Tailbone pain—also known as coccydynia—can make even the simplest daily tasks like sitting, driving, or bending forward feel unbearable. Though it’s a lesser-known condition, coccydynia can significantly disrupt quality of life, especially when left untreated.
In this post, we’ll explore what coccydynia is, its common causes and symptoms, how it’s diagnosed, and the most effective conservative and medical treatment options available today.
What Is Coccydynia?
Coccydynia is inflammation or pain in the coccyx, the small triangular bone at the base of the spine, often referred to as the “tailbone.” The coccyx plays a minor but important role in weight-bearing when seated, and it serves as an attachment site for ligaments and muscles of the pelvic floor.
Pain in this area can be dull and achy or sharp and stabbing—especially when sitting or standing up from a seated position.
Common Symptoms of Coccydynia
The hallmark symptom of coccydynia is pain in the tailbone region, especially when sitting. However, additional symptoms can include:
- Localized tenderness directly at the tailbone
- Pain when moving from sitting to standing
- Discomfort during bowel movements or intercourse
- Aching pain that worsens with prolonged sitting
- Pain that improves when standing or lying down
Some patients may also feel referred pain into the lower back, buttocks, or legs, though this is less common.
Mechanism of Injury (MOI): What Causes Coccydynia?
Coccydynia can develop from a variety of causes. The most common include:
1. Direct Trauma
A fall directly onto the tailbone—like slipping on ice or falling backward onto a hard surface—is the most frequent cause. Even if the bone isn’t fractured, the impact can inflame the surrounding ligaments and tissue.
2. Repetitive Microtrauma
Activities that place repeated stress on the coccyx, such as cycling or rowing, can lead to irritation and inflammation over time.
3. Childbirth
Vaginal delivery can cause strain, dislocation, or bruising of the coccyx, especially in prolonged or difficult labors.
4. Degenerative Joint Changes
Like other joints, the small joints of the coccyx can undergo wear and tear, leading to inflammation and pain.
5. Poor Sitting Posture
Slumping or sitting on hard surfaces for long periods can shift weight abnormally to the coccyx and increase pressure on the tailbone.
6. Idiopathic
In some cases, no specific cause can be identified. This is referred to as idiopathic coccydynia.
Diagnosis: How Is Coccydynia Identified?
Diagnosis typically begins with a clinical exam and patient history. Your provider will ask about the nature of the pain, recent falls, activities, and how symptoms change with different positions.
A physical exam may include:
- Palpation of the coccyx to identify tenderness
- Rectal exam to assess for internal tenderness or dislocation
- Posture and mobility assessment
Imaging Tests (used when pain is severe or persistent):
- X-rays: To evaluate for fractures or alignment issues
- MRI: To rule out infections, tumors, or disc issues
- Dynamic sitting/standing X-rays: Can detect instability or abnormal motion of the coccyx
Treatment Options for Coccydynia
Fortunately, most cases of coccydynia resolve with conservative management. Here’s a breakdown of commonly used treatments:
1. Activity Modification
- Use a donut or wedge cushion to reduce direct pressure on the tailbone when sitting
- Avoid sitting for long periods when possible
- Use a standing desk to reduce pain with work
2. Manual Therapy
Soft tissue work, joint mobilizations, and muscle release techniques by a chiropractor or physical therapist can help reduce local inflammation and restore mobility to surrounding joints.
3. Exercise-Based Rehabilitation
A structured rehab plan can improve pelvic stability, core strength, and posture. Key focus areas include:
- Pelvic floor coordination
- Deep core activation (transversus abdominis)
- Hip mobility (especially external rotation and extension)
- Gluteal and lumbar spine strength
4. Shockwave Therapy
Radial or focused shockwave therapy can stimulate healing in chronically inflamed tissues and improve circulation around the coccyx region. It’s particularly helpful for cases that don’t respond to manual therapy alone.
5. Medications
NSAIDs (non-steroidal anti-inflammatory drugs) can help reduce inflammation and ease pain in the short term.
6. Injections
For persistent or severe pain, a corticosteroid injection or nerve block at the coccygeal region can provide significant relief and confirm diagnosis.
7. Surgery (Rare)
In rare cases where pain is disabling and unresponsive to conservative care, a coccygectomy (removal of the coccyx) may be considered. This is reserved as a last resort.
Prognosis and Outlook
Most people with coccydynia improve with conservative care within a few weeks to months. Early intervention with proper ergonomics, manual therapy, and structured rehab can accelerate recovery and prevent chronicity.
However, if left unaddressed, tailbone pain can become a long-term issue that limits activity and quality of life—especially for those in sedentary jobs or postpartum individuals.
Don’t Sit in Pain—We Can Help
If tailbone pain is interfering with your daily life, don’t wait for it to go away on its own. Our team at Central Ohio Spine and Joint specializes in diagnosing and treating complex musculoskeletal conditions—including coccydynia.
We use a blend of manual therapy, progressive exercise rehab, and regenerative modalities like shockwave therapy to get you back to pain-free sitting, working, and moving.
Ready to Find Relief?
Click the link below to schedule a consultation and start your personalized recovery plan today.
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