Main Causes of Coccydynia in Children and Adolescents: Impact of Sports on the Development of Pain Syndrome

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Abstract

BACKGROUND: Coccydynia is characterized by intense and persistent pain in the coccygeal region and often presents challenges in diagnosis and treatment owing to its low prevalence and diverse etiology among children and adolescents.

AIM: This study aimed to analyze the causes of coccydynia in children and adolescents participating and not participating in sports.

METHODS: The outpatient records of 906 patients presenting with coccygeal pain to a consultative and diagnostic department between January 2010 and March 2025 were reviewed. Medical history, physical examination findings, and imaging data were analyzed.

RESULTS: The study included patients aged 9–18 years. There were 5.5 times more girls than boys. Most of the patients did not participate in sports. Traumatic coccydynia was identified in 37% of patients. In most cases, the injury resulted from falls onto the buttocks, typically at school or outdoors. Among the patients with traumatic coccydynia, only 5.1% were participating in sports. The causes of nontraumatic coccydynia included coccygeal instability, coccygeal retroversion, coccygeal spicule, and weight loss. In 40.7% of cases, the cause was not identified. Among the patients participating in sports, 64% of the cases of coccygeal pain were associated with coccygeal instability, which presented under conditions of chronic static or repetitive coccyx overload during training.

CONCLUSION: The most common types of coccydynia in children and adolescents are traumatic and idiopathic. Coccygeal injuries during sports training occur twice as rarely as household injuries. In young athletes, repetitive excessive loads during equestrian sports, cycling, choreography, and ballet are associated with the development of coccygeal instability. The prevention of coccydynia among children participating in sports may involve proper exercise technique, gradual increase of load, and use of protective equipment.

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About the authors

Svetlana I. Trofimova

H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery

Email: trofimova_sv2012@mail.ru
ORCID iD: 0000-0003-2690-7842
SPIN-code: 5833-6770

MD, Cand. Sci. (Medicine)

Russian Federation, Saint Petersburg

Andrey V. Sapogovskiy

H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery

Email: sapogovskiy@gmail.com
ORCID iD: 0000-0002-5762-4477
SPIN-code: 2068-2102

MD, Cand. Sci. (Medicine)

Russian Federation, Saint Petersburg

Olga E. Agranovich

H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery

Author for correspondence.
Email: olga_agranovich@yahoo.com
ORCID iD: 0000-0002-6655-4108
SPIN-code: 4393-3694

MD, Dr. Sci. (Medicine)

Russian Federation, Saint Petersburg

Ekaterina V. Petrova

H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery

Email: pet_kitten@mail.ru
ORCID iD: 0000-0002-1596-3358
SPIN-code: 2492-1260

MD, Cand. Sci. (Medicine)

Russian Federation, Saint Petersburg

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Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Distribution of patients by age.

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3. Fig. 2. Computed tomography of the sacrococcygeal spine (sagittal plane reconstruction): post-traumatic deformity of CoII with ventral wedge-shaped vertebrae, anterior decentration of CoI.

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4. Fig. 3. Computed tomography of the sacrococcygeal spine (volume visualization and sagittal plane reconstruction): consequences of posterior dislocation of CoI, anterior dislocation of CoII.

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5. Fig. 4. Computed tomography scan of the sacrococcygeal spine (volume visualization and reconstruction in the sagittal plane): bone spicule.

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6. Fig. 5. Causes of coccygodynia depending on the type of sports activity in child athletes.

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