Coccydynia, or tailbone pain, refers to persistent pain at the very bottom of your spine. Our video walk-through can help you picture how tailbone pain develops:
Your tailbone (cocyx), which is highlighted below in blue, is made up of small bones. There is limited movement in the coccyx, and its size can vary from person to person.
Common causes of tailbone pain
Pain may develop in your tailbone due to any of the following:
- An injury or sudden force, such as falling down the stairs and/or slipping off a ladder
- Excess pressure on the area, which may be caused by sitting for long periods on a hard chair and/or sitting with added weight on your lap
- During childbirth, the baby's head may press against the tailbone and force it backward
Any of the above events can force your coccyx to move beyond its limited range of motion. This in turn may lead to symptoms of both local inflammation and pain.
Rare causes of tailbone pain
Tailbone pain may be caused by other rare factors, including:
- The bones of the coccyx can fracture due to serious trauma to the area
- A tumor or infection in the coccyx
When seated, a woman's hips are typically tilted forward, and the sacrum is rotated outward.
As a result, women are more likely to bear weight on their tailbones when they sit, and are more likely to injure their tailbone in a fall. Therefore, coccydynia is more prevalent in women than men.
Additionally, individuals who are overweight are more likely to develop tailbone pain. This is because pelvic rotation, including movement of the coccyx, is lessened in individuals who are overweight. This in turn leads to more stress on the coccyx
The diagnosis of tailbone pain typically begins with a doctor reviewing your medical history, and this will likely include questions regarding how your symptoms developed.
Next, your doctor may perform the following tests:
- Palpation to check for local tenderness
- Intrarectal exam and manipulation
- Dynamic X-ray imaging tests
Symptoms and treatment
The above image pictures ligaments being stretched as the tailbone moves beyond its normal range of motion. When your tailbone is moved beyond its normal range of motion, you may notice your pain is worse when you switch from a sitting to standing position. Sexual intercourse may also aggravate your pain.
The good news is that tailbone pain usually heals on its own.
But if your tailbone pain persists, it can typically be managed with the following conservative measures:
- Cold therapy
- Heat therapy
- Diet changes, including increases fiber and water intake
- Activity modification, including less sitting
If your pain persists in spite of the above conservative treatment measures, you can discuss the possibility of surgery with your doctor. However, surgery for coccyx pain, known as coccygectomy surgery, is rarely recommended and performed. The is because recovery from this surgery is typically long and painful.