Coccyx pain, when severe, can interfere with your entire day. Imagine not being able to sit down, ever. Where would you do your work? Is it reasonable to stand in all your meetings? Could you go out to dinner with your friends, or colleagues? Too many people are living their life with untreated tailbone pain, and fortunately, it’s one of the easiest conditions for us to treat in pelvic health.

When we talk about the tailbone, we are referring to the part of the body that attaches to the sacrum, or the very tip of the lower spine. When your tailbone hurts, simple actions like going from sit to stand, sitting on the floor, engaging in sexual activities, or even having a bowel movement can be excruciating. The tailbone has attachments to the pelvic floor muscles, to several ligaments including the sacrospinous ligament, and to a muscle called the coccygeus. These soft tissues are frequently culprits in persistent coccyx pain. It’s easy to injure this part of the body through a fall such as on the stairs, on slippery surfaces, when participating in sporting activities, or even during during childbirth. Most patients will react to pressure on these soft tissues with a report that this is exactly where their tailbone pain is located. Even though the bone or joints might be the cause of the pain, clinical experience and research agrees that treating the soft tissues is often the most effective way to resolve tailbone pain.

How do we treat this area? There are a variety of ways to get to these soft tissues, and the most efficient way seems to be when we work directly on them. This can be done by working near the gluteal muscles, or buttocks, and just to the sides of the tailbone. Internal pelvic muscle work is even more direct, and allows for a firm, gentle stretch to the soft tissues that are almost always involved when your tailbone hurts. “Internal” work means that the therapist places one gloved, well-lubricated finger inside the anal opening and into the canal so that this painful area can be treated. (The image below shows how a treatment can be directed to the coccygeus muscle through a canal.) While it might seem awkward initially, the pain relief that follows is well worth getting through the treatment according to our patients.

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Sitting is far too important of a daily task to suffer severe pain that limits sitting. It’s never too late to address tailbone pain, regardless of how old the injury is or how severe symptoms are. We hear too many stories of patients being told that the pain is coming from their low back or sacrum, or that there is “nothing that can be done.” Most patients have never had their tailbone properly assessed or touched to see from where the pain originates. More aggressive approaches such as removing the tailbone don’t guarantee the pain will be better. If you have questions, give us a call. Every therapist at Flow is trained in this specialty condition.

1. Developing testicular pain might be an emergency, especially if you’ve never had it before. Go to your medical provider, walk-in clinic, or emergency room if the pain is severe. One of the potential culprits of new onset testicle pain is testicular torsion, in which the cord that travels from your lower abdomen to the scrotum is twisted. This twist, or torsion, can cut off blood supply to your testicle and that is why quick intervention is needed. Oftentimes, a simple procedure such as an ultrasound is all that is needed to find out if this is the cause.

2. Even if not an emergency, testicular pain could be an infection or a mass, so making sure that all is well can ease your mind and help keep you healthy. It is also helpful to ease your mind so that you don’t worry too much about your symptoms. Some men find that worrying increases their testicular pain, and it is possible to create testicular pain by constantly squeezing your testicles to see if there is a lump! Doing self-exams is important, but you want to avoid over-doing the checking, and always apply a gentle pressure as the testicles are sensitive structures.

3. Getting a blow or kick to your groin is not an uncommon way to feel temporary pain in the testicles. Once the initial injury has calmed down, if pain persists, follow-up with a medical provider to make sure everything is healthy, and you will likely be advised to use conservative strategies such as a cold pack, rest, and maybe lightly compressive shorts to give a lift and support to your scrotum.

4. Sometimes the nervous system gets a bit overactive and can tell the smooth muscles around the testicles and scrotum to pull up, and up, and up. So much so that the testicle can even retract into the lower abdomen. Although it’s not always the case, for some men this can be very painful. Learning to identify the triggers for this such as cold, stress, low back pain and then identifying strategies to avoid or alleviate this issue can be accomplished in pelvic rehabilitation.

5. Because the testicles are supplied by nerves that branch off of your spine at the level of the low back, even a bout of low back pain may be related to developing pain in the scrotal area. Don’t be surprised if your therapist wants to examine your thoracic and lumbar spine, your abdomen, pelvis, or another nearby region. Many men who sit for really long periods of time every day have symptom improvement when they include more movement and less sitting into their day.

6. While having a vasectomy often involves a simple recovery with short-term discomfort only, sometimes pain develops after this procedure. In some men, a small granuloma forms at the surgery site, or a nerve that travels along with the vas deferens gets irritated. Rehabilitation providers have a lot of techniques and tools to help you recover from this discomfort.

7. A great way to develop new testicular pain is to start doing 300 sit-ups a day, especially if you haven’t been exercising AT ALL. I lost count of the number of men I’ve examined who decided, for some unreasonable reason, to start off a new exercise regimen with 200, 300, or maybe even 500 sit-ups per day, every day. That amount of effort on the abdominal wall can really annoy structures such as the nerves that travel from your low back to the scrotal area. Remember this when you start planning, give your body a chance to gradually adjust and remember to stretch related areas like the hip flexors.

8. Some authors and healers have found a relationship between testicular pain and being worried about such things as your job, your marriage or relationships, and other important topics related to your emotional well-being. Fortunately, some men find relief from their pain when they are able to share with a mental health provider any worries or fears, anger that may be carried in the body.

9. No matter where your pain is, strategies such as deep breathing, focusing on what you can do to help yourself (and them doing them), visualization, gentle movement such as walking, or even a hot bath can be helpful. Just knowing that there are providers who are trained to help recover from testicular pain can ease symptoms by providing some hope and relief.

10. Most importantly, physical therapists and other pelvic health providers are trained to treat testicular pain, and much of the time, this treatment is simple and effective. Before you let anyone convince you to have a painful testicle removed (which might not even fix the pain!), be sure to find a pelvic health provider to sort out how your body may be influenced by all the amazing structures involved.