Tailbone pain (coccydynia)

Symptoms of coccydynia 

The main symptom of coccydynia is pain and tenderness in the area just above the buttocks.

You can get it if you injure or strain your coccyx or the surrounding muscles and ligaments.

In most cases, the pain will improve over a few weeks or months. But occasionally it can last much longer and severely affect your ability to carry out every day activities.

The pain may:

• be dull and achy most of the time, with occasional sharp pains
• be worse when sitting down, moving from sitting to standing, standing for long periods, having sex and going for a poo
• make it very difficult to sleep and carry out everyday activities, such as driving or bending over

Some people also have back pain, shooting leg pains (sciatica) and painful buttocks and hips.

When to see your GP 

Coccydynia will often improve on its own after a few weeks. There are some simple treatments you can try at home.

See your GP if:

• the pain doesn't start to improve within a few weeks
• simple home treatments don't relieve the pain
• your pain is very severe
• you also have bleeding, a high temperature (fever) or pain away from your coccyx

Your GP will carry out an examination to check for more serious causes of your pain, such as infection or a fracture.

In some cases, they may also refer you for tests such as X-rays or an MRI (magnetic resonance imaging) scan.

Causes of coccydynia 

Common causes of coccydynia include:

• childbirth
• an injury or accident, such as a fall
• repeated or extended periods of strain on the coccyx
• poor posture
• being overweight or underweight

Less common causes can include a bony growth on the coccyx, the coccyx being too flexible or too rigid, and arthritis.

Rare but serious causes include infection and cancer.

In many cases, no obvious cause can be found. Age-related ’wear and tear’ may play a part.

Treatments for coccydynia 

There are a number of treatments for coccydynia.

Simple measures you can try at home are usually recommended first. Other treatments may be used if these don't help.

The main treatments are:

• self-care measures, such as avoiding long periods of sitting, using a specially-designed coccyx cushion (doughnut cushions), applying hot or cold packs to your lower back and wearing loose clothing
• non-steroidal anti-inflammatory (NSAID) painkillers that you can buy from shops and pharmacies, such as ibuprofen

Persistent symptoms lasting longer than eight weeks may benefit from:

• physiotherapy exercises, massage and stretching
• injections of anti-inflammatories (corticosteroids) and painkillers into the coccyx or surrounding area

Where other treatments haven't helped, surgery may be needed to manipulate the coccyx.

Very rarely the coccyx may need to be removed (coccygectomy).

More useful links

• How to use your health services
• Coccydynia