A quick look at tailbone pain symptoms
- Aching (dull) or stabbing pain at the base of the spine
- Pain while sitting down or standing up
- Painful bowel movement
- Pain during intercourse
- Pain during your menstrual cycle
- Back pain and sciatica
- Sleep disorders
- Depression and anxiety
Coccydynia is observed in both males and females; however, women seem to be affected more frequently than men.. Gender-specific risk factor in females is trauma related to giving birth; the coccyx may endure substantial pressure as the baby descends through the mother’s pelvis.
Coccydynia can occur in children and adults. Degenerative changes of the sacrococcygeal junction and the intercoccygeal junctions, as well as fusion at these sites, seem to increase with age.
What should you know about tailbone pain?
In medical terms, ‘Coccydynia” is used for pain in your tailbone. Your tailbone (coccyx) is located at the very end of your spine, composed of three to five fused vertebrae (bones).
Your tailbone performs several vital functions. When you sit, it provides stability and support. It also serves as the attachment point for various tendons, ligaments, and muscles. However, if your tailbone hurts, it is literally a pain in the rear, and it can interfere with daily activities and your quality of life. It is nonetheless treatable.
If the pain persists and affects your daily life, consult a healthcare professional.
What is causing the tailbone pain?
Common causes of tailbone (coccyx) pain include:
1. Pregnancy and childbirth:
During pregnancy, your body releases hormones, especially the hormone relaxin, which relaxes and softens the pelvic area, including the space between your tailbone and sacrum. Relaxin increases the laxity of ligaments, making them more flexible to accommodate the baby’s development and assists in childbirth. Sometimes, this can stretch the muscles and ligaments around the tailbone enough to cause pain.
Childbirth is a common cause of tailbone pain. During delivery, the ligaments and muscles around the coccyx can become stretched and strained, resulting in discomfort. Although rare, the bones in your coccyx could also break during labour.
Furthermore, changes in posture during pregnancy to accommodate the baby’s weight also exert pressure, causing the pelvis to tilt forward. This tilt can lead to pain in the pelvic region and tailbone. The weight of the growing baby also puts pressure on the tailbone. This may cause the pelvic floor muscles, which are attached to the tailbone, to contract more tightly, resulting in pain.
You may still feel pain months after giving birth. Talk to your doctor if the condition doesn’t improve.
2. An injury or accident, such as a fall onto your coccyx:
Tailbone pain can be caused by an injury, such as falling backwards and landing on your tailbone. Such a fall can bruise, dislocate, or break your tailbone. The pain can also result from injuries from repetitive strain.
These injuries can happen when you’re playing sports or engaging in activities like bicycling that require repetitive motion, which can strain the tissues around your tailbone.
3. Repeated or prolonged strain on the coccyx
If you sit on a hard surface, on a narrow surface, or in an uncomfortable position for too long, that can cause minor trauma to the tailbone. Repetitive sitting in these positions can also cause pain.
4. Being overweight or underweight:
Carrying too much weight puts extra pressure on your coccyx when you sit down, which can lead to tailbone pain.
However, if you don’t have enough fat in your buttocks to cushion the area, your tailbone can rub against the muscles, ligaments, and tendons, causing inflammation and pain.
5. Age:
As you age, you lose subcutaneous fat in the area, which can contribute to pain. Additionally, as you get older, the cartilage that helps hold the coccyx in place degrades, so the small bony segments fuse more tightly.
6. Joint hypermobility
Increased flexibility of the joint that attaches the coccyx to the bottom of the spine
However, sometimes the cause of tailbone pain is unknown.
How do doctors diagnose tailbone pain?
First, a doctor will review your medical history. They’ll ask about any past injuries or trauma to your tailbone area, like falls or a difficult childbirth. Next, they’ll examine the area to check for fractures, lumps, or abscesses (pockets of infection).
To check for a fracture, your doctor may follow these steps:
- Step I- An X-ray: to show whether your coccyx has been fractured or dislocated
- Step II- A CT (computed tomography) scan or MRI (magnetic resonance imaging): to see fractures, as well as tumours and cancer.
- Step III- A bone scan: to determine whether you have inflammation and tumours, if the CT scan and MRI are inconclusive.
What treatment plan should be followed?
Tailbone pain treatment depends on the cause and the severity of your discomfort. Home remedies might be all you need. But if home remedies don’t work, your doctor may recommend nonsurgical or surgical treatments.
Home remedies for tailbone pain
In 90% of cases, people with tailbone pain find relief with home remedies. Here are some things you can try:
- Take NSAIDs (nonsteroidal anti-inflammatory drugs) to reduce pain and swelling.
- Sit on a donut pillow or wedge-shaped gel cushion to take pressure off your tailbone.
- Take a hot bath to relax your muscles and ease pain.
- Apply hot (to relax the muscle) or cold (in case of recent injury or inflammation) packs to your lower back. Apply for about 20 to 30 minutes, several times a day.
- Take stool softeners if you have pain when you poop.
Nonsurgical treatments for tailbone pain
If home remedies don’t work, or if your pain keeps coming back, your doctor might recommend nonsurgical treatments, like:
- Coccygeal nerve block (an injection of numbing medications and steroids to relieve pain and inflammation).
- Massage therapy, which your doctor does through your rectum, can help relieve pain from muscle spasms or ligament pain.
- Physical therapy to stretch your muscles and improve your posture.
- Acupuncture.
- TENS (transcutaneous electrical nerve stimulation).
Surgical treatments for tailbone pain
In extremely rare instances, your doctor may recommend:
- Partial coccygectomy (removal of part of your coccyx).
- Total coccygectomy (removal of your entire coccyx).
Recovery time from a coccygectomy can take several weeks to several months. Even after a surgeon removes the bone, there’s no guarantee that your pain will go away. For this reason, doctors only recommend coccygectomy when other treatments don’t work.
Treatment for cancerous coccydynia:
If the underlying cause of your coccydynia is cancer, your doctor can recommend the appropriate cancer treatment, such as radiation, chemotherapy, and surgery.
If you have a pilonidal cyst, your doctor may numb the area and make an incision to drain the cyst. If it comes back, you may need surgery to remove it.
Additional treatments
You may experience other symptoms in addition to tailbone pain, particularly with chronic coccydynia. If you develop conditions like depression or anxiety, it’s essential to get treatment for these issues, too. Ignoring these symptoms can affect your quality of life.
What should you do to prevent tailbone pain in the future?
You can’t always prevent tailbone pain because it often occurs after accidents or as a symptom of an underlying condition.
You might be able to reduce your risk if you:
- Avoid sitting for long periods of time, especially on hard surfaces.
Use caution when cycling or participating in other activities that could cause tailbone pain
There are also things you can do to reduce your risk of falls:
- Keep your floors and pathways clear.
- Install a railing for your stairs, if possible.
- Try to keep stairways well-lit.
- Avoid looking at your phone when walking.
Tailbone pain can be annoying, but most of the time it doesn’t indicate a serious health issue. However, you should call a healthcare provider if you have tailbone pain that doesn’t go away, additional pain in your hips or lower back, or a fever of 103 degrees Fahrenheit (39.4 degrees Celsius) or higher. A healthcare provider can give you a diagnosis and help you find appropriate treatment.
Frequently asked questions:
What can I expect if I have tailbone pain?
Tailbone pain usually goes away on its own in a few days with the help of home remedies and a little bit of patience. It can take a little longer for more severe injuries. But if you have tailbone pain that doesn’t go away (chronic coccydynia), your healthcare provider can do an exam to determine why.
Will tailbone pain improve after childbirth?
For most women, tailbone pain eases soon after childbirth. Unfortunately, sometimes the instability caused by loose ligaments during pregnancy and the trauma of delivery can lead to ongoing tailbone pain and postpartum pelvic floor dysfunction. If over-the-counter medication and physical therapy don’t work, some individuals may benefit from corticosteroid injections. Doctors try to avoid these injections during pregnancy because they are usually guided by fluoroscopy, an imaging technique that uses X-rays.
Only in the most severe cases, your doctor may recommend surgery. This would likely not be considered until after delivery, and only if the more conservative treatments are not effective.
Can tailbone pain and injury be prevented?
You can’t always prevent tailbone pain because it often happens after accidents or as a sign of an underlying condition. You might be able to lower your risk by practicing good posture, especially when sitting for long periods, avoiding sitting on hard surfaces for extended periods, or trying exercises that strengthen your muscles, boost flexibility, and keep you healthy and strong.
When should I see my doctor for tailbone pain?
You should see your doctor if you have severe coccyx pain, your pain worsens over a few weeks, you are in distress, or your ability to move is limited because of tailbone pain.
Can you work with tailbone pain?
Yes, however, it is recommended to rest to promote healing, including limiting physical activities like work, which can worsen pain.
