Psychological treatments for pain
Coccyx pain is generally caused by physical problems such as injury. Before trying psychological methods, I suggest that you read the What is coccydynia? section and visit your doctor to have the source of your pain investigated.
In some cases no physical problem can be found, or pain persists after physical causes have been removed. In these cases it is suggested that the pain is a result of the brain mistakenly interpreting normal sensations from the coccyx area as evidence of injury. And that hurts just as much as an injury!
Psychological treatments for pain aim to correct this mistake and so relieve the pain. Various doctors have developed methods to acheive this, including John E Sarno, who has written Healing Back Pain and David Schechter and Arthur Smith who wrote Back Pain as a Distraction Pain Syndrome. David Wise and Rodney Anderson treat pelvic pain using a combination of learning to relax pelvic tension and manual treatments, described in their book, A Headache in the Pelvis and at pelvicpainhelp.com.
This kind of approach certainly works for some people - a number have written to say that Sarno's method has worked for them: Frederick, Todd, Patrice, Manuel, Silke, Susan, Anonymous, Mike, Nataly, Sandra, AG, Helena,John. And some found it didn't work: Birgit, Sameera, John.
Pain Reprocessing Therapy (PRT)
In the past it was unclear how many people benefit from a psychological approach. There is now evidence that it can benefit many people. A version of the psychological approach called Pain Reprocessing Therapy has been shown to relieve the pain for most back pain patients. A published randomised clinical trial of this method found that 66% of back pain patients treated with PRT were pain-free or nearly pain-free compared with 20% who had placebo treatment and 10% who had usual care.
Alan Gordon and Alon Ziv have written a book for patients about Pain Reprocessing Therapy, called The Way Out. Although this book describes the methods used in detail and could be applied without professional help, the success rates in the clinical trial above were acheived using trained staff providing 8 psychological treatment sessions over 4 weeks.
Sören had coccyx and other pains which largely disappeared within 2 months using PRT. He has written a discussion about this approach, called Learned pain as a leading cause of chronic pain (Less Wrong).
Updated 2025-04-13
