyspareunia (painful intercourse) and pain in the rectum during defecation.
Piriformis problems are very diverse and very common, and fortunately
respond very well to treatment in massage therapy".
Diagnosis
Piriformis syndrome is usually diagnosed on the basis of the pattern of
symptoms. One website, Neurography.com, says that special MRI scans can
show up piriformis problems.
Trying to stretch the piriformis muscle has been suggested as a way of
diagnosing the problem - if it hurts to stretch it, you may have piriformis
syndrome. The instructions for stretching it are: Lie flat on your face on a bed.
Bend your legs 90 degrees at the knee, lifting your feet in the air. Let the feet
spread apart from each other, keeping the knees together and bent at 90
degrees.
Treatment
Treatments include stretching the muscles, Massage therapy, injections of
corticosteriods.
More information
There is detailed information on piriformis syndrome on the Spine-Health web
site, and more general information on the International Society for pelvic pain
site, and the OrthoDoc Massage Therapy site.
Updated 2003-01-12
Coccyx Org
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