Tailbone Pain Uncovered: Causes, Relief, and Effective Treatments

Let's talk about tailbone pain, which is quite literally a pain in a lot of people's ass. The tailbone, or coccyx, is a small triangular bone that can be tricky to deal with and is often a source of frustration for both patients and medical providers trying to manage patient pain. Why? Let's dig into this pelvic floor topic and learn more.

Anatomy of Your Coccyx:

The tailbone sits at the very base of the spine where it attaches to the sacrum. It bends and stretches in a way that's similar to the lower part of your back. It's a place where different parts, like ligaments, tendons, and muscles from your lower back and bottom area, attach.

In addition to being an attachment site, the tailbone's role is to act as one leg of a tripod (the other two legs being your sit bones) to provide weight-bearing support when you sit and help support the position of the anus.

The Major Causes of Tailbone Pain:

There are many different reasons why the tailbone can become painful, including external trauma, internal trauma, and non-traumatic causes to your coccyx.

-External trauma: A direct fall onto the tailbone leading to bruising, dislocation, or even breaking. Additionally, repetitive or prolonged sitting on hard, narrow, or uncomfortable surfaces.

-Internal trauma: Childbirth, especially during a difficult delivery or if an instrument like forceps was used. As well as surgical injuries to your tailbone area.

-Non-trauma: Pregnancy, due to hormonal changes and added pressure on the spine from the growing baby. Degenerative joint or disc disease, joint hyper-mobility (too much mobility) or hypo-mobility (stiffness), rapid weight loss resulting in loss of cushioning, or the pain might actually come from a different area, like a muscle spasm in your pelvic floor.

In most cases, pain will usually worsen with sitting for an extended period, leaning back while sitting, standing for a long time, walking, driving, or standing up from a seated position. Some people also experience pain with intercourse or when pooping.

When should I see a doctor for tailbone pain?

You should consult a doctor if the pain is severe, persists for more than a few weeks, interferes with your daily activities, or is accompanied by unexplained weight loss or fever.

Treatments for Coccyx/Tailbone Pain:

Finding an effective treatment for tailbone pain can be challenging. The most common approach is to change the surface on which you are sitting or use a wedge-shaped or donut cushion. This can help alleviate some of the pain but might not address the underlying cause unless there was a direct injury to the tailbone.

Traditional medical management usually consists of pain-relieving medications, injections, or nerve blocks in and around your tailbone area. Removal of the tailbone is considered a very last resort if all other therapies fail, which sounds absolutely horrifying to us!

Pelvic Floor PT Treatments for Coccyx/Tailbone Pain

Of course, since you're reading a Pelvic Floor Physical Therapy blog, we have to highlight this option. Pelvic Floor Physical Therapy is a safe and conservative way to treat tailbone pain in patients of any age and gender.

What does a Pelvic Floor Examination look like for tailbone pain?

First, we investigate the underlying causes of your pain, including examining your posture and movement patterns that might be affecting your tailbone. Then, we check your tailbone directly. This can be done externally, but the most accurate way to assess the mobility of your tailbone and your pelvic floor muscles contributing to your pain is through a rectal exam. We understand this may be uncomfortable, but it provides us with the best information on how to treat your pain effectively. The information we gather through the exam helps us tailor treatments to address the root causes of your pain. Below is an example of what that exam looks like, and it would be conducted on your side while completely covered with a comfortable sheet in a private room.

A Pelvic Floor PT exam of the Tailbone & Coccyx area

Experiencing tailbone pain and not sure if Pelvic Floor PT is the right thing to do?

Give us a call or send a contact form in, and we’d be happy to chat!

Written by Chicago Pelvic very own, 

Dr. Rebekah Wolinetz, PT, DPT, WCS, PRPC, PCES, Cert. DN