Bothobesityand sudden weight loss can be weight-related causes.
Symptoms of tailbone (coccyx) pain can vary.
This article discusses tailbone pain symptoms, as well as trauma and other causes of tailbone pain without injury.
Illustration by Alexandra Gordon for Verywell Health
Illustration by Alexandra Gordon for Verywell Health
What Is the Tailbone?
The tailbone is a curved bony structure shaped like a triangle at the bottom of the spinal column.
It’s made up of three to five small bones known ascoccygealvertebraeand is 1- to 4-inches long.
The coccyx is located just below the sacrumthe point where the pelvis and spine intersect.
It starts above the gluteal cleft (buttcrack) and can extend to just above the anus.
What Does Tailbone Pain Feel Like?
For some people, coccydynia is a faint, throbbing pain or dull ache.
Depending on the cause, tailbone pain can persist from a few days to a few months.
While short-term pain is considered to last three months, people often experiencechronic pain.
What Causes Tailbone Pain?
The most obvious cause of tailbone pain is acute trauma.
Acute Trauma
A sudden injury to your tailbone can cause this kind of pain.
For example, you might fall hard on your bottom while skiing.
This can cause inflammation or strain of the structures around your tailbone.
If this happens, you may need to see an orthopedic surgeon to reset the bones.
This is because these activities cause repeat pressure or friction on the tailbone.
Pain from repetitive stress injuries typically subsides after avoiding the activity for a while.
On the other hand, low body weights and rapid weight loss can lead to tailbone pain, too.
Childbirth
Vaginal childbirth can put pressure on the tailbone and can cause lingering pain.
This is especially true if the delivery is difficult.
This is because the baby’s head puts pressure on the top of the tailbone.
The use of forceps can also contribute to this kind of pain.
Tailbone pain from childbirth is often brought on by a bone bruise or ligament strain.
Sometimes, though, the tailbone can fracture during childbirth.
Osteoarthritis
Wear and tear from repetitive motions can causeosteoarthritis.
This is a degenerative disease that can affect any joint in the body.
Bone Spurs
Every tailbone is different.
Some people also have abone spuron the lowest tip of the tailbone.
A bone spur is a small, bony growth.
A bone spur can irritate the tailbone area when you sit down.
It can pinch the skin and the fatty tissue between the spur and the chair.
Scoliosis
Some experts report thatscoliosisis a possible cause of tailbone pain.
This is an abnormal curve in the spine.
Nerve Pain
Tailbone pain can also be due to compressed or irritated nerves.
Pelvic floor muscles help support many of your body’s internal organs.
Muscle spasms and irritation of these muscles can causelevator anisyndrome.
This is a condition that causes a dull, aching pain often felt in the tailbone.
It may also be felt in the rectum, the last few inches of yourlarge intestine.
This is often due to defective collagen production from a genetic disorder known asEhlers-Danlossyndrome(EDS).
Infection
Tailbone pain can be brought on by an infection, such as apilonidalcystorpilonidal sinus.
These ulcers form when long-term pressure limits blood flow to the area.
Signs of osteomyelitis include:
Cancer
In rare instances, a tumor can spread to the tailbone.
Primary bone tumors may also occur on the tailbone or in the tailbone area.
A primary tumor is a tumor that happens on its own and is not the result of cancer spread.
This is also rare.
You don’t want to wait too long to see a healthcare provider for a diagnosis.
The pop in of doctor to see for tailbone pain depends on the cause.
An injury to the bone can be treated by an orthopedic specialist or surgeon.
Chiropractors and osteopathic physicians can also assess and treat tailbone pain.
Muscle and ligament pain can be treated by a physiatrist (physical medicine specialist) or physical therapist.
For example, tailbone pain with heavy, painful periods may be assessed by a gynecologist.
Urinary problems with tailbone pain can be diagnosed by a urologist.
When in doubt, check with your primary care provider or local urgent care clinic.
How Is Tailbone Pain Diagnosed?
Your medical history will help your doctor find the cause of your pain.
Let your doctor know about any falls or other accidents that involved your tailbone.
If your pain came on gradually, a physical exam might be necessary.
If the area is tender, it could mean there’s a fracture.
Your healthcare provider may also decide to do arectal exam.
This helps evaluate the range of motion in the joints and ligaments.
It can also reveal tenderness in the area.
Imaging
Sometimes, but not always,x-rayscan identify a tailbone injury.
These x-rays may be done while you’re standing and sitting down.
This can help find the extent of the injury.
It may also find alignment problems, dislocations, or fractures.
In rare cases, your doctor may order amagnetic resonance imaging scan (MRI).
During this scan, a magnetic field and radio waves create images of the internal structures around your tailbone.
This can be used to find cancer or infection.
How Do I Get Rid of Tailbone Pain?
Lifestyle changes can help alleviate most causes of tailbone pain and allow it to heal on its own.
Recovery may take a while.
A bruised tailbone can take between a few days and a few weeks to completely heal.
A fractured tailbone can take up to three months.
You should be able to return to normal daily activities over time as you heal.
A full return to sports depends on the sport.
Lifestyle Treatment Options
Here are some self-care strategies you could do at home.
Special pillows with a face cut out let you lie on your stomach with your head down.
Medication
Your doctor may also recommend a topical or oralnonsteroidal anti-inflammatorydrug (NSAID).
This can help reduce pain and inflammation.
If your pain doesn’t go away after at-home care, your doctor may prescribe a stronger pain medication.
Asteroid injectioninto the joint or ligaments in the tailbone area may also help control pain.
If your pain is due to the ganglion impar, a nerve block may help.
This is an injection that helps block pain signals.
Infection can be treated with antibiotics.
It may also need to be surgically drained.
In very rare cases, you may need surgery to remove your tailbone, known as acoccygectomy.
This surgery is only performed as a last resort after more conservative treatments have failed.
Preventing Tailbone Injury
Acute tailbone injuries can’t always be prevented.
Still, you’ve got the option to take steps to stop them from happening.
Aphysical therapistcan offer exercises that can help you recover from your specific injury.
In rare cases, tailbone pain may be resulting from an infection or cancer.
See your healthcare provider if your pain is severe or does resolve with self-care strategies.
A tailbone lump or signs of infection like fever and redness are also reasons to seek treatment.
You may also need imaging.
Tailbone pain can usually be treated at home.
Medication may also help.
Some causes of pain can be treated with physical therapy.
Rarely, you may need surgery.
2023 Oct 27;18(1):802. doi:10.1186/s13018-023-04098-5.
2023 Jul 1;36(3):272-280. doi: 10.3344/kjp.23175.
Icahn School of Medicine at Mount Sinai.Tailbone trauma - aftercare.
2023 Jun;65:102770. doi:10.1016/j.msksp.2023.102770.
Chilaka C, Toozs-Hobson P, Chilaka V.Pelvic floor dysfunction and obesity.Best Pract Res Clin Obstet Gynaecol.
2023 Aug;90:102389. doi: 10.1016/j.bpobgyn.2023.102389.
2020 Jan;97(1):168-178. doi: 10.1111/cge.13624.
2014;8(6):705710. doi:10.4184/asj.2014.8.6.705
Foye PM.Coccydynia: tailbone pain.Phys Med Rehabil Clin N Am.
2017 Aug;28(3):539-49. doi:10.1016/j.pmr.2017.03.006
