Coccydynia (aka Tailbone Pain)

Coccydynia is defined as pain near your tailbone. You may experience this pain when sitting down, standing for long periods, getting up from or lowering down into a chair, or bending at the low back or hips.

Your coccyx (tailbone) is the bottom tip of your spine. A number of muscles and ligaments attach to the coccyx, including your pelvic floor muscles and glute max, the bigger muscles that form the back of the buttock.

Pain can occur for a number of reasons, such as a fall directly on your tailbone, fracture, childbirth, bad posture, prolonged sitting, or pelvic floor dysfunction. There are also nerves that run near the coccyx that may become irritated if the coccyx is misaligned. 

Treatment involves finding out why the pain occurred in the first place. The coccyx (tailbone) has a small amount of mobility. This mobility is important for having a comfortable bowel movement and being able to sit and change positions without irritation.

Trauma or increased tension in the pelvic floor muscles can cause the coccyx to get stuck in one position. If the coccyx gets stuck out of alignment or in too much flexion or extension, the muscles that attach to it will have increased difficulty contracting when they need to. Tension in the pelvic floor muscles can also contribute to pulling the coccyx too far forward and into a position that creates pain.

Pelvic floor physical therapists can evaluate the position of the coccyx and mobilize it if needed.

What causes Coccydynia?

Tailbone pain may occur after a fall or other specific trauma. Sometimes coccyx pain can develop months or even years after an injury.

Coccydynia may also develop slowly as a result of poor posture, overactive pelvic floor muscles, pregnancy, childbirth, or from the body compensating for an old injury.

What are symptoms of Coccydynia?

Coccydynia symptoms can vary depending on the origin of the pain.

You may feel sharp or dull pain deeply near your tailbone. The pain may be concentrated at the inferior tip of your coccyx bone or where your coccyx meets your sacrum. It can even refer to your glutes.

Pain resulting from misalignment of the tailbone may also present as pelvic floor discomfort, pain with penetrative sex, or pain with bowel movements.

Some patients experience constipation.

How is Coccydynia diagnosed?

After discussing your symptoms with you, your pelvic floor physical therapist will evaluate the position of your tailbone and the condition of the surrounding muscles and tissue to determine the cause of your discomfort.

How is Coccydynia treated?

Different healthcare practitioners will have different approaches to treating your tailbone pain. Your pelvic floor physical therapist can use different techniques to mobilize the coccyx and free up congested or inflamed tissue in the surrounding musculature. This can involve working externally at the low back and buttocks or internally in the vaginal canal or rectum.

A physical therapist can also identify and treat muscular tension and radiating pain that may have resulted from dysfunction at the tailbone but has spread to other parts of the body.

Coccydynia and pregnancy 

Your body must adapt to changes in your connective tissue and center of gravity throughout your pregnancy. As the pregnancy progresses, the bones that make up the pelvis will widen apart in anticipation of a vaginal birth.

It’s very common to develop increased muscle tension and pain in places where you have never experienced it before. An important function of the pelvic floor muscles is to support the contents of your abdominal cavity.

When you are pregnant, this includes the weight of the growing infant. Muscles in the pelvic floor attach to the bones in your pelvis, including the coccyx.

Increased tension in the pelvic floor and the laxity of the connective tissue in the pelvis during pregnancy can lead to coccydynia.

What are exercises that can help with Coccydynia?

Your physical therapist can teach you techniques for releasing tension near the coccyx.

This may involve muscle energy technique to free a stuck coccyx or using a massage ball to relax tight muscles pulling on the tailbone.

You may also benefit from stretches and mobility exercises that loosen up tight muscles in your hips, low back, and thighs.