The vast majority of tailbone pain comes from a fall, childbirth, long sitting or strain on the coccyx and the muscles around it. It is uncomfortable and can be stubborn, but it isn't dangerous. Rarely, though, pain at the base of the spine is a sign of something that needs prompt medical care.
See a doctor promptly if you have tailbone pain with:
- Fever, chills or feeling generally unwell. This could mean an infection, such as an abscess or an infected cyst near the tailbone (a pilonidal cyst).
- A lump, swelling, redness or a wound near the tailbone.
- Unexplained weight loss, or a history of cancer. Very occasionally, a growth in or near the sacrum or coccyx causes pain.
- Pain that is severe and getting steadily worse, or pain that is just as bad lying down at night.
- Pain after a major accident such as a road traffic collision or a fall from height, where a fracture is possible.
Go to an emergency department straight away if you have:
- Numbness around the buttocks, genitals or inner thighs (sometimes called "saddle" numbness)
- New difficulty passing urine, or loss of bladder or bowel control
- Weakness in one or both legs
These can be signs of pressure on the nerves at the bottom of the spinal canal, which needs urgent assessment.
Why a proper examination matters
Because so many conditions can cause pain low in the back and pelvis, a specialist first takes a careful history and examines the coccyx, the joints around it and the pelvic muscles. When needed, X-rays taken sitting and standing can show whether the coccyx moves abnormally, and an MRI can rule out other causes. Only once the cause is clear should treatment begin.
If none of the warning signs above apply, tailbone pain is usually treatable with self-care and targeted, hands-on therapy. Surgery is rarely needed.
