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Tailbone Pain Without Injury: Causes and Treatments

Instead, try a standing desk that allows you to switch between sitting and standing. You can get a desk topper that does this, and it’s much cheaper than buying a nice office chair. A standing desk will also relieve the pressure associated with sitting while allowing you to keep working.

Causes of Tailbone Pain and Treatment Options

Elizabeth Quinn is an exercise physiologist, sports medicine writer, and fitness consultant for corporate wellness and rehabilitation clinics.

Updated on September 22, 2022

Oluseun Olufade, MD, is a board-certified orthopedist. He teaches as an Assistant Professor of Orthopedics at Emory School of Medicine in Atlanta, Georgia.

Table of Contents
Table of Contents

Tailbone pain is felt at the base of your spine. It is often caused by injury to the tailbone. Tailbone pain tends to occur when sitting, standing for long periods, and rising from a seated position. Pain during bowel movements and pain during sex are also common.

Americans see their primary care doctors less often than they did a decade ago. Adults under 65 made nearly 25% fewer visits to primary care providers in 2016 than they did in 2018, according to National Public Radio. In the same time period, the number of adults who went at least a year without visiting a primary care provider increased from 38% to 46%.

Tailbone pain can vary from person to person. For some people, it’s a faint, throbbing pain. Others have severe, sharp pain that can radiate to other areas. The pain can be disabling.

This article discusses the causes, treatment, and prevention of tailbone pain. It also discusses how this pain is diagnosed, and when you should see a doctor.

Where Tailbone Pain Is Felt

An injured tailbone will cause pain in the area just above the top of your buttocks at the base of your spine. The pain can be dull or sharp and is often worse while you’re seated. Depending on the cause, it can persist from a few days to a few months.

What Causes Tailbone Pain?

Tailbone pain is usually caused by some kind of trauma, but sometimes it can have other causes like an infection. The pain can originate in the bones of the tailbone or in the surrounding tissues.

The tailbone is also called the coccyx , and tailbone pain is called coccydynia . The tailbone consists of three to five small bones called coccygeal vertebral bones. They are located at the very end of your spinal column.

Various muscles, tendons, and ligaments attach to the tailbone. Ligaments connect bone to bone. Tendons connect muscle to bone.

There are a few possible causes of tailbone pain. Some are more common than others.

Common Causes

The bones of the tailbone can be injured directly, such as in a fall. Injury can also occur over time, due to repetitive activities.

Many muscles and ligaments attach to the tailbone. Tailbone pain could also be caused by an injury to these muscles and ligaments.

Acute trauma: A sudden injury to your tailbone can cause this kind of pain. For example, you might fall hard on your bottom while skiing. This can cause inflammation or strain of the structures around your tailbone.

The injury may cause a bruise or a fracture of the bones. Rarely, the joint between your tailbone and your sacrum may be dislocated. This is the triangle-shaped bone at the base of your spine.

Repeated trauma: Activities like horseback riding or cycling can lead to tailbone pain over time. This is because these activities cause repeat pressure or friction on the tailbone. You may also get tailbone pain after sitting on a hard surface for a long period of time.

Vaginal childbirth: Vaginal childbirth can cause tailbone pain. This is especially true if the delivery is difficult. This is because the baby’s head puts pressure on the top of the tailbone. The use of forceps can also contribute to this kind of pain.

Tailbone pain from childbirth is often caused by bone bruise or ligament strain. Sometimes, though, the tailbone can fracture.

Degenerative joint disease: Wear and tear from repetitive motions can cause osteoarthritis . This is a degenerative disease that can affect any joint in the body.

Unique coccyx morphology: Not everyone has the same number of tailbone bones. Some people also have a bone spur on the lowest tip of the tailbone. A bone spur is a small, bony growth.

A bone spur can irritate the tailbone area when you sit down. It can pinch the skin and the fatty tissue between the spur and the chair.

Some experts say scoliosis is a possible cause of tailbone pain. This is an abnormal curve in the spine.

Nerve pain: The ganglion impar is a bundle of nerves. It is located in front of the upper part of the tailbone. Overactivity or irritation of these nerves may cause recurrent tailbone pain.

Pelvic floor muscle spasms: The tailbone is where a deep layer of pelvic floor muscles attach. Pelvic floor muscles help support many of your body’s internal organs.

Muscle spasms and irritation of these muscles can cause levator ani syndrome. This is a condition that causes a dull, aching pain. This pain is often felt in the tailbone. It may also be felt in the rectum, the last few inches of your large intestine.

Referred Pain

You may have referred pain to your tailbone. This means the pain feels like it is coming from your tailbone when it’s really coming from another part of your body.

Conditions that may refer pain to the tailbone include:

Lumbar spine disease: In the lower spine, degenerative disc disease (DDD) may refer pain to the tailbone. If your pain is caused by DDD, you won’t have tenderness in your tailbone.

Pelvic organ diseases: Pelvic organ disease may refer pain to the tailbone. Examples include:

Pelvic inflammatory disease, in females
Prostatitis, in males

Proctalgia fugax : This is a severe but fleeting episode of rectal pain. It can be caused by pudendal nerve compression. Your pudendal nerve is the main nerve of your perineum. This is the area between your tailbone and a joint called the pubic symphysis.

Rare Causes

Other causes of tailbone pain are less common. Still, these causes can be dangerous. They require urgent medical attention.

Cancer: In rare instances, a tumor can spread to the tailbone. This may happen with certain cancers such as:

Prostate cancer
Ovarian cancer
Cervical cancer
Colon cancer

When this happens, the tumor may cause tailbone pain.

Primary bone tumors may also occur on the tailbone or in the tailbone area. A primary tumor is a tumor that happens on its own and is not the result of cancer spread. This is also rare.

Infection: An infection may also cause tailbone pain. A pilonidal cyst is an example of this kind of infection. The infection can cause:

Swelling
Pain over the tailbone
Redness
Warmth
Pus, which is thick, whitish fluid

A bone infection called osteomyelitis may also cause tailbone pain. This is also rare.

This kind of bone infection can begin with a pressure ulcer. These ulcers form when long-term pressure limits blood flow to the area. Signs may include:

Fever
Warmth
Redness near the tailbone

When to See a Healthcare Provider

See a doctor if:

Your pain is severe or gets in the way of daily activities.
Your pain doesn’t go away even though you’ve tried treating it.
You have a lump or mass on your tailbone.
You have a fever or redness, warmth, swelling, or drainage near or on your tailbone.

How Are the Causes of Tailbone Pain Diagnosed?

Your medical history will help your doctor find the cause of your pain. Let your doctor know about any falls or other accidents that involved your tailbone. If your pain came on gradually, a physical exam might be necessary.

Physical Examination

During your exam your doctor will look for:

Bruising
Swelling
Rash
Signs of infection, like warmth, redness, or discharge
A skin dimple, which could be a sign of a bone spur

Your doctor may also press on your tailbone. If the area is tender, it could mean there’s a fracture.

Your doctor may also decide to do a rectal exam. During this exam, the doctor inserts a lubricated, gloved finger into your anus and grasps your tailbone between thumb and forefinger.

This helps the doctor evaluate the range of motion in the joint and ligaments. It can also reveal tenderness in the area.

Imaging

Sometimes, but not always, x-rays can identify a tailbone injury.

These x-rays may be done while you’re standing and sitting down. This can help find the extent of the injury. It may also find alignment problems, dislocations, or fractures.

In rare cases, your doctor may order a magnetic resonance imaging scan (MRI). During this scan, a magnetic field and radio waves create images of the internal structures around your tailbone. This can be used to find cancer or infection.

Treatment of Tailbone Pain

Lifestyle changes can help most causes of tailbone pain. Recovery may take a while.

A bruised tailbone can take between a few days and a few weeks to completely heal. A fractured tailbone can take four to six weeks.

You should be able to return to normal daily activities over time as you heal. A full return to sports depends on the sport. Before you can go back to high-impact activities, you need to be able to sit, bend, and walk without pain.

Lifestyle Treatment Options

Here are some self-care strategies you can do at home. These can help ease pain and avoid further injury as you heal.

Avoid prolonged sitting: When you sit down, lean forward to take pressure off your tailbone. Do not sit on a “doughnut.” This is a circular cushion with a hole in the middle. A doughnut can isolate your tailbone. This puts more pressure on it.

Instead, use a coccygeal cushion. This is a special wedge-shaped cushion available over the counter. These cushions help ease pressure on the tailbone.

Apply ice or heat: Apply ice to the tailbone area for 10 to 15 minutes several times a day. Do this for up to three days after the injury. This can help reduce pain.

You may want to try both ice and heat to see which works best for you. Neither has been shown to be better than the other.

Avoid constipation: Constipation can make tailbone pain worse. Eat high-fiber foods and drink plenty of water. This will help soften stools and make bowel movements easier.

Medication

Your doctor may also recommend a topical or oral nonsteroidal anti-inflammatory drug (NSAID). This can help reduce pain and inflammation.

If your pain doesn’t go away after at-home care, your doctor may prescribe a stronger pain medication. A steroid injection into the joint or ligaments in the tailbone area may also help control pain.

If your pain is caused by the ganglion impar, a nerve block may help. This is an injection that helps block pain signals.

Infection can be treated with antibiotics. It may also need to be surgically drained.

Physical Therapy

If your pain is caused by pelvic floor muscle spasms, physical therapy can help. This often includes:

Exercises to help you improve your posture
Stretching
Reverse Kegels, or relaxation exercises for your pelvic floor

Surgery

In very rare cases, you may need surgery to remove your tailbone.

Preventing Tailbone Injury

Many tailbone injuries can’t be prevented. Still, you can take steps to stop them from happening.

Use protective gear when you play sports. The right padding can often reduce the risk of tailbone injury.

Summary

Tailbone pain can have many causes. It may be degenerative. It may also happen because of a sudden injury or repetitive stress. Bone spurs, nerve pain, and problems with the muscles of the pelvic floor can also cause tailbone pain. Rarely, tailbone pain may be caused by an infection or cancer.

See a doctor if your pain is severe and does not go away after self-care. A tailbone lump or signs of infection like fever and redness are also reasons to see a doctor.

Your doctor will diagnose the cause of your pain based on your medical history, symptoms, and a physical exam. You may also need imaging.

Tailbone pain can usually be treated at home. Medication may also help. Some causes of pain can be treated with physical therapy. Rarely, you may need surgery.

You can help protect yourself from sports-related tailbone injury by using protective gear.

Tailbone pain is common. Try not to feel embarrassed or self-conscious about it.

Frequently Asked Questions

How can I sleep comfortably with tailbone pain?

Lying on your side takes pressure off of the tailbone. Other strategies that may work include using a soft foam mattress topper. Special pillows with a face cut out let you lie on your stomach with your head down.

Why does giving birth cause tailbone pain?

Certain circumstances during childbirth put pressure on the tailbone and can cause tailbone pain. A difficult delivery increases the risk. The use of forceps increases it even more. It’s possible that mothers with a body mass index greater than 27 may also be more likely to suffer tailbone injuries.

Can you exercise when you have an injured tailbone?

Yes, but contact sports that could re-injure the tailbone should be avoided. Also, avoid sitting exercises like biking or rowing that put pressure on the area. Stretching is recommended. A physical therapist can offer exercises that can help you recover from your specific injury.

15 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Blocker O, Hill S, Woodacre T. Persistent coccydynia–the importance of a differential diagnosis. BMJ Case Rep. 2011;2011:bcr0620114408. doi:10.1136/bcr.06.2011.4408
Young JD, Gelbs JC, Zhu DS, Gallacher SE, Sutton KM, Blaine TA. Orthopaedic injuries in equestrian sports: a current concepts review. Orthop J Sports Med. 2015;3(9):2325967115603924. doi:10.1177/2325967115603924
Márquez-Carrasco ÁM, García-García E, Aragúndez-Marcos MP. Coccyx pain in women after childbirth. Enferm Clin. 2019;29(4):245-247. doi:10.1016/j.enfcli.2019.01.005
Gonnade N, Mehta N, Khera PS, Kumar D, Rajagopal R, Sharma PK. Ganglion impar block in patients with chronic coccydynia. Indian J Radiol Imaging. 2017;27(3):324–328. doi:10.4103/ijri.IJRI_294_16
Faubion SS, Shuster LT, Bharucha AE. Recognition and management of nonrelaxing pelvic floor dysfunction. Mayo Clin Proc. 2012;87(2):187–193. doi:10.1016/j.mayocp.2011.09.004
Saleem S, Aslam HM, Rehmani MA, Raees A, Alvi AA, Ashraf J. Lumbar disc degenerative disease: disc degeneration symptoms and magnetic resonance image findings. Asian Spine J. 2013;7(4):322–334. doi:10.4184/asj.2013.7.4.322
Jeyarajah S, Purkayastha S. Proctalgia fugax. CMAJ. 2013;185(5):417. doi:10.1503/cmaj.101613
Wilking AN. What is causing this patient’s tailbone pain?J Am Acad PA. 2019;32(4):54-6. doi:10.1097/01.JAA.0000554227.56253.88
Dudareva M, Ferguson J, Riley N, Stubbs D, Atkins B, McNally M. Osteomyelitis of the pelvic bones: a multidisciplinary approach to treatment. J Bone Jt Infect. 2017;2(4):184–193. doi:10.7150/jbji.21692
Lirette LS, Chaiban G, Tolba R, Eissa H. Coccydynia: an overview of the anatomy, etiology, and treatment of coccyx pain. Ochsner J. 2014;14(1):84–87.
Malanga GA, Yan N, Stark J. Mechanisms and efficacy of heat and cold therapies for musculoskeletal injury. Postgrad Med. 2015;127(1):57-65. doi:10.1080/00325481.2015.992719
Scott KM, Fisher LW, Bernstein IH, Bradley MH. The treatment of chronic coccydynia and postcoccygectomy pain with pelvic floor physical therapy. PM R. 2017;9(4):367-376. doi:10.1016/j.pmrj.2016.08.007
Antoniadis A, Ulrich NH, Senyurt H. Coccygectomy as a surgical option in the treatment of chronic traumatic coccygodynia: a single-center experience and literature review. Asian Spine J. 2014;8(6):705–710. doi:10.4184/asj.2014.8.6.705
Cleveland Clinic. Coccydynia (tailbone pain).
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Additional Reading

Foye PM. Coccydynia: tailbone pain. Phys Med Rehabil Clin N Am. 2017 Aug;28(3):539-49. doi:10.1016/j.pmr.2017.03.006
Lirette LS, Chaiban G, Tolba R, Eissa H. Coccydynia: an overview of the anatomy, etiology, and treatment of coccyx pain. Ochsner J. 2014;14(1):84-87.

By Elizabeth Quinn
Elizabeth Quinn is an exercise physiologist, sports medicine writer, and fitness consultant for corporate wellness and rehabilitation clinics.

Tailbone Pain Without Injury: Causes and Treatments

Most offices don’t spring for the most expensive, most comfortable office chairs, leaving their employees to instead sit in uncomfortable office chairs for long periods of time that can cause damage to the neck, back, spine, buttocks, and hips over the years.

However, upgrading to a new office chair, especially one made to treat tailbone or another type of lower back pain associated with prolonged sitting, can be expensive. Instead, you should look into other more affordable relief options, such as alternative chair types and seat cushions .

What Causes Tailbone Pain?

Tailbone pain or coccydynia refers to the pain that you experience around the small bone at the base of your spinal column. This bone, the coccyx, is located right above the cleft of your buttocks and can become damaged for many reasons—causing you pain.

With Injury

While we want to focus on how tailbone pain occurs without injury, let’s briefly take a look at some injuries that can cause tailbone pain. Sometimes you can injure your tailbone without knowing it, so it’s essential to understand how injuries occur in order to take them out of the equation.

If you’ve experienced a fall or another type of trauma, you could be experiencing tailbone pain related to that event. When you fall on your tailbone, you can cause a bruise, some dislocation, or even a fracture to the bone.

Without Injury

However, more commonly, tailbone pain doesn’t occur as a direct result of a traumatic incident like a fall. Instead, a common cause of tailbone pain is repetitive movements or unsupportive chairs in the office, at home, and even in your vehicle.

What Does Tailbone Pain Feel Like?

If you’re experiencing pain in the tailbone, you may have symptoms such as:

Dull and achy pain that occasionally flares up with sharper pains
Pain that worsens when you’re sitting down, moving from sitting to standing up or standing for long periods
Pain that makes it difficult to carry out daily tasks and activities such as driving, sleeping, and bending over

However, tailbone pain is different for everyone. Some people may experience pain in the lower back, hips, thighs, and neck because of their posture or the chair they sit in every day. You may not experience tailbone pain alone.

Complications Associated with Pain from Prolonged Sitting

The most common complication from prolonged sitting is sciatica. Sciatica is damage to the sciatic nerve, a nerve that runs from your lower back, through your butt, and down to your knees. Sitting too much may trigger or worsen exciting sciatica pain. Sciatica normally lasts between four to six weeks but can last longer in more serious circumstances.

People who sit for too long every day have a much higher risk of developing diabetes. Sitting can cause insulin resistance, meaning your body will go on strike from making it—which can cause a host of different problems.

You can also develop some types of cancers, including lung, uterine, and colon cancers, because of prolonged sitting, although these are incredibly rare in this situation.

Varicose veins (also known as spider veins) are also more common in people who sit more frequently. They cause blood to pool in your legs. You can avoid developing varicose veins by remembering to prop your legs up every once and a while.

Treatment for Tailbone Pain

There are many different options for treatment for tailbone pain. In most cases, if you see a doctor, they’ll instruct you first to try to relieve your pain at home. More severe injuries to the tailbone, such as breaks or fractures, may require surgery. The only way to know is with a physical exam and a scan like an x-ray, CT scan, or MRI.

If you’re a candidate for it, you can have surgery performed to remove the coccyx. This is only recommended when all other treatment options have failed and you’re left with pain that refuses to subside. Most people do not get this surgery.

Occasionally, when at-home treatment doesn’t work, you can opt for physical therapy. A physical therapist will show you how to relax your pelvic floor to provide relief for the pain you’re experiencing. They can also help you adjust poor posture and reduce joint pain.

Many patients find relief for their tailbone pain (and other pain associated with prolonged sitting) by getting a massage. A massage can help relieve tension in the muscles, reducing any discomfort. You can also try manipulation, which is done through the rectum. During manipulation, the muscles attached to the tailbone are massaged to relieve pain.

How to Find At-Home Relief

At home relief for tailbone pain can easily be achieved through a variety of methods, including:

Over-the-counter medications: (Ibuprofen: Advil and Motrin, Acetaminophen: Tylenol)
Hot and cold pack treatment like a heating pad or an ice pack
Stretching and yoga
A better chair or a seat cushion to help prevent further damage and pain

Office Chair Alternatives

Of course, the best way to prevent and relieve pain is to change up what caused you the pain. If you have an uncomfortable office chair, upgrading your chair is the way to go. However, genuinely ergonomic office chairs are costly.

Instead, try a standing desk that allows you to switch between sitting and standing. You can get a desk topper that does this, and it’s much cheaper than buying a nice office chair. A standing desk will also relieve the pressure associated with sitting while allowing you to keep working.

There are also a variety of chair options other than the standard desk chair. You could try a kneeling chair, an ergonomic stool, or an exercise ball chair. If none of those options work for you, or if you’re looking for something more affordable, you could always add a seat cushion to your office chair for improved support.

Why You Need a Seat Cushion

An office chair can help you get the support you need without breaking the bank. There are so many different seat cushions , including ones designed specifically to support the coccyx and prevent tailbone pain.

We offer a coccyx seat cushion , wedge cushions , lumbar back support cushions , footrest cushions, as well as many other supportive products. Our cushions are constructed from high-quality memory foam and gel inserts that provide both protection to the body’s shapes and cooling properties.

With the proper seat cushion, you can make any chair (whether it’s an office chair, hard chair, bench, or bleacher) more comfortable. You deserve relief for your tailbone pain, and a seat cushion is the most affordable way to relieve pain while also preventing long-term or recurring pain.

Tailbone Pain Without Injury: Causes and Treatments

Causes of Tailbone Pain and Treatment Options

Where Tailbone Pain Is Felt