Tailbone Pain (Coccydynia): What You Need to Know
Tailbone pain can make life uncomfortable at best and unbearable at worst. Your coccyx, a small triangular bone at the bottom of your spinal column, can get bruised or even fractured. Home remedies like medication and ice packs usually ease symptoms. But in some cases, you might need treatment like numbing injections or, very rarely, surgery.
Overview
What is coccydynia (tailbone pain)?
“Coccydynia” is the medical term for tailbone pain (“coccyx” = tailbone, “dynia” = pain). Your coccyx (tailbone) is at the very bottom of your spine, and it consists of three to five fused vertebrae (bones).
Your tailbone has a few important jobs. When you sit down, it helps steady you and support your weight. It’s also where several tendons, ligaments, and muscles in your body connect. But when your tailbone hurts, it’s a real pain in the rear — and it can interfere with daily routines and quality of life.
How common is tailbone pain?
Tailbone pain is common. It’s five times more likely to occur in women and people assigned female at birth (AFAB) than men and people assigned male at birth (AMAB). Adolescents and adults get it more often than children.
Symptoms and Causes
What are the symptoms of tailbone pain?
Coccydynia symptoms may include:
- Dull (achy) or sharp (piercing) tailbone pain.
- Tailbone pain that worsens when you go from sitting to standing.
- Pain when you poop.
- Pain during sex.
Other related symptoms that may occur in people with tailbone pain include:
- Back pain.
- Sciatica.
- Sleep disorders.
- Depression.
- Anxiety.
What causes tailbone pain?
There are many reasons why you might develop tailbone pain. Possible causes include:
- Falls: A bad fall can bruise, break (fracture), or dislocate your tailbone.
- Repetitive strain injuries (RSI): Sports like bicycling and rowing require you to lean back and forth. Too much of that repeated motion can strain the tissues around your tailbone.
- Pregnancy or childbirth: During the third trimester of pregnancy, your body secretes hormones that soften the area between your tailbone and sacrum, allowing for more flexibility during childbirth. However, this can sometimes stretch the muscles and ligaments around your tailbone too far.
- Carrying extra weight: Extra weight places additional pressure on your tailbone.
- Not carrying enough weight: Less fat means less cushioning, which can cause your tailbone to rub against muscles, ligaments, and tendons, resulting in inflammation.
- Prolonged sitting: Sitting for long periods on hard surfaces can put excessive pressure on your tailbone.
What causes tailbone pain without injury?
In rare cases, tailbone pain may be a sign of cancer near your coccyx, such as chordoma, prostate cancer, or colorectal cancer. Additional symptoms could include numbness, tingling, and difficulty with urination or bowel movements.
Diagnosis and Tests
How do healthcare providers diagnose tailbone pain?
First, your healthcare provider will review your medical history and ask about any prior injuries or trauma to the tailbone. A physical examination will be conducted to check for fractures, lumps, or abscesses.
What tests can help diagnose tailbone pain (coccydynia)?
To check for a fracture, your healthcare provider may recommend:
- X-ray
- CT (computed tomography) scan
To check for inflammation or abscesses, your provider may recommend:
- MRI (magnetic resonance imaging)
- Bone scan
Management and Treatment
How do healthcare providers treat tailbone pain (coccydynia)?
Treatment depends on the cause and severity of your discomfort. Home remedies may be sufficient for mild cases, but more severe pain may require medical intervention.
Home remedies for tailbone pain
In 90% of cases, people with tailbone pain find relief with home remedies. Some remedies include:
- Taking NSAIDs (nonsteroidal anti-inflammatory drugs) like ibuprofen to reduce pain and swelling.
- Sitting on a donut pillow or wedge-shaped gel cushion to take pressure off your tailbone.
- Taking hot baths to relax your muscles and ease pain.
- Applying hot or cold packs to your lower back for 20 to 30 minutes, several times a day.
- Taking stool softeners if you have pain when pooping.
Conservative treatment is successful in 90% of cases, and many cases resolve without medical treatment. Treatments for refractory cases include:
- Pelvic floor rehabilitation
- Manual manipulation and massage
- Transcutaneous electrical nerve stimulation (TENS)
- Psychotherapy
- Steroid injections
- Nerve block
- Spinal cord stimulation
- Surgical procedures (in extreme cases)
Nonsurgical treatments for tailbone pain
If home remedies don’t provide relief, your healthcare provider may recommend nonsurgical treatments, such as:
- Coccygeal nerve block (an injection of numbing medications and steroids to relieve pain and inflammation).
- Massage therapy (usually provides temporary relief).
- Physical therapy to stretch muscles and improve posture.
- Acupuncture.
- TENS (transcutaneous electrical nerve stimulation).
Surgical treatments for tailbone pain
In extremely rare cases, your provider may recommend:
- Partial coccygectomy (removal of part of your coccyx).
- Total coccygectomy (removal of your entire coccyx).
Recovery time from a coccygectomy can take several months, and there’s no guarantee that the pain will go away.
Additional treatments
If you have chronic coccydynia, conditions like depression and anxiety can develop. It’s important to seek treatment for these issues as well.
Prevention
Can I prevent coccydynia (tailbone pain)?
While it’s not always preventable, you can reduce your risk by:
- Avoiding prolonged sitting, especially on hard surfaces.
- Taking care when cycling or participating in activities that put strain on your tailbone.
- Minimizing the risk of falls by keeping floors clear, installing handrails, and using caution when walking.
Outlook / Prognosis
What can I expect if I have tailbone pain?
Tailbone pain often resolves with home remedies in a few days. Chronic cases may require medical treatment.
Living With Tailbone Pain
Should I be worried if my tailbone hurts?
Tailbone pain can be bothersome, but it’s usually not a serious health issue. However, you should see a healthcare provider if:
- Your pain doesn’t go away.
- You experience additional pain in another area of your body.
- You have a fever of 103°F or higher.
Schedule a Complimentary Consultation Online to See What’s Right for You
Surgery is a personal decision that should be made after exploring all options, understanding the risks, and consulting with a qualified pelvic health specialist. For some women, surgery may provide much-needed relief, but for others, a tailored program of pelvic floor therapy may offer equally effective results without the associated risks.
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