Coccydynia: Tailbone Pain Causes, Symptoms, Treatment, and Relief
Updated: 3 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer: What is coccydynia?
Coccydynia means pain in the coccyx, or tailbone. It may feel dull and achy or sharp and piercing. Pain often becomes worse when moving from sitting to standing, and it may also occur during bowel movements or sex. A fall, repetitive strain, pregnancy or childbirth, prolonged sitting, and pressure on the tailbone are possible causes. [1]
What the research says
Pain improved with every treatment category in a large systematic review, but the evidence is mostly observational and supports starting with non-invasive care. The review pooled 1,980 patients across 64 studies (only 5 were randomized controlled trials). Mean pain scores on a 10-cm visual analog scale fell by 5.11 cm with radiofrequency therapy, 5.06 with extracorporeal shockwave therapy, 4.86 with coccygectomy and 4.22 with injection, compared with 2.98 for ganglion block, 2.19 for stretching or manipulation and 1.69 for conservative or usual care. The authors describe a stepwise approach, starting with noninvasive methods before considering coccygectomy (Andersen et al., Global Spine J, 2022). [2]
After childbirth, tailbone pain was often linked to a difficult delivery and a dislocated coccyx. In a case series of 57 women with postpartum coccydynia, 7.3% of all coccydynia in women seen at a specialist clinic was related to childbirth. Deliveries were often instrument-assisted (forceps 50.8%) or described as difficult, and the coccyx was dislocated in 43.9% of these women versus 17.0% of 192 women with coccydynia from other causes; fracture occurred in 5.3%. A body mass index above 27 and two or more vaginal deliveries were associated with more frequent dislocation (Maigne et al., Eur J Phys Rehabil Med, 2012). [3]
What is coccydynia?
Coccydynia is the medical term for tailbone pain. The coccyx is the small, triangular bone at the very bottom of the spine. It helps steady the body and support weight while sitting, and several tendons, ligaments, and muscles connect there. Tailbone pain can interfere with daily routines and quality of life. [1]
Where is the tailbone?
The coccyx is at the bottom of the spine and is made of three to five fused vertebrae. When you sit, it helps steady you and support your weight. Tendons, ligaments, and muscles also attach around it. [1]
Because the tailbone is involved in sitting and connects with nearby soft tissues, pain in this area can affect ordinary activities. Some people also experience related back pain, sciatica, sleep disorders, depression, or anxiety.
What does coccydynia feel like?
Coccydynia may cause dull, achy pain or sharp, piercing pain at the tailbone. The pain may worsen when you move from sitting to standing. It may also hurt during a bowel movement or sex. [1]
Tailbone pain can occur with other symptoms. Related symptoms include back pain, sciatica, sleep disorders, depression, and anxiety. Chronic discomfort can affect quality of life, so emotional and sleep-related symptoms also deserve attention. [1]
Symptom pattern | What you may notice |
Pain quality | Dull and achy or sharp and piercing pain at the tailbone. |
Movement-related pain | Pain that worsens when moving from sitting to standing. |
Pressure-related pain | Pain when sitting or during activities that place pressure on the coccyx. |
Other situations | Pain during bowel movements or sex. |
Related symptoms | Back pain, sciatica, sleep disorders, depression, or anxiety. |
What causes tailbone pain?
Tailbone pain can have several causes. A fall may bruise, fracture, or dislocate the coccyx. Repetitive movements from activities such as bicycling or rowing can strain the tissues around the tailbone. [1]
Pregnancy or childbirth can also contribute. During the third trimester, hormones soften the area between the tailbone and sacrum, the part of the pelvis above the tailbone. This allows more flexibility during childbirth, but in some cases the surrounding muscles and ligaments stretch too far and provide less support at the correct angle. [1]
Other possible causes include prolonged sitting, especially on hard surfaces, carrying extra weight that adds pressure, or having less cushioning around the tailbone. [1]
Possible cause | How it may contribute |
Fall or trauma | A fall may bruise, fracture, or dislocate the tailbone. |
Repetitive strain | Repeated leaning and movement during bicycling or rowing may strain nearby tissues. |
Pregnancy or childbirth | Softened tissues and stretching around the tailbone may reduce support. |
Extra weight | Added pressure may make the tailbone lean backward and become painful. |
Less cushioning | Less fat can reduce cushioning and allow the tailbone to rub against nearby tissues. |
Prolonged sitting | Long periods of sitting can place excess pressure on the tailbone, especially on hard surfaces. |
Can tailbone pain happen without an injury?
Yes. In very rare cases, tailbone pain may be a sign of cancer near the coccyx or cancer that has spread to the bones. This is very uncommon. Named examples include chordoma, prostate cancer, and colorectal cancer. [1]
Additional symptoms that may occur when a tumor causes tailbone pain include numbness or tingling in the arms, legs, or groin; difficulty urinating or having a bowel movement; or a visible mass around the tailbone. [1]
These symptoms do not establish a diagnosis. Get emergency care right away if you suddenly lose control of your bladder or bowels or have numbness in your groin or inner thighs. They are reasons to contact a healthcare provider for evaluation, especially when tailbone pain does not go away or occurs with other concerning changes.
How is coccydynia diagnosed?
Diagnosis starts with a healthcare provider reviewing your medical history. The provider may ask about a fall, another injury, or a difficult childbirth. Next, they examine the area for a fracture, lump, or abscess, which is a pocket of infection. [1]
Imaging depends on what the provider needs to check. X-ray or CT may help look for a fracture. MRI or a bone scan may help assess inflammation, abscesses, or tumors. [1]
Evaluation step | What it may help assess |
Medical history | Past falls, trauma, childbirth, or other events involving the tailbone. |
Physical examination | Fractures, lumps, or abscesses. |
X-ray or CT | Possible fracture. |
MRI or bone scan | Possible inflammation, abscesses, or tumors. |
What can help tailbone pain at home?
Treatment depends on the cause and severity of the discomfort. Home remedies may be enough for many people. In 90% of cases, people with tailbone pain find relief with home remedies.
Common home measures include taking NSAIDs to reduce pain and swelling, sitting on a donut pillow or wedge-shaped gel cushion, taking a hot bath, and applying hot or cold packs to the lower back for about 20 to 30 minutes several times a day. Stool softeners may help when bowel movements are painful. [1]
Medication may not be appropriate for everyone. Ask a healthcare provider or pharmacist what is safe for your situation, especially if you have other health conditions or take other medicines.
Home-care option | Purpose |
NSAIDs | May reduce pain and swelling. |
Donut pillow or wedge-shaped gel cushion | May take pressure off the tailbone. |
Hot bath | May relax muscles and ease pain. |
Hot or cold packs | May help when applied to the lower back for about 20 to 30 minutes several times a day. |
Stool softeners | May help when bowel movements are painful. |
What nonsurgical treatments are available?
If home remedies do not work or pain keeps returning, a provider may recommend nonsurgical care. Options include a coccygeal nerve block, massage therapy, physical therapy, acupuncture, and TENS. [1]
A coccygeal nerve block uses an injection of numbing medication and steroids to relieve pain and inflammation. Massage therapy usually provides temporary relief. Physical therapy may stretch muscles and improve posture. TENS stands for transcutaneous electrical nerve stimulation. [1]
Nonsurgical option | What it involves |
Coccygeal nerve block | An injection of numbing medication and steroids to relieve pain and inflammation. |
Massage therapy | May provide temporary relief. |
Physical therapy | May stretch muscles and improve posture. |
Acupuncture | A listed nonsurgical treatment option. |
TENS | Transcutaneous electrical nerve stimulation. |
Is surgery ever used for coccydynia?
Surgery is used only in extremely rare cases. A provider may consider partial coccygectomy, which removes part of the coccyx, or total coccygectomy, which removes the entire coccyx. [1]
Recovery from a coccygectomy can take several months, and surgery does not guarantee that pain will go away. For that reason, providers recommend coccygectomy only when other treatments do not work. [1]
Chronic coccydynia may also occur with depression or anxiety. These symptoms should be treated as part of overall care because ignoring them can negatively affect quality of life.
How long does tailbone pain last?
Tailbone pain usually goes away on its own in a few days with home remedies and time. More severe injuries can take longer. [1]
Pain that does not go away may be chronic coccydynia. A healthcare provider can examine you to determine why the pain is continuing.
Can coccydynia be prevented?
Tailbone pain cannot always be prevented because it may occur after an accident or as a symptom of an underlying condition. You may be able to reduce risk by avoiding prolonged sitting, especially on hard surfaces, and using caution when cycling or doing other activities that could cause tailbone pain. [1]
Fall-prevention steps include keeping floors and pathways clear, installing a stair railing if possible, keeping stairways well lit, and avoiding looking at a phone while walking. [1]
Risk-reduction step | Practical focus |
Reduce prolonged pressure | Avoid sitting for long periods, especially on hard surfaces. |
Use caution during activities | Take care during cycling and similar activities that may strain the tailbone. |
Make pathways safer | Keep floors and walkways clear. |
Improve stair safety | Use a railing if possible and keep stairs well lit. |
Stay visually aware | Avoid looking at a phone while walking. |
When should you call a healthcare provider?
Call a healthcare provider if tailbone pain does not go away, if you develop additional pain such as hip or lower-back pain, or if you have a fever of 103°F (39.4°C) or higher. [1]
Most tailbone pain does not indicate a serious health issue. However, persistent or worsening symptoms deserve professional evaluation. A provider can diagnose the cause and help identify appropriate treatment.
What questions should you ask about coccydynia at an appointment?
Useful questions about coccydynia include what caused the tailbone pain, how long it might last, whether a cushion would help and whether imaging or physical therapy is needed.
Question | Why it may help |
What caused my tailbone pain? | Different causes may require different approaches. |
How long might the pain last? | Recovery can vary depending on the severity of an injury. |
Which over-the-counter medicines are appropriate? | A provider can help you choose a safe option for your situation. |
Would a donut cushion or wedge-shaped cushion help? | Cushions may reduce pressure on the tailbone. |
Do I need imaging? | X-ray, CT, MRI, or bone scan may be used for different concerns. |
Could physical therapy help? | Physical therapy may stretch muscles and improve posture. |
When would a procedure or surgery be considered? | More invasive options are generally considered only when other treatments do not work. |
Conclusion: Tailbone pain is common and usually manageable
Coccydynia is tailbone pain that may feel dull and achy or sharp and piercing. Falls, repetitive strain, pregnancy or childbirth, prolonged sitting, and pressure around the coccyx are possible causes. [1]
Many people improve with home remedies such as NSAIDs, a pressure-relieving cushion, hot baths, hot or cold packs, and stool softeners when needed. If pain persists or returns, a provider may consider imaging, physical therapy, nerve block, acupuncture, TENS, and—very rarely—surgery. [1]
Frequently Asked Questions
What is coccydynia?
Coccydynia is the medical term for pain in the coccyx, or tailbone, at the bottom of the spine.
What are common coccydynia symptoms?
Symptoms may include dull or sharp tailbone pain, pain when moving from sitting to standing, pain during bowel movements, and pain during sex. Back pain, sciatica, sleep disorders, depression, and anxiety may also occur.
What causes tailbone pain?
Possible causes include falls, repetitive strain from activities such as bicycling or rowing, pregnancy or childbirth, prolonged sitting, extra pressure, and less cushioning around the tailbone.
How is tailbone pain diagnosed?
A provider may review your history and examine the area. X-ray or CT may help check for a fracture, while MRI or a bone scan may help assess inflammation, abscesses, or tumors.
What is the best home remedy for tailbone pain?
The listed home measures include NSAIDs, a donut pillow or wedge-shaped gel cushion, hot baths, hot or cold packs, and stool softeners when bowel movements are painful.
Does tailbone pain go away on its own?
Tailbone pain usually goes away in a few days with home remedies and time, although more severe injuries can take longer. Persistent pain should be examined.
Is surgery needed for coccydynia?
Surgery is extremely rare. Partial or total coccygectomy may be considered only when other treatments do not work, and recovery can take several months.
When should I call a healthcare provider?
Call if tailbone pain does not go away, if you develop pain elsewhere such as in the hips or lower back, or if you have a fever of 103°F (39.4°C) or higher.
Related guides
Related Reading
Pelvis X-Ray: What It Shows, What to Expect and When You Need More Imaging explains the X-ray of the pelvic bones used for fractures and arthritis.
References
Cleveland Clinic. Tailbone Pain (Coccydynia). Cleveland Clinic. Last updated August 14, 2023. https://my.clevelandclinic.org/health/diseases/10436-coccydynia-tailbone-pain
Andersen GØ, Milosevic S, Jensen MM, et al. Coccydynia—the efficacy of available treatment options: a systematic review. Global Spine J. 2022;12(7):1611-1623. PMID 34927468. https://doi.org/10.1177/21925682211065389
Maigne JY, Rusakiewicz F, Diouf M. Postpartum coccydynia: a case series study of 57 women. Eur J Phys Rehabil Med. 2012;48(3):387-392. PMID 22820826. https://pubmed.ncbi.nlm.nih.gov/22820826/
Disclaimer
This article is for general educational purposes and is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified healthcare professional with any questions about a medical condition or treatment.
Comments