Lower Back Pain

Conservative Treatments for Coccydynia

By: Richard Staehler, MD

Treatments for coccydynia are usually conservative and local. The first line of treatment typically includes:

Non-steroidal anti-inflammatory drugs NSAIDs. NSAIDs (such as ibuprofen, naproxen, COX-2 inhibitors) help reduce the inflammation that can cause pain.
A donut-shaped pillow to help take pressure off the coccyx when sitting

Patience is also very important, since it often takes many weeks, or even months, for the pain to subside.

If the pain is persistent or severe, additional conservative treatments may include:

A local injection of a numbing agent (lidocaine) and steroid (to decrease inflammation in the area) can provide some relief.
Some practitioners treat the condition with manipulations.
Stretching the ligaments attached to the coccyx can be helpful.
Physical therapy with ultrasound can also be helpful.

Provided that infection and tumor has been ruled out as a cause of pain (through exam, x-ray, and MRI scan), then prolonged conservative treatment is a reasonable option.