The medical term for tailbone pain is coccydynia. The coccyx is made of five small bones that are fused together in a tail-like appearance. Pain that occurs in or around this bony structure can be dull, achy, sharp, or stabbing. Tailbone pain can go away on its own, or it may persist for months.
Tailbone pain is often described as sharp during certain activities, like rising from a seated position or when sitting down. For many individuals, defecation and sex can lead to tailbone pain. Many women report tailbone pain that makes menstruation uncomfortable.
Causes of Coccydynia
Tailbone pain can be caused by a variety of things. Trauma or fracture to the coccyx can result in persistent tailbone pain. The pain is often related to the movement to an existing hairline break. When a person defecates, moves stands, sits, or does other activities, the movement of the break can lead to pain. In addition, coccydynia can occur spontaneously. Common causes of tailbone pain are:
- Childbirth – During delivery, the baby’s head comes in contact with the coccyx, and the pressure results in injury to the surrounding structures and the bone itself.
- A direct blow to the tailbone – Can occur from a fall or through contact sports.
- Repetitive/prolonged stress against the tailbone – This occurs from prolonged sitting, cycling, or rowing.
- Other causes – Nerve root compression, cysts, bone spurs, tumor, and local infections.
If your tailbone pain doesn’t improve with rest and nonsteroidal anti-inflammatory drugs (NSAIDs), you can:
- Lean forward when sitting down
- Sit on a doughnut-shaped pill or V-shaped cushion
- Apply ice or heat to the area
Positioning leads to Pain
Tailbone pain is often troublesome to deal with. One reason this pain is an issue is that it often persists due to pelvic girdle and sacroiliac joint misalignment. The tailbone forms a joint with the sacrum, which becomes an attachment point for many pelvic structures. Problems stem from this joint that causes pain in the region of the coccyx. The two strongest pelvic ligaments are the sacrotuberous and the sacrospinous ligaments, which originate above this joint, and when irritated, can cause perceived tailbone pain. Rising from a seated position, or sitting for long periods of time, can irritate these ligaments.
Another reason why tailbone pain is hard to treat is that a direct blow can lead to serious inflammation. When the tailbone and surrounding structures become inflamed, it causes a deep bruise sensation. This also causes pelvic floor muscle contraction, which further irritates the tailbone. Muscle dysfunction of occurs due to the pain, which is further irritated from certain positionings, like standing or sitting down.
When coccydynia persists, there are several possible treatment options. These include:
- Manual manipulation – The doctor may massage the muscles attached to the tailbone to ease the existing pain. This is often done through the rectum.
- Physical therapy – A therapist can show you how to do pelvic floor relaxation techniques, such as relaxing the pelvic floor during deep breathing.
- Medication – The doctor can inject a local anesthetic into the tailbone region to relieve pain for weeks. When neuropathic pain is to be considered, the doctor may prescribe anticonvulsants or antidepressants, which are used for nerve-related issues.
- Surgery – A coccygectomy is where the coccyx is surgically removed. This is only recommended after all other treatments are deemed to fail.