You probably never gave your tailbone a single thought, until it started to hurt. Tailbone pain is centered at the very bottom of your spine, right above your buttocks, where this multi-segmented bone sits. The tailbone is small, but it does have a few important jobs. It helps to stabilize you when you sit, and many tendons, muscles, and ligaments run through the area.
Your doctor might call your tailbone by its medical name: the coccyx. The word comes from the Greek term for “cuckoo,” and it was named because the coccyx looks a lot like the beak of the bird. Pain in your coccyx is called coccydynia.
Pain from an injured tailbone can range from mild to intense. The pain can get worse when you sit down or stand up from a chair, or when you lean back while sitting. You can also feel soreness when you use the bathroom or have sex. Women may feel discomfort in that area during their period.
Sometimes the pain can shoot all the way down your legs. Standing or walking should relieve the pressure on your tailbone and ease discomfort.
Your tailbone might have started hurting after something as simple as sitting on a hard bench or other uncomfortable surface for a long period of time. Falls and other traumas can bruise, dislocate, or break your tailbone.
Joint damage from repetitive motions or general wear and tear from aging can also contribute to tailbone pain. During the last trimester of pregnancy, the ligaments connected to and around the coccyx naturally loosen to make room for the baby. According to the National Health Service, that’s why women are about 5 times more likely to experience tailbone pain than men. You’re also more prone to tailbone problems if you’re overweight. But if you lose the weight quickly, you’ll lose the padding that protects your tailbone and you may be more likely to injure it.
In rare cases, the cause of coccyx pain may be an infection or tumor.
When to contact your doctor
See your doctor if the pain is severe or lasts more than a few days. Most of the time, tailbone pain isn’t serious. It can sometimes be a sign of an injury. In very rare cases, tailbone pain can be a sign of cancer.
You may get an X-ray or MRI scan to look for signs of injury, such as a bone fracture or a tumor pressing on the bone. X-ray pictures may be taken both sitting and standing to show possible problems with your tailbone in different positions. The doctor will also feel around the area for any growths that might be putting pressure on your coccyx.
The pain should go away in a few weeks, or sometimes months. You can try over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve discomfort until your tailbone heals. These drugs include ibuprofen (Motrin, Advil) or naproxen (Naprosyn). Acetaminophen (Tylenol) also can relieve pain. For more severe pain, your doctor can inject a local anesthetic, nerve block, or steroid medicine into the area. Some people get a combination of anesthetic and steroid injections. You can also take an antidepressant or anti-seizure medicine by mouth to ease the pain. Be sure to discuss your treatment options with your doctor.
To ease discomfort, sit on a heating pad or ice pack, or go for a massage. The way you sit also matters. Poor posture can put too much pressure on your coccyx. Sit with your back against the chair and your feet flat on the floor to take the weight off your tailbone. Lean forward when you go to sit down. You can also sit on a special donut-shaped pillow or wedge-shaped cushion to relieve pressure on that sensitive area.
A physical therapist can show you exercises to strengthen the muscles that support your tailbone. These include your stomach muscles and pelvic floor. You can also try a technique called coccygeal manipulation. This is when a doctor inserts a gloved finger in your rectum and moves the tailbone back and forth to shift it back into position.
Most of the time, these treatments will relieve your pain until your tailbone heals. If no treatment has worked, your doctor might recommend surgery as a last resort to remove part of or the entire coccyx. This procedure is called a coccygectomy. Surgery doesn’t always work right away. It can take time before the pain goes away. In some cases, it doesn’t work at all. Surgery can also carry risks, like infection. It’s a decision that you need to make very carefully with your doctor.
Start with home pain-relief measures like NSAIDs, heat, and massage. If your tailbone still hurts, check in with your doctor, who can help you find a treatment that works for you.