Hemorrhoids and Tailbone Pain. A Real Pain in the…

Medically reviewed by: Gary H. Hoffman, MD

Hemorrhoids and Tailbone Pain. A Real Pain in the...

Everyone has heard that hemorrhoids can bleed, itch, and burn. They may even protrude out of your anus. But what about tailbone pain? Tailbone pain is that sharp or dull discomfort that you might feel during prolonged sitting, walking or even while sleeping.

As it turns out, tailbone pain is one of the most common complaints heard in our proctology practice. And other colon and rectal surgeons report that their clients often suffer tailbone pain, as well.

Hemorrhoids May Bring Unexpected Symptoms

Hemorrhoids have many symptoms. There are some well-known, classic symptoms of hemorrhoids that are almost unavoidable and universally understood as a part of suffering through the condition. These symptoms include:

  • Rectal bleeding
  • Burning and pain around the anus
  • Protrusion, sometimes called prolapse
  • Itching
  • Swelling

What many people do not realize, however, is there are also many other symptoms of the condition. Our patients commonly report tailbone pain along with the classic symptoms. Still, it seems unbelievable to many people that a small irritated and engorged blood vessel could cause major discomfort in a nearby but unrelated part of the body.

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Tailbone pain may seem unrelated to your hemorrhoids, but a quick anatomy lesson is all it takes to understand why it happens. In fact, tailbone pain is not only a symptom of inflamed hemorrhoids but a relatively common symptom.

Anatomy 101: The Key Lies in the Muscles

In order to prevent the untimely, accidental discharge of feces, liquid or gas out the anus, our bodies have special muscles called the levator muscles. The levator muscles work in concert with our anal sphincters to give us our full control of our bowels under normal circumstances. The levators elevate the abdominal contents out of the pelvic cavity — think “elevator” — and also contract around the rectum to hold in the contents and aid in peristalsis. Peristalsis is the pulsing of these muscles to help to push the content of the colon and rectum forward.

The each of the group of levator muscles has an origin (a beginning attachment) and an insertion (an ending attachment). These attachments are the key to the strong muscle contractions necessary for peristalsis. Each end of each levator muscle is attached to a stationary bone.

The levators begin in the front of the pelvic cavity and end in the back of the pelvis. One of the points of termination for some of these muscles is the coccyx, or tailbone.

Because of this connection and the strength of the levator muscles, the tailbone flexes slightly with each muscle contraction. This connection and movement explains why an issue that seems to only affect the anus can cause tailbone pain.

Understanding Hemorrhoids

Many people do not understand what hemorrhoids are, and this leads to confusion and misunderstanding. These structures are one of the most common causes of anal pathology, and if you have a problem with them you unwillingly think about them a lot. But we find that many of our patients do not understand what hemorrhoids are and what happens when things go wrong.

First and foremost, hemorrhoids are normal tissue. Everyone has them from birth. They serve to cushion and protect the anal opening during bowel movements. What people generally think of as “hemorrhoids” are actually inflamed and enlarged hemorrhoidal tissues. It is this inflammation and swelling that turn these normal tissues into the dreaded condition no one wants to talk about.

Hemorrhoids are a collection of veins, arteries, nerves and connective tissue which are located inside, and sometimes outside, of the anal canal. Blood flows into the area, delivering oxygen and nutrients to the tissues. The blood then returns to the heart via the hemorrhoidal veins. Problems begin when the hemorrhoidal veins begin to dilate.

This is similar to the varicose veins seen in our legs. When these veins dilate, they become larger and closer to the surface. The irritation caused by inflammation and swelling leads to classic hemorrhoid symptoms.

Hemorrhoids and Tailbone Pain

When the hemorrhoidal tissues become inflamed or enlarged, and especially when they prolapse, they cause the levator muscles to pull harder. This moves the coccyx more than normal, causing tailbone pain.

Like other bones, the coccyx has pain nerve fibers. These fibers cause pain when stretched. When the levator muscles pull on the tailbone too hard, it stretches the bone ever so slightly. This can also happen because of other common health concerns, including anxiety or stress. This occurs because stress can lead to muscle spasms in the levator muscles as well as other susceptible muscles.

The tailbone pain often associated with hemorrhoids may be acute and occur suddenly without warning. In other cases, it may be chronic and long-lasting. Some of our patients report acute pain waking them up at night. Then, chronic tailbone pain follows them throughout the day. As you can imagine — and may have experienced — both acute and chronic pain can be major distraction or even cause you to miss work.

The good news is that this type of tailbone pain is not related to cancer or any other serious, life-threatening problems. Of course any unexplained pain, especially unremitting pain, should be evaluated by your doctor to be sure that nothing else is causing the pain.

Clinical management of inflamed hemorrhoids should stop the tailbone pain and it should not occur again unless the hemorrhoids recur. When inflamed hemorrhoids are treated and the swelling in these tissues goes down, the symptoms of the hemorrhoids should also disappear.
Without swelling or inflammation, the levator muscles no longer have to work as hard and should not put extra stress on the tailbone. Your pain should stop within a few days of the disappearance of your other hemorrhoid symptoms.

Los Angeles Hemorrhoid Treatment to Stop Tailbone Pain

In most cases, hemorrhoids only require conservative treatment. Once see a doctor and you have a diagnosis, you can begin making the small lifestyle changes likely recommended by your doctor. You can use sitz baths and over the counter medications recommended by your doctor to manage pain and symptoms until you heal.

Often, eating a diet higher in fiber and with increased water intake can help keep your bowel movements regular and prevent a recurrence. If a recurrence does occur or if your case is serious, your doctor may recommend an in-office procedure to treat your hemorrhoids. In some cases, surgery for hemorrhoids in Los Angeles may be necessary.

If you do not have a doctor, the team from Los Angeles Colon and Rectal Surgical Associates can help. We are trained to diagnose and treat hemorrhoids, including tailbone pain or any other unusual symptoms you may have. Make an appointment and confidential consultation by calling our team today at (310) 273-2310.

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