“I’ve never been aware of this part of my body and now I’m battling to even sit. What is going on? The base of my spine is so tender and it stabs as I stand up. Why is this happening to me?’ my patient asked me today.
What is Coccyx Pain?
Coccyx or tailbone pain (also called coccydynia) refers to pain in the sacrococcygeal region resulting from pressure on the coccyx. The exact cause of the pain is usually unknown, but falling onto the coccyx and vaginal birth can be factors. It is five times more common in females than males. Obesity and advancing age are also contributing factors.
When you see how many of the pelvic floor muscles attach to the tailbone, it’s no surprise that these are often involved with tailbone pain.
I treat a lot of coccyx pain in my pelvic health physio practice and many of the ladies have struggled for years without ever having their pelvic floor muscles assessed.
What helps if your tailbone hurts?
The following is what I usually advise the ladies I treat:
- Your pelvic floor muscles are probably a little tight. So practice inhaling into your belly and imagine your anus melting and softening to lengthen your pelvic floor.
- Avoid constipation. Increased weight on the pelvic floor muscles from 💩 in your rectum can make them tighten.
- Try and keep a little arch in your lower back when you are sitting on a chair. A rolled towel under your sit bones can help with this. This puts the pelvic floor muscles in a more optimal position so you don’t get that stabbing pain as you stand up!
- Avoid prolonged sitting on hard surfaces where possible. A donut cushion can be a HUGE help in taking some of the pressure off of your coccyx while you are sitting too.
- Check you aren’t holding your tummy in all the time. Over gripping the upper abdominal muscles can increase intra abdominal pressure and make the muscles activate in return.
- See a pelvic floor physio! They will check your pelvic floor muscles and ideally do vaginal or rectal exam to help you to connect to and lengthen the muscles and help to release them internally with a little myofascial release ‘massage’.
- Take painkillers to help alleviate the pain, just make sure they don’t constipate you and exacerbate the problem.
- Stretch your hips and lower back.
- Focus on overall stress reduction in your life. Remember that after three months, pain can be exacerbated by stress and your nervous system being overwhelmed. The more you can relax your body and mind, the better your coccyx should feel.
- ONLY consider surgery as a very last resort. Removing the tailbone can be done, but I have yet to treat anyone who has had full relief from this surgery. This should only be done if all other conservative treatments have failed.
Tailbone pain can be very frustrating and debilitating, but seeing a pelvic health physio could really help you.
References:
Algain, A. et al. (2024) ‘Chronic coccydynia and coccygectomy: A case report and review of the literature’, Cureus [Preprint]. doi:10.7759/cureus.71400.
Kodumuri, P. et al. (2018) ‘Coccydynia – could age, trauma and body mass index be independent prognostic factors for outcomes of intervention?’, The Annals of The Royal College of Surgeons of England, 100(1), pp. 12–15. doi:10.1308/rcsann.2017.0089.