Tailbone pain — pain that occurs in or around the bony structure at the bottom of the spine (coccyx) — hence also called coccydynia, can be caused by trauma to the coccyx during a fall, prolonged sitting on a hard or narrow surface, degenerative joint changes, or vaginal childbirth.
Tailbone pain can feel dull and achy but typically becomes sharp during certain activities, such as sitting, rising from a seated to a standing position or prolonged standing. Defecation and sex also might become painful. For women, tailbone pain can make menstruation uncomfortable as well.
If it occurs during pregnancy, tailbone discomfort is yet another symptom for which you can thank hormones. The hormones relaxin and estrogen that are released during the first trimester make the ligaments throughout your body looser and more flexible, particularly in the pelvic area. This allows space for your baby to grow and enables you to give birth to him or her.
While this is great for baby, it can be tough for mamma, as it makes it easier for the hips and tailbone, which are typically more stationary joints, to slip out of alignment or move farther than they should, causing pain.
- Lean forward while sitting down
- Sit on a doughnut-shaped pillow or wedge (V-shaped) cushion
- Apply heat or ice to the affected area
- Take over-the-counter pain relievers, such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) or aspirin
Medical management of coccydynia includes:
- Physical therapy. A physical therapist might show you how to do pelvic floor relaxation techniques, such as breathing deeply and completely relaxing your pelvic floor — as you would while urinating or defecating.
- Manipulation. Massaging the muscles attached to the tailbone might help ease pain. Manipulation is typically done through the rectum.
- Medication. An injection of a local anesthetic into the tailbone can relieve pain for a few weeks. Certain antidepressants or anti-epileptic medications might relieve tailbone pain as well.
- Surgery. During a procedure known as a coccygectomy, the coccyx is surgically removed. This option is typically only recommended when all other treatments fail.