The sacrum and coccyx are part of the vertebral spinal column and could contribute to low back pain. They are not like the other bones in the spinal column. The sacrum, also known as the sacral vertebra, sacral spine, and S1 is a large, flat triangular-shaped bone that is between the hip bones and below the last lumbar vertebra known as L5. The coccyx, known as the tailbone, is positioned below the sacrum.
The sacrum and coccyx are made up of smaller bones that fuse and grow into a solid bone mass by the age of 30. The sacrum is composed of 5 fused vertebrae known as S1-S5 and 3 to 5 smaller bones that fuse creating the coccyx. Both are weight-bearing bones and are integral to walking, standing, and sitting functions.
The sacrum forms the back of the pelvis. Along with the coccyx and the two sacroiliac joints make up the pelvic girdle. S1 is at the top of the sacrum and connects to the last lumbar vertebrae L5. Together they create the lumbosacral spine. Where they join forms the lumbosacral curves known as lumbar lordosis and lumbar kyphosis.
The curvature works to support the upper body, weight/force distribution maintains spinal balance and flexibility. Lordosis is the inward curve of the spine, but too much can cause swayback that can be associated with spondylolisthesis. Loss of this curve can cause spinal imbalance and can lead to Flatback syndrome.
Kyphosis is the outward curve of the spine. The location of the sacrum at the intersection of the spine and pelvis means it has an important role in the movement of the low back and hips. The sacrum’s joints help to bear weight and help stabilize the spinal column along with the ligaments, tendons, and muscles help support/stabilize joint movement.
Joint L5 and S1 connect the lumbar spine to the sacrum. The pressure at this meeting point can be massive as the curve of the spine shifts from the lordotic forward curve to a kyphotic backward curve. The L5-S1 region bears weight, absorbs, and distributes the upper body’s weight when moving and resting. Disc herniation and spondylolisthesis are more common at L5-S1 for this reason.
The sacroiliac joints connect the sacrum to the left and right sides of the pelvis. The range of movement of the sacroiliac joints is minimal compared to other joints like the knees. However, the joints are essential for walking, standing, and stabilization of the hips. Sacroiliitis and sacroiliac joint dysfunction are two spinal disorders related to the joints. Other spinal disorders related to the sacral spine include:
The coccyx commonly known as the tailbone is just below the sacrum. It is smaller than the sacrum and has an important weight-bearing function. It helps supports weight while sitting. An example is leaning back while sitting. This motion and position increase the pressure/weight on the coccyx. An injury in this area can cause tailbone pain. Inflammation of the coccyx’s connective tissue that results in tailbone pain that gets worse when sitting is a common symptom. A traumatic event like a fall or auto accident that causes a tailbone fracture can also cause this pain.
The spinal cord ends at L1-L2, which branches out into the cauda equina, which is a bundle of nerves that looks like a horse’s tail. In the sacrum, there are sacral nerves known as the sacral plexus. Plexus means a network of nerve structures. The sacral and lumbar plexus compose the lumbosacral plexus. This is where the sciatic nerve, which is the largest nerve in the sacral plexus converges into the band. Sciatic nerve compression causes a combination of symptoms known as sciatica. It is very well known for causing low back and leg pain.
The coccygeal nerve serves the tailbone. There are five sacral nerves numbered S1 through S5 and are part of the spinal cord.
Injury or trauma to the sacral spine can cause mild stress fractures to severe bone fractures. These fractures can cause sacral nerve compression and intense pain. Symptoms include:
A doctor or chiropractor, physical therapist are excellent sources for information to help prevent sacrum and coccyx pain. These medical professionals will utilize a patient’s medical history, recommend lifestyle changes and injury prevention guidelines.
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Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system.
Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.
We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.
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