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Coccyx / Tailbone pain


Published March 15, 2024

Coccyx tailbone pain, or coccydynia, can turn sitting, standing, and everyday movements into a challenge. 

For such a small, seemingly insignificant thing at the base of your spine, your coccyx can cause some major discomfort! Whether it’s from injury, sitting for too long, childbirth, or just out of the blue, it can have a pretty big impact not just on your body, but on your everyday life. 

We understand the complexity of coccyx pain and are dedicated to guiding you through understanding, managing, and preventing this condition. 

Anatomy of the coccyx

Commonly referred to as the tailbone, your coccyx is a small, triangular bone at the base of your spine. Though tiny, it’s mighty in function. 

Made up of 3-5 fused vertebrae, your coccyx connects to the sacrum above it, acting as a crucial support, especially when sitting. But its location and role in weight distribution means your coccyx is vulnerable to stress and injury. It’s also less protected than other parts of your spine by your body’s natural cushioning, which increases the risk of bruising, dislocation, and fractures. 

It acts as a weight-bearing structure when you sit, especially in a leaning back position. It also serves as an anchor point for tendons, ligaments, and muscles of the pelvic area, helping with stability and control over pelvic floor functions. 

Symptoms of coccyx tailbone pain

Coccyx pain can manifest in different ways, and can deeply affect your daily activities and overall quality of life. Understanding the symptoms and recognising them early on is crucial for getting timely, effective treatment. 

Common symptoms include:

  • Localised pain: Sharp or achy pain at the base of the spine, particularly noticeable when sitting or transitioning from sitting to standing. 
  • Increased discomfort: Pain intensifies while seated on hard surfaces or sitting for prolonged periods. 
  • Tenderness: The area around the coccyx becomes extremely sensitive to touch.
  • Reduced mobility: Difficulty with activities that involve sitting or bending, such as driving or bending over. 

Common causes of coccyx pain

Coccyx pain, while complex, often stems from a few common scenarios. Knowing what triggers this pain is essential for addressing it effectively. Common causes of pain include:

  • Falls: Landing directly on your tailbone can cause bruising, fractures, or even dislocations.
  • Impact sports: Athletes participating in contact sports or activities with a high risk of falls (like cycling or horse riding) are more susceptible to coccyx injuries. 
  • Poor posture: Sitting for extended periods, especially on hard or poorly designed surfaces, can increase pressure on the coccyx, leading to discomfort. 
  • Occupational hazards: Jobs that require long hours of sitting, like desk jobs or driving, can make coccyx pain worse. 
  • Pressure during labour: Pregnancy and childbirth can put significant pressure on the coccyx, leading to pain post-delivery, especially if the tailbone was pushed out of alignment. 
  • Weight changes: Sudden weight gain or loss can alter the cushioning around your coccyx, affecting its load-bearing capacity.
  • Repetitive strain: Activities that involve repetitive sitting and standing can strain the coccyx over time. 
  • Age-related changes: As we age, the coccyx can become more vulnerable due to degenerative changes in the spine and weakening of ligaments. 
  • Post-surgical complications: Patients recovering from spinal or pelvic surgeries might experience coccyx pain as a side effect of the procedure or prolonged bed rest. 
  • Infection of tumours: Though much less common, infections near the tailbone or tumours can also contribute to coccyx tailbone pain. 

Impact on daily life

Coccyx pain doesn’t just linger in the background; it can have a ripple effect on other areas of your life, from physical activities to mental well-being and work efficiency. 

Mobility and activity limitations

Coccyx pain can turn basic movements into hurdles. 

Sitting, standing, and transitioning between the two can become excruciating, limiting your ability to engage in routine activities or enjoy hobbies that once brought you joy. 

This restriction not only affects physical health through reduced activity but can also diminish your overall quality of life – especially if sleep is also affected.

Read more about how to sleep with coccyx pain.  

Professional life and productivity

Work life can often take a hit with coccyx pain. If you have a desk job, the continuous need to sit can worsen your pain and reduce concentration and productivity. 

On the other hand, jobs that require physical labour can also be challenging, as bending, lifting, or even standing for long periods can aggravate your pain. The constant distraction of managing discomfort can lead to decreased job satisfaction and performance. 

Mental health 

Persistent pain can take its toll on anyone’s mental health. In fact, chronic pain is a well-known risk factor for developing conditions like depression and anxiety. The ongoing discomfort can lead to feelings of frustration, helplessness, and isolation. 

Social and recreational impacts

Social interactions and leisure activities often involve sitting or physical activity – both of which can be daunting if you are dealing with coccyx pain. As a result, you might withdraw from social gatherings, hobbies, and sports, leading to isolation and loss of community. 

Self-care and daily routines 

Even the simplest of self-care routines or household tasks can become monumental challenges with coccyx pain. Cooking, cleaning, driving, and shopping all require a level of mobility and comfort that coccyx pain disrupts. 

Diagnosis of coccyx pain

If you have persistent coccyx pain, you’ll likely go through a thorough assessment to rule out other medical conditions and pinpoint the exact cause of discomfort. 

  1. Patient history: A detailed discussion about your symptoms, any recent injuries, and how your lifestyle might be affecting your condition. 
  2. Physical examination: A gentle examination to check for tenderness, swelling, or any abnormalities in the tailbone area. This can help identify the nature of the pain. 
  3. Imaging tests: You may have an X-ray to detect any fractures, dislocations, or degenerative changes, or an MRI/CT scan if soft tissue damage is suspected. If that’s the case, your health practitioner will want to get a detailed view of the muscles around the coccyx, too. 
  4. Other assessments: In some cases, you might need further tests to exclude conditions with similar symptoms. 

Treatments for tailbone pain

Treating coccyx pain often requires a multifaceted approach that combines self-care practices with professional treatment to address both immediate discomfort and long-term recovery. 

Self-care techniques

  • Ice and heat therapy: Alternating between ice packs and heat pads can help reduce inflammation and soothe pain. Ice is especially beneficial in the first few days following an injury, while heat is more effective in chronic conditions. Read more about how to use heat and cold therapy
  • Cushioning and seating adjustments: Did you know you can get specialised coccyx cushions? They’re designed with a cutout at the back to reduce pressure and relieve tailbone pain. Ergonomic chairs that support proper posture are also essential. Read more about how to sit comfortably with coccyx pain. 
  • Activity modification: Adjust your daily activities to avoid prolonged sitting or standing. When sitting is unavoidable, regular breaks and shifts in position can help. 

Professional interventions

  • Physiotherapy: Tailored physical therapy programs are at the core of treating coccyx pain. Techniques can include pelvic floor strengthening, manual therapy to mobilise the coccyx, and exercises to improve posture and flexibility. Read more about how physios for coccyx pain can help below. 
  • Medications: Over-the-counter pain relievers can offer temporary relief for mild coccyx pain. In more severe cases, your healthcare provider might recommend prescription medications to manage pain and inflammation. 
  • Injections: If you’re struggling with more persistent coccydynia, injections such as corticosteroids or nerve blocks might be an option. These are typically reserved for cases where other treatments have not provided relief. 
  • Surgery: In rare cases, where conservative treatments fail to help with pain and quality of life is significantly impacted, surgical options like a coccygectomy (surgical removal of the coccyx) might be explored. This is a last resort, though. 


Coccyx tailbone pain treatment with physiotherapy

The role of physiotherapy in treatment of coccyx tailbone pain

Physiotherapy is really the cornerstone in managing and alleviating coccyx pain. By addressing both the symptoms and the underlying causes of coccyx pain, your physio can craft a personalised treatment plan that fosters healing, improves functionality, and enhances your quality of life. Here’s how.

Initial assessment

You will always have a thorough assessment first, including a detailed history of your condition, a physical examination, and an evaluation of your posture and movement patterns. This first step is crucial in identifying the specific factors contributing to your coccyx pain and allows for your physio to develop a targeted treatment plan. 

Manual therapy

Manual therapy techniques are used to relieve pain, reduce inflammation, and improve mobility in and around your coccyx area. This can include gentle manipulation and mobilisation of the coccyx itself (if appropriate) and the surrounding tissues, helping to alleviate tension and restore normal movement patterns. 

Pelvic floor rehabilitation

The coccyx plays an integral role in pelvic floor function, so your physio will often incorporate pelvic floor exercises into your treatment plan. Strengthening and relaxing your pelvic floor muscles can help manage coccyx pain, especially when it’s related to tension or dysfunction in these muscles. 

Postural education and ergonomics

Improper posture and seating can worsen coccyx pain. Your physio can provide some guidance on ergonomic adjustments and postural techniques to minimise stress on your coccyx during daily activities. This might include recommendations for supportive seating, workplace ergonomics, and strategies for safe lifting and bending. 

Exercise prescription 

It’s always good to have a balance of manual therapy and exercise rehabilitation; one helps with immediate relief of pain while the other builds up your strength around the target area to prevent more pain in the future. 

Specific stretches and strengthening exercises can improve flexibility and muscle tone in the lower back, hips, and core, offering support to the coccyx and alleviating pain. These exercises are designed to be performed safely, both in the clinic and as part of a home exercise program. 

Check out some of the common exercises and stretches used for coccyx pain. 

Pain management strategies

Your physio can also equip you with strategies for managing pain at home, including the application of heat or cold, relaxation techniques, and guidance on over-the-counter pain relief options. Keep in mind that these strategies are meant to complement the hands-on treatment and exercises provided by your physio – not replace them. 

Education and support

Education is an integral part of physio. Understanding your condition, its causes, and how to prevent future episodes empowers you to take an active role in your recovery. Your physio for coccyx pain will provide ongoing support, adjusting your treatment plan as needed based on your progress and feedback. 

Coccyx tailbone pain prevention

Preventing coccyx pain is about taking proactive steps to protect and strengthen the area. By creating a supportive physical environment and being mindful of your daily habits, you can reduce your risk of coccyx pain. 

Optimise your sitting posture

  • Ergonomic seating: Choose chairs that support the natural curve of your spine. You can also use a coccyx cushion, which has a cutout at the back to reduce the pressure on your tailbone. 
  • Alignment checks: Regularly check your posture to make sure your back is straight, your shoulders are back, and your feet are flat on the floor. This alignment reduces strain on your coccyx. 
  • Frequent breaks: Stand up, stretch, and walk around every 30 minutes if your job involves prolonged sitting. This helps relieve pressure on the coccyx and promotes blood flow. 

Tailor your work environment

  • Adjustable desks: If you’re able to, use a standing desk or adjustable workstation to alternate between sitting and standing positions while you work.
  • Computer and desk setup: Ergonomics are important! Position your computer screen at eye level and keep essential items within easy reach to avoid straining your posture. 

Tailbone-friendly activities

  • Strengthening exercises: Try to incorporate exercises that strengthen the muscles around your coccyx, including the pelvic floor, abdominals, and glutes. Strong muscles support and protect the coccyx. 
  • Gentle stretching: Regularly practice stretches that promote flexibility in the lower back and pelvic area, reducing your risk of injury and strain. 

Lifestyle adjustments

  • Mindful movement: Be cautious during activities known to put stress on your coccyx, like cycling or rowing. Always use the proper equipment and techniques to minimise impact.
  • Healthy weight management: Maintain a healthy weight to avoid extra pressure on your coccyx and lower spine, which can worsen pain. 

Listen to your body

  • Address discomfort sooner rather than later: If you start experiencing tailbone pain, don’t ignore it! Early intervention can prevent worsening symptoms and promote a speedier recovery. 

Take control of your coccyx tailbone pain today

Take the first step to conquering coccyx pain with Integrity Physiotherapy, Como. We offer personalised treatments, ergonomic solutions, and effective pain management strategies to help you reclaim your comfort and mobility. 

Don’t let tailbone pain control your life – our experienced team of coccyx pain physios is ready to support you in your recovery. Reach out and book an appointment today.

Leslie Trigg

Director & Senior Physiotherapist at Integrity Physiotherapy Leslie Trigg, has over 15 years of experience in clinical practice. He has graduated with a degree in Human Biology (Anatomy and Physiology) from Curtin University in 2001 and later completed a Masters of Physiotherapy in 2007. He has tremendous experience in musculoskeletal, orthopaedic, neurosurgical and sports physiotherapy. In his spare time, he enjoys swimming, listening to music and spending time with his family.