What is coccygectomy?
Coccygectomy removes part or all of the coccyx, or tailbone. For pain alone, it is an uncommon operation reserved mainly for persistent disabling coccygodynia when assessment supports the coccyx as the source and suitable non-surgical treatment has not provided adequate control.
When is it considered?
Many cases of tailbone pain improve with time, pressure-relieving cushions, medication, physiotherapy and, where appropriate, targeted injection. Surgery may be discussed when pain remains severe and functionally limiting despite these measures. Selected tumors, destructive infection or major injury may also require resection, but the assessment and wider treatment plan are different in those situations.
Risks and alternatives
Wound infection and delayed wound healing are particularly important because of the location of the incision. Other risks include bleeding, persistent or recurrent pain, numbness, injury to nearby structures including the rectum, and further treatment. Continuing non-surgical care or repeating a targeted intervention may remain reasonable alternatives in selected cases.
Recovery and what to expect
Pressure on the wound must be managed while it heals, so sitting may be restricted or modified at first. Return to driving, work and exercise depends on wound healing, pain, the reason for surgery and the physical demands of the activity.
How we approach your care
- 01
Find the true source
We begin with a thorough history and examination, supported by imaging where appropriate, to pinpoint the precise source of the problem.
- 02
Consider appropriate options
Where clinically appropriate, we consider established non-surgical options before surgery. The plan depends on the diagnosis, symptoms, health and priorities of the individual patient.
- 03
A plan built around you
Every step is explained clearly, so you always understand your options and what comes next.
This may help if
- Disabling tailbone pain has persisted despite an appropriate course of non-surgical care
- Examination and, where appropriate, dynamic imaging or injection support the coccyx as the pain source
- The effect of wound healing and sitting restrictions on recovery has been discussed
Suitability can only be assessed after reviewing your symptoms, examination, relevant imaging and previous treatment.
Common questions
When is coccygectomy considered for tailbone pain?
It is usually reserved for persistent disabling coccygodynia after suitable measures such as activity modification, a coccyx cushion, medication, physiotherapy and targeted injection have not provided adequate control.
Why can the wound take time to heal?
The incision is close to the cleft between the buttocks, where moisture, pressure and bacteria can affect healing. Careful wound care and pressure management are therefore important after surgery.
What are the risks?
Wound infection and delayed wound healing are important risks. Other risks include bleeding, persistent or recurrent pain, numbness, rectal injury and the need for further treatment.