Tailbone Pain (Coccydynia)

Coccydynia is tailbone pain that occurs at the tip of the tailbone between the buttocks.

Inflammation of the tailbone (coccyx or bony area located deep between the buttocks above the anus) is referred to as coccydynia. Coccydynia is associated with pain and tenderness at the tip of the tailbone between the buttocks. Sitting often worsens coccyx pain.

An injury or trauma may cause inflammation of the coccyx, but it may occur seemingly spontaneously. There are many causes of pain in the area of the tailbone that can mimic tailbone pain (coccydynia), including

• sciatica,
• infection (including shingles of the buttocks),
• pilonidal cysts,
• sacroiliitis, and
• fractured bone (broken tailbone or tailbone fracture).

Why does my tailbone hurt?

Your tailbone pain is most likely due to an injury to the coccyx or pelvic bones, which can result from a fall on the tailbone, prolonged sitting on a hard surface, or trauma during childbirth. Other possible causes include strain from activities like cycling, as well as discomfort from being overweight or maintaining poor posture.

At times, you might experience discomfort in your tailbone without any injury, and this could probably be a sign of cancer near your coccyx or metastatic cancer. Some of the cancers associated with tailbone pain include:

• Chordoma
• Colorectal cancer
• Prostate cancer

Along with tailbone pain, you may experience additional cancer symptoms, which include:

• Difficulty peeing or difficulty with bowl movements.
• Numbness or tingling in the arms, legs, or groin
• A visible mass around the tailbone

Although it is rare for tailbone pain to be caused by cancer, it is important to consult a health care professional for a thorough evaluation if you have concerns.

Other tailbone pain causes include:

• Pregnancy
• Hemorrhoids
• Vertebral tumor

The major risk factor for coccydynia is an injury to the coccyx or pelvic bones. Tailbone injury occurs when you fall backward and land on your tailbone, causing it to bruise, dislocate, or break. Repetitive strain, such as from sports or cycling, can also cause tailbone pain. Cycling, in particular, involves repetitive motion that stresses the tissues surrounding the tailbone.

Pain and local tenderness that occur at the coccyx are the major symptoms of coccydynia. Tailbone pain can lead to difficulty sitting or leaning against the buttocks. Along with the coccyx pain with sitting, there is typically exquisite pain in the tailbone area.

Doctors may diagnose coccyx inflammation based solely on the symptoms and the examination findings of local pain. Other conditions can be excluded by the examination (such as shingles, which typically would be associated with local rash) and another testing (to exclude bone or tissue disorders, such as with a CAT scan or MRI scan).

Patients with coccydynia are advised to use a well-padded seat when sitting and avoid long periods of sitting when possible.

How do you relieve tailbone pain?

Tailbone pain can be relieved with home remedies such as rest, heat application, ice packs, and stretches as well as over-the-counter pain relievers.

The following home remedies may help reduce tailbone pain:

• Avoid prolonged sitting and lean forward while sitting down
• Apply heat or ice to the affected area
• Take a hot bath to relax muscles and ease pain
• Use a wedge-shaped gel cushion or coccygeal cushion (donut pillow) when sitting
• Lie on your side to reduce the pressure on the coccyx
• Stretch the muscles of the lower back and pelvis
• Wear loose-fitting clothing
• Take stool softeners to reduce pain during bowel movements
• Avoid activities that worsen the symptoms
• Take over-the-counter pain relievers, such as Tylenol (acetaminophen), Advil (ibuprofen), or aspirin

Treatment for patients with persistent coccydynia involves local cortisone injections. This corticosteroid shot is simply performed in the doctor's office and can potentially dramatically relieve chronic pain and even resolve the symptoms for many. Sometimes, the injection includes fluoroscopy or ultrasound ( to help guide the injection site )

Physical therapy with exercises can be helpful with a patient's recovery. Rarely, when patients have unrelenting or severe coccyx pain, surgery can be performed on the coccyx to remove the irritated bony prominence.

If your tailbone pain does not improve despite these measures, consult a doctor who can help rule out other serious conditions such as a tailbone, hip, or spinal fracture. If the condition becomes severe or persistently troublesome, then medical attention should be sought to accurately evaluate the cause of the pain, especially if there is associated bruising or rash.

The majority of people with coccydynia have complete recovery in response to the conservative treatments described above.

Call your doctor immediately if your tailbone pain is accompanied by other symptoms such as:

• A sudden increase in swelling or pain
• Sudden numbness, weakness, or tingling in either or both legs
• Constipation that persists for a long time
• Inability to control bowels or bladder movements

Because coccydynia is associated with injury, avoiding trauma to the coccyx bone is the best method of preventing coccydynia.

• How to fix tailbone pain: To fix tailbone pain, you can maintain a good sitting posture, take nonsteroidal anti-inflammatory drugs (NSAIDs), sit on a donut pillow or wedge-shaped gel cushion, and apply hot or cold packs to the affected area.
• How do I know if my tailbone pain is serious? Your tailbone pain may be serious if you experience the following symptoms:
  • Pain that doesn’t subside
  • Pain in other areas, such as your hips or lower back, along with tailbone pain
  • A fever of 103 F or higher
• Does tailbone pain go away? Tailbone pain usually goes away on its own within a few weeks to months with proper care. However, if the pain persists or worsens, it’s important to consult a health care professional.
• What causes tailbone pain without trauma? Tailbone pain is often caused by prolonged sitting, poor posture, or repetitive activities. Other common causes include pregnancy, muscle tension, infections, and age-related changes. While rare, serious conditions such as cancer, especially chordoma, colorectal cancer, or prostate cancer can also lead to tailbone pain.
• Can walking cure tailbone pain? Walking may help relieve pressure on the tailbone and ease discomfort, but it cannot cure tailbone pain.
• How to sleep with coccyx pain: If you have coccyx pain, you should sleep on your abdomen to take the pressure off the tailbone.
• What is the best medicine for tailbone pain? Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or acetaminophen are the most prescribed medicines for tailbone pain, as they effectively reduce pain and swelling.