Rear End Relief: Treating Tailbone Pain with Ease

The term “coccydynia” refers to pain in the tailbone. The tailbone, or coccyx, is located at the very bottom of your spine and consists of three to five fused vertebrae.The tailbone plays several important roles. It helps stabilize and support your body when sitting, and it serves as an attachment point for various tendons, ligaments, and muscles. However, when the tailbone becomes painful, it can significantly disrupt daily activities and diminish your quality of life.

How Common Is Tailbone Pain?

Tailbone pain is relatively common. It’s five times more likely to affect women and those assigned female at birth (AFAB) compared to men and those assigned male at birth (AMAB). This condition is more prevalent in adolescents and adults than in children.

What Are the Symptoms of Tailbone Pain?

Symptoms of tailbone pain (coccydynia) can include:

• A dull ache or sharp, piercing pain in the tailbone.
• Pain that worsens when moving from sitting to standing.
• Pain during bowel movements.
• Discomfort during sexual activity.

Additional symptoms that may be experienced by those with tailbone pain include:

• Lower back pain.
• Sciatica.
• Sleep disturbances.
• Depression.
• Anxiety.

What Causes Tailbone Pain?

Several factors can lead to tailbone pain, including:

• Falls: A severe fall can bruise, fracture, or dislocate the tailbone.
• Repetitive Strain Injuries (RSI): Activities like cycling and rowing, which involve repetitive motion, can strain the tissues around the tailbone.
• Pregnancy or Childbirth: Hormonal changes in the third trimester soften the area between the tailbone and sacrum, increasing flexibility for childbirth but potentially overstretching muscles and ligaments, leading to pain.
• Excess Weight: Carrying extra weight adds pressure to the tailbone, causing it to lean backward, resulting in discomfort.
• Low Body Weight: Insufficient fat in the buttocks can lead to the tailbone rubbing against surrounding muscles, ligaments, and tendons, causing inflammation.
• Prolonged Sitting: Sitting for extended periods, especially on hard surfaces, can exert excess pressure on the tailbone.

Causes of Tailbone Pain Without Injury

In very rare instances, tailbone pain might indicate the presence of cancer near the coccyx or cancer that has spread to the bones. Although uncommon, the cancers most likely to cause tailbone pain include:

• Chordoma
• Prostate cancer
• Colorectal (colon) cancer

If a tumor is the cause of tailbone pain, additional symptoms may include:

• Numbness or tingling in the arms, legs, or groin
• Difficulty with urination or bowel movements
• A visible lump near the tailbone

Diagnosis and Tests

Your healthcare provider will start by reviewing your medical history, asking about any past injuries or trauma, such as falls or complications during childbirth. They will then examine the tailbone area to check for fractures, lumps, or abscesses (infections).

What Tests Can Help Diagnose Tailbone Pain (Coccydynia)?

To determine if there is a fracture, your healthcare provider may recommend:

• X-rays
• CT (computed tomography) scan

To detect inflammation, abscesses, or tumors, the following tests might be suggested:

• MRI (magnetic resonance imaging)
• Bone scan

Management and Treatment

How Do Doctors Treat Tailbone Pain (Coccydynia)?

The treatment for tailbone pain depends on its cause and severity. While home remedies may be sufficient in many cases, persistent pain might require nonsurgical or surgical interventions.

Home Remedies for Tailbone Pain

In 90% of cases, individuals with tailbone pain experience relief through home remedies. Some suggestions include:

• Taking NSAIDs (nonsteroidal anti-inflammatory drugs) to reduce pain and inflammation.
• Using a donut pillow or wedge-shaped cushion to alleviate pressure on the tailbone.
• Taking a hot bath to relax muscles and ease pain.
• Applying hot or cold packs to the lower back for 20 to 30 minutes several times a day.
• Taking stool softeners if bowel movements cause pain.

Nonsurgical Treatments for Tailbone Pain

If home remedies are ineffective, or if the pain persists, your healthcare provider might recommend nonsurgical treatments, such as:

• Coccygeal nerve block (injections of numbing medications and steroids to relieve pain and inflammation)
• Massage therapy (though relief is often temporary)
• Physical therapy to improve posture and stretch muscles
• Acupuncture
• TENS (transcutaneous electrical nerve stimulation)

Surgical Treatments for Tailbone Pain

In extremely rare cases, surgical options may be considered, such as:

• Partial coccygectomy (removal of part of the coccyx)
• Total coccygectomy (removal of the entire coccyx)

Recovery from coccygectomy can take several months, and there is no guarantee that the pain will be eliminated. Because of this, surgery is only recommended when all other treatments have failed.

Can Tailbone Pain (Coccydynia) Be Prevented?

While it’s not always possible to prevent tailbone pain, especially when it results from accidents or underlying health conditions, there are steps you can take to reduce your risk:

• Avoid sitting for prolonged periods, particularly on hard surfaces.
• Exercise caution during activities like cycling that could strain the tailbone.

To minimize your risk of falls, consider the following:

• Keep floors and walkways free of clutter.
• Install a handrail on stairs if possible.
• Ensure stairways are well-lit.
• Avoid using your phone while walking.
  

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