How common is it?
Tailbone pain is common. Women are affected around five times as often as men, partly because of pregnancy, childbirth and the shape of the pelvis. It is unusual in children.
Coccydynia (tailbone pain): symptoms, causes and self-check
Understanding coccydynia
A small bone that can take over your whole day.
The coccyx is the last few small vertebrae at the base of your spine. It carries part of your weight every time you sit and anchors several muscles, tendons and ligaments of the pelvic floor. When it's injured, inflamed or out of position, the pain is called coccydynia.
It often follows a fall onto the backside, childbirth, long hours on hard seats, or repetitive strain like cycling or rowing. Sometimes there's no clear cause. Either way, it is treatable, and it rarely needs surgery.
🛝Falls & direct trauma
🤰Pregnancy & childbirth
💺Prolonged sitting
🚴Repetitive strain
⚖️Sudden weight change
❔No obvious cause
Quick symptom check
Tick everything that sounds familiar. This is not a diagnosis, just a guide to whether a specialist consult makes sense.
Select the symptoms that apply to you.
Talk to a specialist
Medical facts
What doctors know about tailbone pain
A plain-language summary based on leading medical references. It is general information and not a substitute for an examination.
Usual causes
- A fall onto the backside, or another injury
- Pregnancy and childbirth
- Long hours sitting, especially on hard seats or while driving
- Repetitive strain, such as cycling or rowing
- Being well above or below a healthy weight; very flexible or very stiff joints
- Sometimes no clear cause is found
Typical symptoms
- Aching or sharp pain at the very base of the spine
- Worse when sitting, leaning back, or getting up from a chair
- Pain with bowel movements or during intercourse
- Poor sleep and low mood when it lasts
How it is diagnosed
Through your history and a careful examination of the coccyx and surrounding muscles. Before any hands-on treatment of a displaced coccyx, a dynamic X-ray (taken sitting and standing) shows which way it has shifted. MRI is used when needed to look for inflammation or other causes.
Treatment options
- Self-care: a coccyx cushion, good posture with lower-back support, heat or ice, avoiding long sitting, softer stools
- Hands-on therapy: physiotherapy, pelvic-floor work and manipulation of the coccyx and its muscles
- Injections: local anaesthetic with steroid, when other measures don't help
- Surgery (removing part or all of the coccyx) is rare and kept for cases where everything else has failed
Outlook
Most people improve within weeks with the right care. Pain that lasts more than a few weeks, or keeps coming back, deserves a specialist assessment rather than "just living with it".
Dr Rajveer's five rules while your tailbone hurts
- Sit on a firm cut-out cushionThick at the back, thin at the front, with a gap for the tailbone. A soft pillow doesn't help.
- Get up and walk oftenEvery 30 minutes at work. Movement takes the pressure off the coccyx.
- Stop cycling and bike ridingA narrow saddle puts your weight right under the tailbone.
- No Kegels or squeezing exercisesNot until the direction of the shift is known: they can pull an inward-shifted coccyx further in.
- No external "bone setting"Pressing from outside can push a displaced coccyx deeper. The direction is checked first.
The research in numbers
| Question | What studies found | Source |
|---|---|---|
| Women vs men | About 5 women for every man | Lirette 2014; Garg and Ahuja 2021 |
| Started with an injury or fall | 50–65% of patients | Garg and Ahuja 2021 |
| Sitting and standing X-rays | Found a likely cause in 69% of 208 patients | Maigne 2000 |
| With ankylosing spondylitis | 38% had tailbone pain, about 3 times the rate with ordinary back pain | Deniz 2014 |
| Women with pelvic pain | Half also had coccydynia; 78% of them had a tight coccygeus muscle | Neville 2022 |
| Better without surgery | About 9 in 10 | Lirette 2014; Garg and Ahuja 2021 |
Go deeper
Dr Rajveer explains
See all articles on the blog → Search by topic: sitting, pregnancy, injury, treatment and more.
⚠️ See a doctor promptly if tailbone pain comes with:
- Fever or feeling unwell
- Numbness, tingling or weakness in the legs or around the buttocks
- New problems controlling your bladder or bowels
- A lump, swelling or wound near the tailbone
- Unexplained weight loss, or a history of cancer
- Severe pain after a major accident
For sudden numbness around the buttocks or loss of bladder or bowel control, go to an emergency department straight away.
Sources and further reading
Summarised in our own words for patients. Links open the original pages; we are not affiliated with these organisations.
While you wait for your visit
Five small changes that ease tailbone pain.
1
Lean slightly forward
Shifting your weight onto your thighs takes load off the coccyx.
2
Use a cut-out cushion
A wedge or U-shaped cushion leaves the tailbone hanging free.
3
Stand up every 30 min
Short breaks stop pressure and stiffness from building up.
4
Avoid very soft sofas
Sinking in rolls you back onto the coccyx. Firm, supportive seats are better.
5
Keep things moving
Fibre and water help prevent straining, which often aggravates the pain.
Tired of planning your day around a chair?
Talk to a coccydynia specialist today.