Coccyx Pain

By Sally Ann Quirke, Chartered Physiotherapist | Filed under: Buttocks and Legs

Published: 28 November 2015

People do not believe just how severe and debilitating coccyx pain (coccydynia) can be - unless, of course, you experience it for yourself! It is usually a pain localised to a specific point on your “tailbone” “bum bone”. The coccyx is the bone at the very base of your spine - the one that you sit on every day!

Quite often, people with coccyx pain cannot sit in a normal posture as they have to place all their weight to one side of their bottom, to avoid the excruciating pain that results from sitting directly on the injured bone - even when sitting on a special coccyx cushion or pillow.

Causes of Coccyx Pain

There are many causes of coccyx pain, however, the most common cause that I encounter in my physiotherapy practice is as a result of trauma resulting from falling onto your bottom. Common examples include falling on ice or down a stairs. The resulting pain (the medical term is Coccydynia) in these situations comes from a deep bruise or even fracture to the bone itself.

Bony bruising is incredibly painful and very slow to resolve - It can take months. However, that does not mean you can do anything about it! I commonly encounter patients who have had a fall onto their bottom - say six months previously - and they are still in pain! Quite often their doctor has advised them the only cure is rest. But when the pain does not ease, they have sought physiotherapy assistance.

If the pain has not eased over time, then often this is because the earlier fall caused their coccyx to move out of its correct alignment, and the only cure is to correct the mal-alignment of the coccyx. It takes an experienced chartered physiotherapist (Physical Therapist in the United States) to do this for you.

For this type of injury, my advice is to seek a physiotherapist’s advice if your coccyx pain lasts longer than ten days. More often than not the alignment of your coccyx will have been altered by a hard fall. Rest and time will not correct this problem. The earlier you seek physiotherapy/physical therapy advice the better.

Another common cause of this type of pain is due to tightness or over-activity in a muscle in your bottom. Muscles that attach to your coccyx can cause pain in this area. If they become overactive, or tight, they can directly pull your coccyx out of alignment - usually resulting in pain. Other situations can result in tight muscles or ligaments altering the movement of your coccyx, again causing a mechanical pain in your bottom! In these cases, we look to treat the overactive muscle, to loosen it and ease the pain.

Another cause of coccydynia that I see results from the bones above the coccyx being too stiff or out of alignment. If the joints above the coccyx are not moving efficiently - they can cause the coccyx to move incorrectly, this will often lead to inflammation and pain in and around the area of the coccyx. The solution for this type of pain is to resolve the movement problem in the joints responsible. Again, a physiotherapist/ physical therapist (USA) will do this for you.

Never ignore your pain for too long. Time will not resolve this type of pain in your coccyx - actually time will worsen the condition greatly!

Sometimes, I treat back pain and even neck-related pain that has occurred secondary to coccydynia, often resulting from poor movement patterns that have developed over time to protect the body from coccyx pain. So, if you have pain in the coccyx area lasting longer than ten days always seek a physiotherapist’s advice. Physiotherapists are trained to diagnose and treat alignment issues of the coccyx, and often can detect resolved which x-rays and doctors may not see.

Finally, if you have a desk or driving job and are sitting in a poor posture you may also develop pain in your “tailbone”. Most patients that I see with sitting-related back pain sit too far back on their coccyx. We call this a slumped posture. Over time, this may result in excess pressure on your coccyx which will eventually scream at you to stop by giving you pain!!! Sit tall! Learn how to sit correctly and make it a habit!