Tailbone pain — pain that occurs in or around the bony structure at the bottom of the spine (coccyx) — can be caused by trauma to the coccyx during a fall, prolonged sitting on a hard or narrow surface, degenerative joint changes, or vaginal childbirth.
Tailbone pain can feel dull and achy but typically becomes sharp during certain activities, such as sitting, rising from a seated to a standing position or prolonged standing. Defecation and sex also might become painful. For women, tailbone pain can make menstruation uncomfortable as well.
Tailbone pain, also called coccydynia or coccygodynia, usually goes away on its own within a few weeks or months. To lessen tailbone pain in the meantime, it might help to:
- Sit completely upright with proper posture — keeping your back firmly against the chair, knees level with your hips, feet flat on the floor and shoulders relaxed
- Lean forward while sitting down
- Sit on a doughnut-shaped pillow or wedge (V-shaped) cushion
- Apply heat or ice to the affected area
- Take over-the-counter pain relievers, such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin, others) or aspirin
If your tailbone pain doesn't improve (chronic coccydynia), consult your doctor. He or she might do a rectal exam to rule out any other conditions. Depending on the circumstances, he or she might refer you to a specialist in anesthesiology, physical medicine and rehabilitation, or orthopedic surgery. Your doctor or the specialist might recommend using magnetic resonance imaging (MRI) to find out if you have a fracture, degenerative changes or, in rare cases, a tumor.
Possible treatments for chronic tailbone pain might include:
- Physical therapy. A physical therapist might show you how to do pelvic floor relaxation techniques, such as breathing deeply and completely relaxing your pelvic floor — as you would while urinating or defecating. He or she might also show you exercises to strengthen your abdomen and pelvic floor.
- Manipulation. Massaging the muscles attached to the tailbone might help ease pain. Manipulation is typically done through the rectum.
- Medication. An injection of a local anesthetic into the tailbone can relieve pain for a few weeks. Certain antidepressants or anti-epileptic medications might relieve tailbone pain as well.
- Surgery. During a procedure known as a coccygectomy, the coccyx is surgically removed. This option is typically only recommended when all other treatments fail.