10436 Coccydynia Tailbone Pain

Overview

Coccydynia is the medical term for pain in the tailbone, the small bony structure at the very bottom of your spine. The pain can feel like a dull ache or a sharp, stabbing discomfort, particularly when you sit down, lean back, or get up from a chair.

It is fairly common. Many people experience tailbone pain at some point in their lives, especially those who spend long hours sitting. It is not usually a sign of anything serious.

Anyone can get tailbone pain, but it is most common in teenagers and adults. Women are affected more often than men, likely because the shape of the female pelvis leaves the tailbone more exposed to pressure and injury.

Symptoms

Common symptoms

• Pain at the very bottom of the spine, just above the buttocks
• Pain that worsens when sitting on a hard surface or leaning back
• A sharp or stabbing pain when standing up from a seated position
• Tenderness when the area is touched or pressed
• Pain during a bowel movement or during sex, in some cases

Symptoms in children

• The same type of pain as in adults, often after a fall onto the bottom
• In younger children, you may notice crying or irritability when sitting on a hard surface or during nappy changes

Symptoms in older adults

• Similar pain, sometimes accompanied by stiffness in the lower back
• Pain may be less obvious at rest and more noticeable when standing up from a chair or walking on uneven ground

Causes

Main causes

• Trauma from a fall directly onto the bottom
• Prolonged sitting on a hard, narrow, or poorly padded surface
• Childbirth — pressure from the baby's head during delivery
• Repetitive strain from activities like cycling or rowing
• In some cases, no clear cause is found

Risk factors

• Being female — the tailbone is more exposed to pressure
• Jobs or hobbies that require long periods of sitting
• Obesity or being very thin, which can affect sitting posture
• Arthritis or other spinal conditions that change the alignment of the tailbone
• A previous tailbone injury

When to see a doctor

See a doctor urgently if:

• Sudden numbness or weakness in your legs or the saddle area (the bottom area that would touch a saddle)
• Loss of bladder or bowel control
• A high temperature and redness or swelling around the tailbone

Book a routine appointment if:

• Pain that continues for more than a few weeks despite home care
• Pain that interferes with your daily activities, work, or sleep
• A visible lump or colour change in the area
• Pain after an injury where you are not sure how bad it is

Diagnosis

Your doctor will ask you about your symptoms, what makes the pain better or worse, and whether you have had any falls or injuries. They may press gently around your tailbone to see if the area is tender. This is usually enough to diagnose coccydynia.

Tests that may be done

• No tests are usually needed for a straightforward diagnosis.
• If the pain is severe, long-lasting, or follows an injury, your doctor may suggest an X-ray, CT scan, or MRI to rule out other causes like a fracture or arthritis.

What to expect at your appointment

The examination may feel slightly uncomfortable but is very brief. Your doctor will talk through the likely cause and the steps you can take to ease the pain, and they can refer you for further help if needed.

Treatment

Treatment usually starts with simple steps you can do at home: changing the way you sit, using a cushion to take pressure off your tailbone, and avoiding triggers. If the pain persists, your doctor or physiotherapist can offer additional options. Surgery is rarely needed.

Self-care at home

• Use a well-designed 'doughnut' cushion or a wedge-shaped cushion when sitting to lift the tailbone away from the seat.
• Avoid hard or narrow seats whenever you can — use a small pillow or folded jumper if you have no cushion.
• Take regular breaks from sitting — stand up or walk around every 30 minutes.
• Apply a warm or cold pack to the area for 15 to 20 minutes at a time to help ease discomfort.
• When you sit, lean forward slightly to put more weight on your thighs rather than your tailbone.

Medical treatments

Your doctor may recommend an over-the-counter painkiller or a topical anti-inflammatory gel that is applied to the skin. Always ask your pharmacist or doctor which is suitable for you. If simple measures do not help, a physiotherapist can teach you exercises to relax and stretch the muscles around the tailbone. In some cases, a local injection of a steroid and a numbing medicine into the area may be offered, but this is only after a thorough assessment.

When is surgery considered?

Surgery to remove the coccyx (called a coccygectomy) is considered only in rare cases. It is reserved for people with severe, long-term tailbone pain that has not improved after months of other treatments, and after a careful discussion with a specialist about the risks and benefits.

Living with this condition

Day-to-day, tailbone pain often comes down to managing pressure and movement. Finding a comfortable cushion for work and home, changing positions regularly, and planning breaks during long trips can make a big difference. You may also find relief by adjusting how you get up from a chair — lean forward first, then stand.

Lifestyle tips

• Keep moving with gentle activities like walking or swimming — movement helps prevent stiffness.
• Choose chairs with firm but well-padded seats, and avoid slouching.
• If you cycle or row, adjust your seat and ask for advice on posture to reduce pressure.
• Sleep on your side with a pillow between your knees, or on your back with a pillow under your knees to keep the spine comfortable.

Diet and exercise

Eat a balanced diet with plenty of fibre to avoid constipation, which can make tailbone pain worse. For exercise, start gently and choose activities that do not involve long periods of sitting or direct pressure on the tailbone. If a particular exercise hurts, stop or adapt it.

Mental health and emotional wellbeing

Living with pain can be frustrating and tiring, and it may affect your mood, sleep, or confidence. These feelings are understandable. Talking to someone you trust, or to a counsellor, can help. If you are struggling significantly, do reach out to your GP — support is available.

Prevention

Not all cases can be prevented, but you can reduce your risk by using good sitting posture, taking regular breaks from sitting, and being careful on slippery or uneven surfaces to avoid falls. If you regularly sit for work, investing in a well-padded chair or a tailbone-friendly cushion may help.

Complications

If left untreated

• Persistent pain that becomes chronic and affects daily life
• Reduced mobility or stiffness in the lower back and hips
• Sleep difficulties due to discomfort
• Muscle tension or spasms in the buttock area

Long-term outlook

The outlook is very good. Most people recover within a few weeks or months with simple care. Even if the pain lasts longer, a combination of self-care, physiotherapy, and medical advice helps most people get back to their normal activities. You are not alone — support is available and there are effective ways to manage the pain.

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