Tailbone Pain: Causes, Symptoms, Treatment

Tailbone pain is one of those problems that makes you realize how often you sit… which is rude, because sitting is basically the human default setting.
Medically, tailbone pain is often called coccydynia (say it with confidence; nobody will question you). It usually isn’t dangerous, but it can be annoyingly intenseespecially when you’re trying to drive, work, binge a show, or simply exist in a chair like a peaceful adult.

This guide breaks down the real-world causes, the classic symptoms, what doctors look for, and which treatments actually helpstarting with easy at-home fixes and moving up to medical options when your coccyx (that’s the tailbone) refuses to calm down.
(Quick note: this is educational information, not a diagnosis. If you have severe symptoms or “something feels very wrong” vibes, call a healthcare professional.)

What Is the Tailbone (Coccyx), and Why Does It Hurt So Much?

Your coccyx is the small, triangular set of bones at the very bottom of your spine. It’s a meeting point for ligaments, tendons, and musclesincluding parts of your pelvic floorso it’s not just a spare part your body forgot to return.
When the coccyx gets bruised, strained, inflamed, overly mobile, or (less commonly) injured in other ways, pain can flareespecially with pressure from sitting.

Common Causes of Tailbone Pain

1) Direct trauma (the “I fell and saw stars” category)

The most classic cause is a fall backward onto the buttocksthink icy sidewalk, slippery stairs, roller-skating confidence, or a bathtub that tried to end you.
Trauma can cause a bruise, ligament strain, dislocation, or fracture around the coccyx. Sometimes the injury is obvious right away; other times the pain ramps up over a day or two as inflammation builds.

2) Repetitive pressure from sitting (aka modern life)

Prolonged sittingespecially on hard surfacescan irritate tissues around the tailbone. Certain activities that load the area (like cycling, rowing, or riding on bumpy roads) may also trigger coccyx pain, particularly if posture, seat shape, or training volume isn’t doing you any favors.

3) Childbirth and postpartum changes

Vaginal delivery can strain or injure the coccyx, especially during a long labor, assisted delivery, or when baby positioning puts extra pressure on the pelvis.
Postpartum inflammation plus new sitting patterns (hello, endless feeding sessions) can keep the area irritated.

4) Joint hypermobility, instability, or “the coccyx moves too much”

In some people, the sacrococcygeal joints can be unusually mobile (or poorly aligned), which can make sitting and transitions (sitting-to-standing) particularly painful.
Specialized “dynamic” imaging (often done in sitting vs. standing positions) may help identify this in stubborn cases.

5) Pelvic floor muscle tension or dysfunction

The pelvic floor muscles attach near the tailbone. If those muscles are tense, uncoordinated, or guarding due to pain elsewhere, the coccyx region can feel sore, achy, or sharpsometimes alongside symptoms like pain with bowel movements or discomfort during sex.

6) Degenerative changes, arthritis, or referred pain

Wear-and-tear changes in joints, prior injuries, or spine/pelvic conditions can refer pain toward the coccyx region. Not every “tailbone pain” is actually a coccyx problemsometimes it’s coming from nearby structures (lower back, pelvic joints, or soft tissue).

7) Infection, cysts, or tumors (rare, but important)

Most tailbone pain is mechanical and improves with conservative care. But in rare cases, pain can come from infection or a tumor in the region.
Also, conditions near the crease of the buttockslike an infected pilonidal cystcan cause pain that feels “tailbone-ish” but is actually a skin and soft-tissue issue.

Tailbone Pain Symptoms

Tailbone pain can feel different person to person, but the usual pattern looks like this:

• Localized pain at the very bottom of the spine (often midline, just above the anus)
• Worse with sitting, especially leaning back, or sitting on hard chairs
• Sharp pain with transitions (standing up after sitting, rolling over in bed)
• Tenderness to touch over the coccyx
• Pain with bowel movements (and sometimes during sex or urination)
• Radiating ache into the buttocks or nearby pelvic area (less common, but possible)

When to See a Doctor (When Your Tailbone Deserves Backup)

A sore tailbone often improves with time and home care. But you should contact a clinician if:

• The pain is severe, worsening, or doesn’t improve after a couple of weeks
• You develop fever or feel ill
• You have unexplained weight loss, fatigue, or swollen lymph nodes
• You notice numbness, weakness, or bowel/bladder changes
• There’s drainage, a lump/mass, rectal bleeding, or significant rectal pain
• The pain is constant and atraumatic (it came out of nowhere and won’t let up)

Those symptoms don’t automatically mean something scarybut they are a good reason to get evaluated rather than white-knuckling it through meetings and car rides.

How Tailbone Pain Is Diagnosed

History and “tell me exactly what hurts” details

Clinicians usually start by asking about a fall or injury, pregnancy/childbirth history, sitting patterns, and which movements trigger pain.
The timeline matters: sudden onset after trauma often suggests a bruise or sprain; gradual onset may point to overuse, posture-related stress, pelvic floor involvement, or other sources.

Physical exam

A typical exam includes palpation (pressing) over the coccyx to see if pain is focal. Providers may also check the lower back, hips, and pelvic region to rule out referred pain.
In select cases, a rectal exam may be used to assess coccyx mobility or muscle tension and to look for concerning findingsawkward, yes, but sometimes informative.

Imaging (only when it’s useful)

Imaging isn’t always necessary for mild, improving pain. But if symptoms are severe, persistent, or follow significant trauma, a clinician may order:

• X-rays to look for fracture or dislocation
• Dynamic sitting/standing X-rays to evaluate instability or hypermobility in stubborn cases
• CT or MRI when fracture is unclear, pain is persistent, or there’s concern for non-mechanical causes (like mass, infection, or other pelvic issues)

Treatment: From Home Remedies to Medical Options

Step 1: The “Make Sitting Less Terrible” starter pack

Most tailbone pain improves with conservative treatment. The goal is to reduce pressure, calm inflammation, and keep muscles from guarding.
Practical options include:

• Activity modification: Avoid long sitting sessions; stand up and move every 20–30 minutes if possible.
• Ice or heat: Ice can help early after an injury; heat may help muscle tension later. Use whichever feels better.
• OTC anti-inflammatories: If safe for you (and OK with your clinician), NSAIDs like ibuprofen can reduce pain and swelling.
• Seat support: A wedge-shaped cushion (often a “cut-out” cushion) can offload pressure better than a classic donut for some people.
• Leaning forward: Shifting weight off the tailbone can reduce painyes, you may look like you’re dramatically contemplating your life choices. Worth it.
• Stool softeners: If bowel movements are painful, a clinician may suggest options to reduce straining while the area heals.

Step 2: Physical therapy (especially pelvic floor-focused care)

If pain lingers, physical therapy can be a game-changer. Treatment may include posture coaching, hip and low-back mobility work, core conditioning, and pelvic floor strategies.
Pelvic floor physical therapy may also include relaxation techniques and breathing patterns to reduce muscle guardingbecause “clenching everything” is not a long-term wellness plan.

Step 3: Manual therapy and targeted techniques

In selected cases, clinicians or therapists may use manual techniques to relax muscles connected to the coccyx or address joint mechanics.
Some approaches involve internal (rectal) manipulation to mobilize the coccyx or release muscle spasmdone by trained professionals, and only when appropriate.

Step 4: Medications and injections

If home care and therapy aren’t enough, a clinician may consider:

• Local anesthetic injection near the coccyx for temporary relief (and sometimes diagnostic clarity)
• Corticosteroid injection to reduce inflammation in painful joints or surrounding tissues
• Nerve-targeting procedures such as a ganglion impar block, which can reduce chronic coccyx pain in some people

Injection-based care isn’t a magic wand, but it can calm pain enough for rehab to finally sticklike giving your body a quieter room to heal in.

Step 5: Surgery (rare)

Coccygectomysurgical removal of the coccyxis considered only when symptoms are persistent, severe, and resistant to conservative treatment, and when evaluation suggests the coccyx is truly the pain generator.
It can help selected patients, but it’s not a first-line option, and recovery can be significant.

Prevention: Protect Your Tailbone Like It Pays Rent

• Upgrade your sitting setup: A supportive chair, good lumbar support, and a cushion can reduce flare-ups.
• Move often: Micro-breaks beat “I sat perfectly still for four hours like a decorative lamp.”
• Train hips and core: Strength and mobility reduce strain on pelvic structures.
• For cyclists: Check saddle shape/tilt, bike fit, and riding volumesmall tweaks can have big consequences (good ones).
• Fall-proof your life: Traction in shoes, careful stairs, and winter awareness save a lot of coccyges.

Quick FAQ

How long does tailbone pain last?

Mild injuries may improve in days to weeks. More significant inflammation or trauma can take weeks to months. If pain persists, recurs, or limits daily life, it’s worth getting evaluated.

Is tailbone pain ever a sign of something serious?

Rarely, yesespecially if it’s constant, unexplained, or accompanied by fever, neurologic symptoms, weight loss, rectal bleeding, drainage, or a mass. Most cases are benign, but red flags deserve attention.

What’s the best cushion for tailbone pain?

Many people do well with a wedge-shaped cushion with a coccyx cut-out, because it reduces direct pressure. Some prefer donut cushions; it depends on anatomy and comfort. If one cushion makes it worse, try another style.

Conclusion

Tailbone pain can be dramatic (and incredibly inconvenient), but it’s often treatable with simple strategies: offload pressure, reduce inflammation, improve mechanics, and let tissues calm down.
If symptoms persistor if you have warning signs like fever, neurologic changes, or unexplained weight lossget evaluated so you can rule out uncommon but important causes and move toward targeted treatment.

Real-Life Experiences: What Tailbone Pain Feels Like (and What Actually Helped)

People describe tailbone pain in surprisingly specific waysbecause once your coccyx is mad, it makes sure you notice. A common story starts with something simple: “I sat down and it felt like I sat on a Lego… internally.”
Others describe a deep ache that feels fine while walking but turns spicy the second they sit, especially if they lean back. The most frustrating part is that it can hijack normal routines: commuting, desk work, meals out, movie nights, even driving.

One frequent scenario is the “office chair betrayal.” Someone switches jobs, starts commuting more, or spends a few intense weeks glued to a chair. At first it’s mild sorenesseasy to ignore. Then it becomes the thing you plan your day around:
choosing seats, shifting positions, standing during calls, and inventing new ways to perch like a worried bird. In those cases, the biggest wins often come from boring fixes that feel too simple to matter: a coccyx cut-out cushion,
timed standing breaks, leaning slightly forward, and a chair setup that doesn’t dump all your weight directly onto the tailbone. People often report improvement once they treat sitting like an activity with techniquenot a passive hobby.

Another common experience is postpartum tailbone pain. New parents describe a weird combination of soreness and sharp pain, especially when sitting to feed the baby (which, tragically, is a lot of sitting).
What helps tends to be a mix of pressure relief and gentle restoration: cushions, avoiding slumping backward, short walks, and pelvic floor-focused therapy when symptoms linger. Many also say that addressing constipation and straining
makes a noticeable differencebecause tailbone pain plus painful bowel movements is a double feature nobody asked for.

Then there’s the classic fall. Some people bruise the area and recover quickly; others get a longer-lasting ache that shows up every time they rise from a chair.
A pattern many describe is “fine once I’m moving, awful during transitions.” That’s a clue that inflammation and local mechanics are involved. People who do best often combine temporary pain control
(ice early, heat later, OTC anti-inflammatories when appropriate) with gradual return to movement. If symptoms persist, a clinician might recommend imaging to rule out fracture or dislocationespecially after a significant injury.

Chronic cases can feel especially discouraging because the pain is “small” in location but huge in impact. Folks often say they start avoiding social plans, workouts, or long drivesthen feel frustrated that a tiny bone is calling the shots.
In those situations, targeted care tends to matter more than toughness. Pelvic floor therapy can help when there’s muscle guarding; guided strengthening and mobility work can reduce strain; and for stubborn pain, injections or nerve-targeting procedures
may provide enough relief to make rehab effective again. The biggest emotional shift people report is moving from “I’m broken” to “I’m irritatedbut treatable.”
Tailbone pain may be stubborn, but it’s rarely unbeatable.