What is included in the physical exam to evaluate coccyx pain?

Updated: Jan 07, 2021
  • Author: Patrick M Foye, MD; Chief Editor: Consuelo T Lorenzo, MD  more...
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Answer

Other aspects of the physical examination include the following:

  • Skin inspection – Direct visual inspection of the skin over the coccygeal region is important. An underlying pilonidal cyst may produce visible discharge, local rash, or a visible skin opening (fistula). In addition, inspecting for a local dimple/divot may be relevant, because in one study, as noted above, 25 (83%) of 30 patients with a bone spicule at the distal coccyx had a "pit" noted in the overlying skin. [22]

  • Neurologic examination - Strength, sensation, and muscle-stretch reflexes can be assessed throughout the bilateral lower limbs to evaluate for any lumbosacral radiculopathy

  • Lumbosacral range of motion - This can be assessed in multiple planes, including documentation of pain with these motions, particularly if the presenting symptoms are reproduced

  • GI and gynecologic physical examination - Depending on the patient's history and the clinician's expertise, abdominal and gynecologic physical examinations may be performed; manual digital rectal examination can assess for hemorrhoids or other intrarectal masses


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