The tailbone, or coccyx, is the bone at the very bottom of the spine. A bruised tailbone can be very painful, but various treatments can help relieve the pain.

The medical name for pain in the tailbone is coccydynia. Tailbone pain can interfere with everyday life because it can make it difficult for a person to sit or stand.

This article explains what causes tailbone pain, how to treat it, and what types of pain relief can help.

A woman holding her back due to the pain from a bruised tailbone.Share on Pinterest
Image credit: Mintr/Getty Images

The tailbone is at the base of the spine and contains three to five sections of bone fused in a triangular shape. The tailbone provides support when a person sits down.

The tailbone also has several ligaments, tendons, and muscles attached to it. Damage to these muscles or the bone can cause pain in the tailbone or the surrounding area.

The tailbone has a small range of movement.

Tailbone pain often feels like a dull, achy pain at the base of the spine or between the buttocks. The pain may get worse when sitting or placing pressure around the bone.

The pain is often worse directly after the injury and eases over time.

The symptoms may include:

  • pain when sitting or leaning on the area around the tailbone
  • pain when standing up from a seated position
  • pain when standing for long periods
  • pain during bowel movements
  • pain in and around the tailbone during sex

In most cases, tailbone pain resolves within weeks to months and does not always need treatment.

A bruised tailbone typically occurs due to a backward fall or another impact injury. It may also occur during childbirth or because of a medical condition.

A 2014 study reports that females are five times more likely to experience tailbone pain than males.

Another study investigating tailbone pain in adolescents found that adolescents and adults are more likely to get tailbone pain than children.

There is a wide range of reasons why tailbone pain might develop.

Injury

Injury to the tailbone can occur after falling backward. Falls onto the tailbone can cause a bruised, dislocated, or broken tailbone.

People might also injure the tailbone through repeated or prolonged sitting on hard, uncomfortable surfaces.

Tailbone pain can also develop if a person has a degenerative joint or disc disease, such as arthritis.

Other factors can increase the risk of tailbone pain, including:

  • hypermobility, when the joints move further than is typical
  • hypomobility, or reduced movement in a joint

Childbirth

Because of its location, the tailbone is prone to injury during childbirth, especially during a difficult delivery.

A study looking into what may cause tailbone pain after delivery indicated that using forceps, having a vacuum-assisted delivery, or a difficult or spontaneous delivery can result in tailbone dislocation or fracture.

The use of forceps led to tailbone pain in 50.8% of women included in the study. Dislocation and fracture were common problems with the tailbone after giving birth.

Sitting

Sitting for long periods on hard or uncomfortable surfaces puts pressure on the tailbone, leading to tailbone pain.

Maintaining a posture that puts excess pressure on the tailbone while sitting can also result in pain.

Sitting down for shorter periods while working may help to stop the tailbone from becoming irritated. Standing up from time to time or using a standing desk while working can minimize time spent sitting down.

There are several ways a person can try to relieve pain from a bruised tailbone. These include making simple changes to medication and surgical options.

Posture

Specially designed cushions can help to reduce tailbone pain when a person is sitting. These cushions have a cut-out section at the back so that there is no pressure on the coccyx while sitting.

A study that appears in the Journal of Bodywork and Movement Therapies concluded that stretching improved tailbone pain.

Many yoga poses can help stretch the muscles surrounding the tailbone to relieve pain.

Heat and cold

Applying warm and cold packs to the tailbone can help relieve tailbone pain. Applying heat to a bruised tailbone can help relax muscles, which can improve pain.

Apply heat with a hot water bottle, a heat pack, an adhesive strip, or a heat gel.

People can make a cold pack by wrapping ice packs in a towel or cloth.

Manual manipulation

A doctor can gently move the tailbone to relieve pain. This procedure involves a doctor inserting their finger into the rectum and gently massaging the area around the coccyx.

This can gradually move a tailbone that is out of alignment back into its normal position. A 5-year study found that manual manipulation cured approximately 85% of people included in the trial.

TENS

Transcutaneous electrical nerve stimulator (TENS) units use electrical stimulation to interfere with pain signals traveling to the brain.

TENS machines can help people keep their medication intake to a minimum and have very few side effects.

Medication

Nonsteroidal anti-inflammatory drugs (NSAIDs) are pain-relieving medications that help reduce inflammation around the tailbone, easing pain. People can buy NSAIDs over the counter (OTC).

Applying pain relief gels to the skin where a person is experiencing pain can also help.

If people are experiencing problems with bowel movements, the National Health Service (NHS) in the United Kingdom recommend trying laxatives to make passing stool easier.

Injections

Steroid injections reduce inflammation. Sometimes, doctors will include a local anesthetic in the injection to enhance pain relief. Doctors give these injections in the area surrounding the tailbone, and the effects can last for weeks or longer.

Surgery

Typically, doctors only consider surgery on the tailbone if the non-surgical options have not improved the pain.

Tailbone surgery typically includes removing part or all of the tailbone. This type of surgery is called a coccygectomy.

A surgeon will carry out a coccygectomy under anesthetic. A doctor will make a small cut over the tailbone and release the ligaments, tendons, and muscles attached to the tailbone before removing the bone.

Generally, tailbone pain improves within a few weeks, according to the NHS.

According to the American Society of Regional Anesthesia and Pain Medicine, if the pain lasts longer than 2 months, a doctor may diagnose it as chronic pain.

If tailbone pain does become chronic, it may mean that a person has dislocated or broken their tailbone and may require specialist treatment.

A broken tailbone may cause a tingling sensation. Anyone experiencing this should visit their doctor for diagnosis and treatment.

If non-surgical options have not improved chronic pain, a doctor may refer the person to a specialist to discuss options, such as surgical manipulation or a coccygectomy. However, doctors tend to recommend surgery only as a last resort.

If a person thinks they have injured their tailbone, they should see a doctor to check they have not damaged other areas of their back.

If a person experiences bruising, numbness in their back or legs, or loss of bladder control, they should see a doctor to rule out any serious back injuries.

A person should see a doctor if their tailbone pain does not get better within 3 months and if painkillers, stretching, or steroid injections have not improved the pain.

Additionally, if a person experiences signs of bone cancer, such as pain, swelling, tingling, weakness, weight loss, fatigue, or fever, a person should seek medical advice. However, according to the American Cancer Society, it is likely that other conditions cause these symptoms.

Tailbone pain can begin after an injury, such as after a fall, childbirth, or because of a degenerative bone disorder.

There is a range of pain relief methods available to reduce the symptoms of tailbone pain, many of which a person can carry out at home.

However, if tailbone pain does not improve using NSAIDs or coccydynia cushions, more invasive or surgical options may be necessary, such as manual manipulation, steroid injections, or surgery.