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Coccydynia Treatment

Chapter 1: What is Coccydynia?

Chapter 2: Coccydynia Causes: Why does the tailbone hurt?

Chapter 3: Coccydynia Pain: When to see a doctor?

Chapter 4: Coccydynia Treatment


Key Takeaway:

  • Coccydynia is commonly known as tailbone pain and is a dull or sharp pain around the coccyx bone which is located in the lower part of the spine, right above the buttocks.
  • Pain in the tailbone can be experienced due to an injury, incorrect or prolonged sitting, sitting for long periods on a hard surface, bodyweight issues, haemorrhoids and in very rare cases, cancers and tumours. An orthopedician on MFine will be able to provide you with an accurate explanation for what may be causing the pain.
  • Coccydynia is more common in women as they have a broader pelvis region. Tailbone pain during pregnancy especially during the third trimester is also a common occurrence due to the size/weight of the baby.
  • A coccydynia diagnosis may involve X-rays and an MRI of the spine to check for signs of injury, dislocation, fracture and even tumours that may be pressing against the coccyx bone.
  • Treatments for coccydynia include physiotherapy, medication and coccygectomy in rare cases. Some home remedies that help with managing pain symptoms include sitting on a doughnut-shaped or v-shaped cushion, yoga and stretches, icing the affected area and eating a balanced diet. Orthopedicians on MFine are there to provide you with an appropriate treatment plan according to your diagnosis.
  • Coccydynia cannot always be prevented when the cause happens to be an injury due to a traumatic accident/fall. Other causes like incorrect sitting can be rectified by avoiding prolonged sitting, taking frequent breaks to stretch and ensuring a correct sitting posture every time. Full body checks and obesity risk assessments from time to time may help in preventing coccydynia in the long run.

Chapter 1: What is Coccydynia?

Coccydynia otherwise referred to as a pain in the tailbone area, is either a dull or sharp pain in the lower part of the spine. It is associated with trauma caused to the bony structure in the bottom of the spine called the coccyx due to an injury, strain, degenerative illnesses or childbirth. It usually fades after a few weeks or months but sometimes can linger for longer periods of time.

The coccyx bone (otherwise known as the tailbone) is a multisegmented bone structure right above the butt area, composed of three to five bony segments held together by many ligaments and joints. The coccyx bone plays a key role in stabilization of the body when you sit.

Coccydynia pain can be experienced when you stand or sit for prolonged periods, and even during sex. Sometimes even going to the bathroom can be painful. Women may experience discomfort or pain in the tailbone area during menstruation and pregnancy. However, sometimes the cause may be unknown. Nevertheless, it is important that you consult an orthopedician when you start experiencing sudden tailbone pain for whatever reason. The sooner they find out the underlying cause the sooner a coccydynia treatment plan can be put in place.

The next few chapters feature a discussion of the causes, symptoms, diagnosis and coccydynia treatment options in further detail. Refer to more of our medical guides for in depth information on various other health related conditions.

Chapter 2: Coccydynia Causes: Why does my tailbone hurt?

Your tailbone may hurt for many reasons. Here are some of the common causes of coccydynia in adults:

  • Trauma or Injury

    Trauma or injuries to the coccyx is the most common reason for tailbone pain in many adults. Studies have revealed that women are more likely to suffer from tailbone injuries as the female pelvis is broader and hence more exposed.  Hard falls or bruises to the area can cause sudden tailbone pain from dislocation or even a fractured tailbone in some cases. Coccydynia can also occur from a repetitive strain on the coccyx bone following sporting activities like rowing and cycling, skating and gymnastics. Along with tailbone pain, many individuals may experience swelling, numbness/tingling in the lower back, weakness in the legs and bowel problems from a tailbone injury. An injury to the tailbone heals slowly but the pain and discomfort can be managed with appropriate treatment.

  • Sitting on a hard surface

    Tailbone pain from sitting occurs when one happens to sit on a hard surface like a chair or a bench for prolonged periods of time. Sometimes, driving or sitting on an overly cushioned couch in an awkward posture can also trigger coccydynia. This is also one of the most coccydynia causes in adults.

  • Body Weight

    Your weight may also be one of the reasons you’re experiencing pain in tailbone area. Obesity results in increased pressure on your coccyx bone when you sit and hence can lead to pain. On the other hand, if you are underweight, the tailbone causes friction from rubbing against neighbouring tissues leading to tailbone pain. Effective weight management by eating the right foods and getting enough exercise can help prevent coccydynia.

  • Pregnancy and childbirth

    Tailbone pain during pregnancy is very common during the last trimester especially as the ligaments in and around the tailbone tend to loosen to accommodate the baby. They can also get stretched or strained during the delivery process and in some cases result in a fractured tailbone, however, this is very rare. Keep your gynaecologist abreast about any issues or pain you may face nearing your due date to avoid complications such as low lying placenta that can cause harm to you or your baby.

  • Haemorrhoids

    Haemorrhoids, otherwise known as piles, is one of the many tailbone pain causes that results in discomfort while sitting and walking. In this condition, the tissues that provide cushion and protection to the anus get inflamed. These muscles tend to tug on the coccyx bone causing pain. Tailbone pain from piles and fistula can be coupled with other symptoms such as bleeding from the anus, itching, swelling and burning.

  • Cancers and Tumours

    In rare cases, coccydynia can be due to an infection, cancer or a tumour. Some types of cancers/tumours that may cause tailbone pain are:
    - Testicular Cancer
    - Chordoma
    - Prostate Cancer
    - Vertebral Tumour
    - Pilonidal Cyst
    - Colorectal Cancer

Chapter 3: Coccydynia Diagnosis: When to see a doctor?

A strain or blow to the coccyx can cause lingering or sudden tailbone pain, that is often never pleasant. Even though it may seem like a good idea to wait it out until it subsides, it is always better to consult an orthopedician at the earliest. In this way, he/she will be able to quickly diagnose and rule out the cause of pain and prescribe a coccydynia treatment plan accordingly.

Here are some ways that you can tell your tailbone has been injured.

  • An intense localized pain in tailbone area
  • Tenderness or swelling around the coccyx bone
  • Pain in the legs
  • Noticeable bruise around the tailbone area
  • Painful bowel movements
  • Discomfort in the lower back during sexual intercourse

Sometimes women may experience tailbone pain during pregnancy. Although this is a common occurrence, it is advised to consult a gynaecologist or an orthopedician for an accurate diagnosis prior to taking any other treatment for the pain.

A coccydynia diagnosis may involve a physical examination to check for any swelling, bruises, mainly to identify a reason for tailbone pain. Further, lab and imaging tests, the most common being an X-ray or an MRI of the spine, may be conducted to check for any signs of a fractured tailbone, or other trauma and injury or if even a tumour might be pressing on the bone. In most cases, tailbone pain is not of concern but in some very rare cases, it can be a sign of cancer.

Chapter 4: Coccydynia Treatment

Tailbone pain usually subsides in a couple of weeks but sometimes it may take months. In rare cases, coccydynia can be chronic. Coccydynia treatment options vary based on the cause, intensity and the duration of tailbone pain. What may work to manage symptoms in one person or even eradicate tailbone pain completely may not work for another. Therefore, it is important that you consult an orthopedician before taking any coccydynia treatment yourself.

Some common coccydynia treatments include:

  • Physiotherapy -  Many have attested to physiotherapy being an effective coccydynia treatment that helps with tailbone pain relief. A physiotherapist may recommend some specific physical movements that help strengthen the supporting muscles around the coccyx. Physiotherapy for coccydynia may also involve pelvic floor relaxation exercises to help ease the discomfort. Another coccydynia treatment in physiotherapy that is used as a tailbone pain remedy is coccygeal manipulation. This tailbone pain treatment involves massaging the muscles supporting the coccyx through the rectum in an attempt to shift it into position.
  • Medication - Medication may be used as a coccydynia treatment when the symptoms and pain are more prominent and even chronic. Doctors may prescribe anti-inflammatory drugs for tailbone pain relief until it fully heals. In more severe cases, doctors may use local anaesthesia injections, nerve block or steroid medication to ease the discomfort. Specific anti-depressants and anti-seizure medications have been known to relieve coccydynia pain as well. However, it is crucial that you discuss coccydynia treatment options with an orthopedician before taking any medication of your own.
  • Surgery - Surgery is done as a last resort when all other coccydynia treatments fail to work. In this case, an orthopedician would carry out a coccygectomy - the removal of part or all of the coccyx bone. However, it is important to note that performing a surgery does not promise instant tailbone pain relief. There is always a risk of infection and so a decision to have a coccygectomy done is something that needs to be considered very carefully with your orthopedician.

Coccydynia home remedies

To help manage symptoms, an orthopedician may also prescribe some tailbone pain treatments you can do at home. Some home remedies for tailbone pain include:

  • Altering your sitting position - Sometimes, tailbone pain from sitting can be attributed to poor posture. By sitting with your back against the backrest along with your feet placed flat on the floor may help to take the strain off the coccyx bone. Ensuring you are leaning forward before you sit and also choosing places that are not hard to sit on are ways to minimize discomfort. An orthopedician may also recommend sitting on a V-shaped or a doughnut-shaped cushion to help relieve pressure on the tailbone.
  • Stretches and Yoga - Stretches are a great way to relieve tension in the muscles supporting the tailbone. Several yoga poses have been known as a great tailbone pain remedy by catering specifically to stretching out and strengthening the muscles attached to the tailbone. Yoga stretches have also been known to ease lingering tailbone pain during pregnancy in women. However, it is important to follow-up with your orthopedician about whether this tailbone pain treatment is helping with the pain or making it worse.
  • Ice treatments - Icing can help in dealing with tailbone pain caused by traumatic injuries. Applying an ice pack to the affected area for 15 to 20 minutes around 4 to 5 times a day post an injury can help in relieving pain and even swelling that may be caused by the blow to the tailbone.
  • Diet - If coccydynia was caused due to severe constipation, then your doctor may recommend eating foods that are rich in fibre to regulate bowel movements, especially soften stools. If your eating habits have not been healthy, a doctor may recommend going on a detox diet or cleanse to reset the body. Eating a balanced diet may also help ease tailbone discomfort caused by weight issues like obesity or even being underweight.

Preventing coccydynia is not possible always as the most common cause of tailbone pain is an accident/fall resulting in an injury to the bone. Other tailbone pain causes like incorrect sitting can be rectified by avoiding prolonged sitting, taking frequent breaks to stretch and ensuring a correct and comfortable sitting posture every time. Also doing full-body checks and obesity risk assessments from time to time may help in preventing coccydynia in the long run. Refer to more of our medical guides for information on treating several other conditions like coccydynia.

Frequently Asked Questions:

  1. What causes tailbone pain?

Some common tailbone pain causes include trauma or injury to the tailbone, prolonged sitting on a hard surface, body weight-related issues and haemorrhoids. In women, tailbone pain is common during pregnancy or delivery. In very rare cases, cancers or tumours may be a cause for tailbone pain.

  1. Does physiotherapy for coccydynia help relieve the pain?

Out of several other coccydynia treatments, physiotherapy is one that has been the most effective in dealing with tailbone pain symptoms. Exercises such as pelvic floor relaxation can help in releasing pressure on the tailbone. Physiotherapy for coccydynia symptoms may also involve physiotherapist-recommended exercises that are specifically designed to strengthen the muscles that work in supporting your coccyx bone.

  1. Can tailbone pain be treated at home?

Absolutely. Some home remedies for tailbone pain include sitting with your back flat against the backrest on a chair with your feet firmly planted on the floor as this helps release the tension of the tailbone area. Other remedies include icing the tailbone area if the pain is due to trauma or injury, yoga stretches and eating a balanced diet with the tailbone pain is caused due to constipation or bodyweight issues.

  1. Is tailbone pain during pregnancy normal?

Yes, it is. Women often complain of pain in tailbone area during their last trimester as the muscles around the coccyx bone shift and stretch to accommodate the baby. Coccydynia pain can also be experienced during delivery. It is advised to let a  gynaecologist know the moment you're experiencing tailbone pain so that a temporary coccydynia treatment plan can be put in place to manage symptoms.

  1. Is surgery an effective coccydynia treatment option? 

Surgery that involves the removal of part or the entire coccyx bone is usually done if other treatments fail to work. This is known as a coccygectomy. This method of treatment does not always promise instant tailbone pain relief as surgery always carries a risk of infection. Therefore, before choosing to do a coccygectomy it is important to thoroughly consider the potential risks involved in this mode of treatment.

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