[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Spine](https://durgical.com/en/anatomy/region/spine/) › Sacrococcygeal joint [Joints and ligaments](https://durgical.com/en/anatomy/system/joints-and-ligaments/) · [Spine](https://durgical.com/en/anatomy/region/spine/) # Sacrococcygeal joint The sacrococcygeal joint is the small joint between the sacrum and the tailbone (coccyx); it lets the coccyx tilt slightly. [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=spine&select=sacrococcygeal_joint&side=r) Opens in the Durgical app, no sign-up needed. ## What it is The small joint between the sacrum and the coccyx. ## What it does Lets the tailbone tilt slightly back when you sit and during childbirth. ## Key points - Coccydynia is several times more common in women, linked to the wider [pelvis](https://durgical.com/en/anatomy/region/pelvis/), childbirth and a more backward-tilted coccyx - The ganglion impar (of Walther), where the two sympathetic trunks meet, lies just in front of the joint: the target of a block for coccyx and perineal pain - The sacral hiatus, just above the joint between the sacral cornua, is the entry for a caudal epidural; the superficial posterior sacrococcygeal ligament closes it - Sacrococcygeal teratoma is the most common tumor of newborns; chordoma, from notochord remnants, favours this region and the clivus ## Key facts **Where** Between the apex of the sacrum (S5) and the base of the coccyx (Co1) **Attaches** Fibrocartilaginous disc; anterior, posterior (superficial and deep) and lateral sacrococcygeal ligaments; intercornual ligaments **Function** Symphysis-type joint; slight flexion-extension, coccyx moves back in sitting and childbirth; often fuses with age ## Relations **In front** Presacral (retrorectal) space and the [rectum](https://durgical.com/en/anatomy/rectum/); the ganglion impar and the [median sacral artery](https://durgical.com/en/anatomy/median-sacral-artery/) lie on the front of the joint **Behind** Superficial and deep posterior sacrococcygeal ligaments; [gluteus maximus](https://durgical.com/en/anatomy/gluteus-maximus-muscle/) arises from the side of the lower [sacrum](https://durgical.com/en/anatomy/sacrum/) and [coccyx](https://durgical.com/en/anatomy/coccyx/); the [skin](https://durgical.com/en/anatomy/skin/) of the natal cleft **Lateral** Lateral sacrococcygeal ligaments, the [coccygeus muscle](https://durgical.com/en/anatomy/coccygeus-muscle/) and the [sacrospinous ligament](https://durgical.com/en/anatomy/sacrospinous-ligament/) and [sacrotuberous ligament](https://durgical.com/en/anatomy/sacrotuberous-ligament/) along the edges of the lower sacrum and coccyx **Below** Coccyx, with the anococcygeal ligament and the [levator ani](https://durgical.com/en/anatomy/levator-ani/) of the pelvic floor attached near its tip ## How to find it In the natal cleft the two sacral cornua are felt as small bumps marking the sacral hiatus; a little lower a slight groove or movable step marks the joint, with the coccyx below. On rectal examination the coccyx can be held between finger and thumb to test movement and tenderness. ## Examination - Pain reproduced by moving the coccyx between a finger in the rectum and a thumb outside, with painless pressure elsewhere, points to coccydynia rather than referred pain ## On imaging MRI shows bone edema, fractures and presacral masses such as chordoma; prenatal ultrasound detects sacrococcygeal teratoma before birth. ## Common problems - Coccydynia: pain at the tailbone when sitting, after a fall, childbirth or for no clear reason. - Fracture or dislocation from a fall onto the buttocks. ## How it is diagnosed Exam (tenderness at the tailbone); X-rays sitting and standing can show abnormal movement. ## Treatment - A cushion with a cut-out, anti-inflammatory medicine, pelvic floor physical therapy, injections. - Rarely, removal of the coccyx (coccygectomy) when nothing else helps. ## Clinical notes - Coccygectomy is reserved for persistent coccydynia; wound infection is the main complication because of the nearby anus - Pilonidal disease in the natal cleft over the coccyx is a skin and hair-follicle problem, not a joint one, but is felt at the same spot - During vaginal birth the coccyx moves backward at this joint to enlarge the pelvic outlet; a difficult delivery can sprain or dislocate it and is a known cause of coccyx pain afterwards ## Anatomical variants - The joint fuses in many adults, especially with age; in some it is partly synovial - The coccyx usually has four segments (range three to five); a sharply forward-hooked coccyx is linked to coccydynia ## Development The coccyx is the remnant of the embryonic tail; its segments ossify late, the first in the early years of life and the last around or after puberty. Remnants of the notochord here explain chordoma. ## Test yourself Think of the answer, then tap the question to see it. ## Which ganglion lies in front of the sacrococcygeal joint, and why is it targeted? The ganglion impar (of Walther), where the two sympathetic trunks meet; it is blocked for coccyx and perineal pain. ## Which opening just above the sacrococcygeal joint is the entry for a caudal epidural? The sacral hiatus, between the sacral cornua, closed by the superficial posterior sacrococcygeal ligament. ## Which tumor of the sacrococcygeal region is the most common tumor of newborns? Sacrococcygeal teratoma; prenatal ultrasound can detect it before birth. ## Why is coccydynia, felt at the sacrococcygeal joint, more common in women? It is linked to the wider pelvis, childbirth and a more backward-tilted coccyx; it is several times more common in women. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/anatomy/sacrococcygeal-joint/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** junctura sacrococcygea TA2 1688 **Official Spanish (DeCS)** Articulación sacrococcígea **English (TA2)** Sacrococcygeal joint **Also called** articulatio sacrococcygea ## Related - [Coccyx](https://durgical.com/en/anatomy/coccyx/) - [Sacrum](https://durgical.com/en/anatomy/sacrum/) Sources: Terminologia Anatomica (TA2); [Anatomy, Back, Coccygeal Vertebrae](https://www.ncbi.nlm.nih.gov/books/NBK549870/). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/sacrococcygeal-joint/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/sacrococcygeal-joint/