What causes tailbone pain, and how can I ease it?

Answer From Margaret Moutvic, M.D.

Tailbone pain is pain in or around the bony structure at the bottom of the spine. This part of the spine is called the coccyx. Tailbone pain is sometimes called coccydynia or coccygodynia.

Tailbone pain can be caused by injury to the coccyx during a fall. It may also result from sitting for a long time on a hard or narrow surface. Other causes include joint changes from arthritis or during childbirth.

Tailbone pain usually goes away on its own within a few weeks or months. To lessen tailbone pain in the meantime, it might help to:

  • Lean forward while sitting down.
  • Sit on a pressure-reduction cushion. Some people find a wedge-shaped one most helpful for reducing pain.
  • Apply heat or ice to the affected area.
  • Take pain relievers, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others).

Tailbone pain that doesn't improve is called chronic coccydynia. For tailbone pain that doesn't go away, consult your health care provider. A rectal exam may be needed to rule out any other conditions. Sometimes MRI testing is used to find out if you have a fracture, joint 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. One technique is breathing deeply and completely relaxing your pelvic floor — as you would while urinating or defecating.
  • Manipulation. Massaging the muscles attached to the tailbone might help ease pain. Manipulation is typically done through the rectum.
  • Medicine. An injection of a local anesthetic into the tailbone can relieve pain for a few weeks.
  • Surgery. Surgery can be done to remove the coccyx. The procedure is called a coccygectomy. This option is typically only recommended when all other treatments fail.


Margaret Moutvic, M.D.

April 21, 2023