Coccydynia, also known as tailbone pain, is an uncomfortable condition that affects the small bone at the very bottom of your spine—the coccyx. It’s a relatively rare condition, but coccydynia can seriously interfere with your daily life. People with this condition often struggle with pain while sitting, standing from a seated position or normal pelvic movements. It has many causes and can impact anyone, but thankfully, treatment is usually nonsurgical.
The spine care team at Summit Orthopedics in the Minneapolis/St. Paul area can diagnose spine problems from neck to tailbone, then build custom treatment plans based on a conservative, nonsurgical approach. If conservative care does not relieve symptoms, our spine care team can refer you for surgical options. Together with you, we will determine the right course of action.
What Is the Coccyx?
The human tailbone is more than an evolutionary leftover. This structure helps support and stabilize your body in a sitting position, maintains the correct positioning of the rectum, and plays a role in pelvic floor stability. When you sit, it tucks under your buttocks to provide support, effectively creating a tripod that evenly distributes your weight.
You can’t move your tailbone independently, but this structure does move with your spine. The coccyx connects several important structures, including ligaments and muscles that allow pelvic movements.
The tailbone is not actually a single bone. It’s made up of several vertebrae connected to the sacrum (the fused section at the base of the spine) by a joint called the sacrococcygeal joint. This allows the tailbone vertebrae to move back and forth.
Interestingly, not everyone has the same number of tailbone vertebrae, and mobility can vary. Tailbones are usually made up of four vertebrae, but also it’s not unusual for a person to have three or five. Between these vertebrae, you will find intercoccygeal joints. For some people, these joints are very mobile and very similar to synovial joints. For others, movement is minimal. In all cases, the coccyx is connected to several important spine and pelvic structures that help you maintain balance.
Coccydynia Symptoms
Most people don’t realize how much they rely on their tailbone until they experience coccydynia. Tailbone pain can feel different for everyone, but most people with coccydynia notice:
- Pain during sex or during bowel movements
- Pain that worsens when sitting or leaning back
- Persistent pain between the buttocks
- Sharp pain when moving from sitting to standing
- Tenderness at the base of the spine
Tailbone pain can vary from person to person. It may be dull, sharp, stabbing or throbbing, and it can radiate or feel like a muscle spasm.
Coccydynia Risk Factors
Anyone with a tailbone can experience coccygeal pain, but it is more common in some groups than others.
Women are five times more likely to develop coccyx pain than men, largely because of injuries during childbirth. Additionally, women’s tailbones are usually situated further back in the pelvis, and that position can make it more likely to be injured.
People with obesity also tend to experience tailbone pain more often. This may be due to weight distribution and pressure when sitting.
On the other hand, significant weight loss can also contribute to tailbone pain. With less cushioning, there’s more direct pressure on the coccyx.
People with osteoarthritis may also be at higher risk—especially if they experience a fall or develop bone spurs.
Coccydynia Causes
Coccydynia can be related to inflammation in the intercoccygeal joints, strained coccygeal muscles, misalignment or even a broken bone. Although it’s not always possible to pinpoint the cause of coccydynia, common causes include:
- Bone spurs or abnormal spinal curvature. These bone conditions can put extra pressure on coccygeal muscles and nearby nerves.
- Childbirth. During pregnancy, hormones will allow your tailbone to naturally become more flexible for childbirth. However, this can also allow the ligaments and muscles to stretch too much and change the angle at which you support your tailbone. This can result in additional pain.
- Injury or trauma. A backward fall or contact sports can easily bruise or fracture the coccyx.
- Pilonidal cyst. These cysts form near the tailbone and can become infected, contributing to coccygeal pain.
- Pregnancy. The pressure of pregnancy can loosen and strain the ligaments and muscles surrounding the coccyx.
- Repetitive stress. Participating in sports that require repetitive movements at the base of your spine—like bicycling or rowing—can strain tailbone tissues.
- Sitting for long periods of time. Prolonged pressure on the tailbone, especially on hard surfaces, can irritate the sacrococcygeal joint and surrounding tissues.
Diagnosing Coccydynia
If you’re experiencing tailbone pain that doesn’t go away on its own, it’s important to get an accurate diagnosis. During your medical visit, your provider will review your symptoms and medical history. They will also perform a physical exam to check for tenderness, swelling or signs of spinal misalignment. Your provider may also recommend diagnostic imaging, such as an X-ray or MRI, to assist in diagnosing your pain.
Coccydynia Treatment
In many cases, coccydynia will heal on its own within weeks or a few months—even without medical treatment. Treating tailbone pain may be faster if you reduce inflammation, avoid activities that worsen pain, provide extra support while sitting and follow your provider’s guidance.
Nonsurgical Treatment for Coccydynia
Nonsurgical treatment for coccydynia focuses on managing the pain and restoring function with conservative care.
- Cushions and supports. Specially designed cushions (like donut-shaped or wedge pillows) help offload pressure from the tailbone while sitting.
- Ice and heat therapy. Applying ice packs can help reduce swelling after an acute injury, while heat pads can relax tight coccygeal muscles and ligaments.
- Injections. For moderate to severe cases, nerve block (a combination of numbing medications and steroids) injections may offer temporary relief by reducing inflammation around the coccyx.
- Medications.Over-the-counter pain relievers like ibuprofen or acetaminophen can reduce inflammation and make movement more comfortable. For more severe cases, the team at Summit Orthopedics may prescribe stronger medications or targeted pain relievers.
- Physical therapy. A skilled physical therapist can teach you exercises to strengthen the pelvic floor, stretch the lower back and correct posture. They may also perform manual therapy to gently massage and stretch the coccyx.
- Self-care, including modifying activity. Avoiding prolonged sitting and taking frequent breaks can prevent further irritation. If your job involves desk work, try using a standing desk or setting reminders to change positions every 30 minutes.
If nonsurgical options don’t relieve your symptoms, your spine specialist can help you determine next steps.
Stay active and support total spine care
Coccydynia can be frustrating, but it’s manageable. Understanding the role of the coccyx and how to protect these tiny but important joints can help you make informed decisions about your care. Whether your pain stems from an injury, prolonged sitting or an underlying condition like a pilonidal cyst, the right combination of self-care, physical therapy and medical treatments can get you back to feeling like yourself again.
Summit Orthopedics has nearly 30 convenient locations across the Minneapolis/St. Paul metro area, serving Minnesota and western Wisconsin. Our state-of-the-art, comprehensive orthopedic centers offer same-day appointments from a team of experts who offer the full scope of orthopedic care.
Find your Summit Orthopedics spine expert, request an appointment or call us at (651) 968-5201 to schedule a consultation.
