Why does my tailbone hurt?
by Aaron Lobo on Feb 28, 2022
Medically reviewed by Meredith Goodwin, MD, FAAFP — Written by Zawn Villines
Tailbone pain or pain in the coccyx may occur suddenly after an obvious injury. It can also appear over time, with no apparent cause. Pain in the tailbone or coccyx, the lowest part of the spine, may radiate to the hips, thighs, or rectum.
It can make sitting difficult, exercise painful, and may even disrupt sleep. The right treatment, as well as some home management strategies, can help.
This article explores the causes of tailbone pain, its diagnosis, and available treatment options.
The technical term for tailbone pain is coccydynia. The causes and symptoms of tailbone pain can vary between people.
Some people may experience tailbone pain as a dull, throbbing ache that feels like a muscle spasm, while others may feel a sharper, stabbing sensation.
Pain around the coccyx can worsen when a person is physically active or sits for long periods. Sometimes, depending on the cause, tailbone pain may also coincide with:
- nausea and vomiting
- loss of sensation
- muscle weakness
- digestive discomfort, including pain in the rectum
Causes of tailbone pain
A wide range of health issues can cause tailbone pain. Sources of tailbone pain include, but are not limited to, the following:
- Physical injury: Physical damage to the coccyx or the tissue surrounding it is the most common cause of tailbone pain. Falls, knocks, and trauma experienced in childbirth can all cause coccyx injuries.
- Cartilage degeneration: As the cartilage in the spine wears down, vertebrae may rub against each other, causing pain. Changes in the spine can also place excess pressure on the coccyx.
- Pelvic floor dysfunction: Damage to a person’s pelvic floor muscles can lead to localized discomfort.
- Infections: An infection of the spine or the tissue surrounding it can lead to pain in the tailbone region.
- Tumors: Bone cancer in the coccyx can lead to pain.
Management of tailbone pain
A person can typically manage their tailbone pain with home remedies, such as:
Over-the-counter painkillers and anti-inflammatories can help a person manage immediate pain symptoms. These medications may include ibuprofen, paracetamol, and aspirin.
Topical ointments, such as Voltaren gel, may also help.
Gentle stretching and light exercise, such as yoga and pilates, can help to stretch the muscles around the coccyx. This may help alleviate pain related to minor back injuries or those caused by being seated for too long.
Massages and posture corrections may also help to relieve the pain of muscular injuries.
Wedge-shaped or U shaped pillows like Apilloz may be beneficial for people that must remain seated for long periods. These can help reduce the pressure put on the tailbone.
Applying ice or heat to the affected area, whether with packs or topical creams, can help increase blood flow and reduce inflammation. This may provide immediate topical relief for pain symptoms.
Pillows that can help with tailbone pain are available for purchase online.
When to see a doctor
Tailbone pain is rarely a cause for serious alarm. However, people should seek emergency care if the pain is due to a sudden trauma and they experience:
- a loss of sensation
- extensive bruising
- changes in movement or coordination
- tingling in surrounding areas
If a person experiences tailbone pain without an obvious physical injury it may be the result of an underlying condition. A person should seek medical help if they are experiencing any of the following:
- unknown tailbone pain that does not improve after two weeks
- chronic pain that improves but then returns
- home treatment makes the pain worse
- other unexplained symptoms accompanying tailbone pain
- a fever
Treatment for tailbone pain usually focuses on managing symptoms. The most common strategies include:
Physical therapy: The physical therapist may recommend strengthening the surrounding muscles, supporting the pelvic floor, or moving and sitting in a way that is less likely to irritate the tailbone.
Prescription pain medication: If symptoms are not responding to over-the-counter treatments, a doctor may prescribe prescription pain medications.
Surgery: A surgeon can address physical issues such as pelvic floor prolapse or herniated discs. Treatment may require the removal of a portion of the coccyx.
Injectable medications: Injectable steroids can often alleviate pain. This may help with muscle tension while a person works with a physical therapist to address the underlying cause of the pain.
Treatment for underlying medical conditions: Muscle stress from other conditions, such as hemorrhoids, may cause tailbone pain. Treating these underlying causes can help reduce pain around the tailbone.
Sometimes coccyx pain requires no treatment. People who experience tailbone pain during pregnancy may find that their symptoms resolve within a few weeks of giving birth, while pain that is due to an injury may get better without treatment.
Tailbone pain is typically the result of physical injury to the coccyx and the surrounding tissue.
Childbirth can often result in tailbone pain. Impact trauma or sitting on hard surfaces for extended periods may also cause damage to the coccyx and surrounding muscles.
People can treat most cases of tailbone pain with over-the-counter medication, light exercise, and seating aids/pillows. However, a person should consult a doctor if the pain persists or if they can’t determine the cause of the pain.
A doctor will typically recommend prescription pain medication, physical therapy, and possibly steroid injections for the treatment of more severe tailbone pain. In some cases, a person may require surgery to repair any bone or muscle damage that is causing pain.