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Tailbone Pain (Coccydynia): Causes, Symptoms, Diagnosis & Treatment

The tailbone, also called as the coccyx, is located at the bottom of the spine and supports the pelvis. The multi-segmented bone is small in size and stabilizes your posture while sitting. The tailbone is actually a point of attachment for many muscles, tendons and ligaments.

Tailbone pain [1] is a severe pain developed at the bottom of the spine above the buttocks. Medically termed as coccydynia, the pain can vary from mild to intense. The condition can cause pain while carrying out normal tasks such as walking, sitting down or while leaning back.

In most cases, the pain reduces within a period of [2] few weeks or months. However, there are cases where the pain lasts for longer periods of time and, this can affect your daily activities.

Symptoms Of Tailbone Pain

Although the discomfort can be understood easily, there are a few specific [3] signs that point out the development of the condition.

  • Pain and tenderness above the buttocks,
  • extreme difficulty while sitting down and leaning back,
  • sharp pain during bowel movement, and
  • throbbing pain and discomfort during sexual intercourse.

Causes Of Tailbone Pain

There are various potential factors that trigger the [4] condition.

1. Trauma

One of the major causes of tailbone pain is trauma caused by a fall, where you could have landed on your bottom. The fall can cause the ligaments in the ligament area to inflame. The injury can cause a bruise or a fracture to the coccyx and in some cases, a dislocation of the sacrococcygeal joint can result in [5] coccydynia.

Likewise, activities such as cycling, horseback riding or anything that involves your hip area can increase the extent of the trauma, worsening the condition. Sitting on a hard surface for a long period of time (car or flight journey) can also contribute to the pain. Basically, traumas that cause any kind of strain or inflammation on the pelvic floor muscles can result in coccydynia.

2. Degenerative joint disease

Wear and tear caused to the bones due to [6] repetitive motions and ageing results in the development of degenerative joint disease of the coccyx. The condition is called as osteoarthritis.

3. Vaginal childbirth

Complications during the delivery that raises the need to use a forceps can cause tailbone pain. In this case, the coccyx receives an excess amount of pressure from the baby's [7] head. Typically, vaginal childbirth results in ligament tear or bone bruise, but fracture to the coccyx is also viewed.

4. Unique coccyx morphology

The number of coccygeal bones can vary from one person to the other. More number of bones accord to more issues, such as, some individuals have a [8] spicule which is bony growth in the lowest part of the coccyx. The spicule can cause discomfort and pain when a person tries to sit, as it can pull on the fatty tissue and the skin.

5. Pelvic floor muscle spasms

As the tailbone is an attachment site for the pelvic floor muscles called the [9] levator ani, a muscle spasm or pulls in the area can cause pain, irritation and ache in the coccyx.

6. Nerve pain

The upper part of the coccyx has a bunch of nerves called the ganglion impar. Any sort of irritation caused by [10] exertion due to overactivity can cause tailbone pain.

Apart from these aforementioned common causes of tailbone pain, there are some rare causes that contribute to the tailbone pain. A malignant tumour [11] that has spread to the coccyx, chordoma (a type of bone cancer), and any infections in the tailbone can also act as causes.

7. Obesity

Individuals who are overweight have reduced pelvic rotation and coccyx movement. This can lead to continual stress to the coccyx, resulting in pain.

When To See A Doctor

Tailbone pain is not fatal if left untreated. However, it can cause hindrances in your daily activities and it is best to consult a doctor if you have [12]

  • extensive bruising in the area,
  • changes in movement or coordination,
  • tingling in surrounding areas, and
  • a loss of sensation.

You must go to the doctor if

  • chronic pain reduces, but then returns,
  • the tailbone pain does not improve after a week or two,
  • the pain is accompanied by other unexplained symptoms,
  • you develop a fever,
  • a lump develops on your tailbone, and
  • there is constant pain even after conservative measures.

Diagnosis Of Tailbone Pain

In order to clearly understand the condition, the doctor will carry out a variety of [13] examinations.

1. Physical examination

During this, the doctor will inspect [14] your tailbone for swelling, bruising, rash, or signs of an infection ( redness, warmth, or a discharge). To check if there is any localised tenderness (sign of a potential fracture), the doctor will press the tailbone.

Apart from these, a rectal exam and a pelvic exam will also be carried out.

2. Imaging

In order to assess the extent of the tailbone injury, an [15] x-ray will be taken in standing and seated position. During this, any dislocations, alignment problems, or fractures of the tailbone will be noted down.

3. Blood tests

This will be done to check for autoimmune conditions or infections.

Treatment For Tailbone Pain

The measures will usually be carried out to managing the [16] symptoms of the condition. The most common strategies used for treating tailbone pain include

  • physical therapy,
  • surgery to address any structural problems,
  • prescription pain medication,
  • manipulation,
  • injectable medications,
  • treatment for underlying medical conditions, and
  • psychotherapy.

Management Of Tailbone Pain

There are few self-care methods through which you can help yourself ease the pain or limit the onset of the condition.

  • Lean forward while sitting down,
  • applying ice or heat to the area,
  • gentle [17] massage to the affected area,
  • gentle stretches and exercise,
  • sitting on a doughnut-shaped pillow or wedge cushion,
  • taking over-the-counter pain relievers such as aspirin, ibuprofen etc.,
  • dietary changes to avoid [18] constipation and regulate easy bowel movement,
  • avoid prolonged sitting, and
  • soaking the area in an [19] Epsom salt bath.

Peripheral Artery Disease (PAD): Symptoms, Causes & Prevention

View Article References
  1. [1] Wray, C. C., Easom, S., & Hoskinson, J. (1991). Coccydynia. Aetiology and treatment. The Journal of Bone and Joint Surgery. British volume, 73(2), 335-338.
  2. [2] Maigne, J. Y., Lagauche, D., & Doursounian, L. (2000). Instability of the coccyx in coccydynia. The Journal of bone and joint surgery. British volume, 82(7), 1038-1041.
  3. [3] Patel, R., Appannagari, A., & Whang, P. G. (2008). Coccydynia. Current Reviews in Musculoskeletal Medicine, 1(3-4), 223.
  4. [4] Kaushal, R., Bhanot, A., Luthra, S., Gupta, P. N., & Sharma, R. B. (2005). Intrapartum coccygeal fracture, a cause for postpartum coccydynia: a case report. Journal of Surgical Orthopaedic Advances, 14(3), 136-137.
  5. [5] Maigne, J. Y., Doursounian, L., & Chatellier, G. (2000). Causes and mechanisms of common coccydynia: role of body mass index and coccygeal trauma. Spine, 25(23), 3072-3079.
  6. [6] Resnick, D. (1985). Degenerative diseases of the vertebral column. Radiology, 156(1), 3-14.
  7. [7] Maulana, R., Wahyuniati, N., & Indra, I. (2015, November). Postpartum Coccydynia: an Anatomy Overview. In Proceedings of The Annual International Conference, Syiah Kuala University-Life Sciences & Engineering Chapter (Vol. 5, No. 2).
  8. [8] Maigne, J. Y., Pigeau, I., & Roger, B. (2012). Magnetic resonance imaging findings in the painful adult coccyx. European Spine Journal, 21(10), 2097-2104.
  9. [9] Reissing, E. D., Brown, C., Lord, M. J., Binik, Y. M., & Khalife, S. (2005). Pelvic floor muscle functioning in women with vulvar vestibulitis syndrome. Journal of Psychosomatic Obstetrics & Gynecology, 26(2), 107-113.
  10. [10] Lirette, L. S., Chaiban, G., Tolba, R., & Eissa, H. (2014). Coccydynia: an overview of the anatomy, etiology, and treatment of coccyx pain. The Ochsner Journal, 14(1), 84-87.
  11. [11] Haasper, C., Länger, F., Rosenthal, H., Knobloch, K., Mössinger, E., Krettek, C., & Bastian, L. (2007). Coccydynia due to a benign notochordal cell tumor. Spine, 32(14), E394-E396.
  12. [12] Foye, P. M. (2017). Coccydynia: tailbone pain. Physical Medicine and Rehabilitation Clinics, 28(3), 539-549.
  13. [13] Foye, P. M., & Patel, S. I. (2009). Paracoccygeal corkscrew approach to ganglion impar injections for tailbone pain. Pain Practice, 9(4), 317-321.
  14. [14] Stanos, S. P., McLean, J., & Rader, L. (2007). Physical medicine rehabilitation approach to pain. Anesthesiology clinics, 25(4), 721-759.
  15. [15] Nguyen, B. D., Daffner, R. H., Dash, N., Rothfus, W. E., Nathan, G., & Toca, A. R. (1993). Case report 790. Skeletal radiology, 22(5), 362-366.
  16. [16] Thiele, G. H. (1963). Coccygodynia: cause and treatment. Diseases of the Colon & Rectum, 6(6), 422-436.
  17. [17] Judd, S. J. (Ed.). (2007). Sports Injuries Sourcebook: Basic Consumer Health Information about Sprains and Strains, Fractures, Growth Plate Injuries, Overtraining Injuries, and Injuries to the Head, Face, Shoulders, Elbows, Hands, Spinal Column, Knees, Ankles, and Feet... Omnigraphics Incorporated.
  18. [18] Failes, J. M., & Cawood, F. W. (1988). Natural healing encyclopedia. FC & A Pub..
  19. [19] McLean, L. (1999). U.S. Patent No. 5,958,462. Washington, DC: U.S. Patent and Trademark Office.

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