A Pain in the Tail…bone (Part 1- What is it? How does it happen? How does it feel?)

Let me tell you a little story. Several years ago, I was on my way to a continuing education course in Minneapolis, MN. I arrived to the airport early for my flight and settled in at the gate with a good book waiting for the boarding call. My flight was delayed…and delayed… a one hour wait became a four hour wait. But, I was reading a great book. I believe I got up one time over those four hours. Then I boarded the plane and sat for another 3 hours (finished the book!). Then I had tailbone pain.

Thankfully, in my case, I was headed to a course full of pelvic health practitioners, and I begged one of them to treat my tailbone on the first day. (Yes, it literally went, “Hi, my name is Jessica, will you treat my coccyx?”) She did, and one day later it felt totally better.

The truth is, my story is not a totally uncommon one. I sat in one place for 7 hours straight (likely in a slumped posture)– and my tailbone didn’t like it. I was lucky, because I know about tailbone pain…I was able to get it treated and I got better very quickly. Many people with the same pain will stay in pain for a long time before getting the treatment that helps. So, my goal today is to tell you exactly what tailbone pain is, how it happens, and what it feels like… and then in part 2 to tell you what you can do about it.

First, where exactly is the tailbone? Seems easy, but you’d be surprised how many people don’t actually know where it is.  Several months ago, I received a referral from a PT colleague to treat a nice lady who was having “tailbone pain.” She came into my office and when I asked where her pain was, she pointed directly to the sacrum.  I have had this happen in reverse too where a patient told me his “back hurt” but pointed to his coccyx. So, where is the tailbone? 

spine-957249_640


The coccyx (tailbone) refers to the 3-5 fused bones at the very end of the spine. These fused segments attach to the sacrum. To feel your coccyx, slide your fingers down from the sacrum between each cheek of your bottom. You will feel a very small boney structure, and can often feel the tip of the coccyx (which will be very close to the anus!).

Several ligaments and muscles attach to the coccyx, including the gluteus maximus and the pelvic floor muscles.  The coccyx does not stay still when we move. In fact, the coccyx moves as we sit and moves again as we stand.

coccyx

Now that we got that out of the way, here are a few things to know about coccydynia (tailbone pain): 

-What is it and what are the common symptoms associated with it? Coccydynia translated means “pain in the coccyx,” and that is how coccydynia is defined.  Most people with coccydynia will complain of pain in sitting (especially on hard surfaces), pain in standing for a long period, and pain when moving from sitting to standing or from standing to sitting. Since the pelvic floor muscles attach to the coccyx, many people with coccyx pain will have pelvic floor muscle involvement to some extent and may complain of constipation or pain with bowel movements, changes in urinary frequency/urgency or pain with sexual intercourse. Clinically, I also will often find that people with tailbone pain will begin to have low back pain too– I believe this occurs as people alter sitting positions and “side-sit” to avoid sitting on the tailbone.

-How common is it? The prevalence is actually unknown. Some literature state that it is “uncommon,” but I don’t really think that’s true. I think it’s likely under-reported (as are many things in the pelvis), and I believe the lack of understanding on treatment options contributes to this. Coccydynia seems to affect women more than men (5x more approximately!) and is more common in people with obesity. 

-What causes it? Coccyx pain is typically divided into two categories– traumatic and non-traumatic. Traumatic coccydynia typically occurs either with a backwards fall on the bottom or during childbirth. In these cases, the coccyx can become bruised, dislocated or even fractured. Nontraumatic coccydynia can occur due to prolonged or repetitive sitting on a hard surface (microtrauma), hypomobility or hypermobility of the coccyx (basically, the tailbone isn’t moving properly), degenerative joint or disc disease, and other variations in the structure of the coccyx. In addition, the coccyx can sometimes become painful if a person has overactive pelvic floor muscles as these muscles attach to the coccyx.  Note: Although much less common, coccyx pain can sometimes come from more serious problems like an infection or even cancer. It’s always important to see a skilled health care provider who can help you determine the contributors to your pain. 

-How is coccydynia diagnosed? As I said previously, coccydynia refers to pain in the coccyx, so the best way to diagnose coccyx pain is with a thorough history of the pain and an exam involving touching the coccyx to determine if it is uncomfortable to the person. (This is where some clinicians run into issues…you see, the tailbone is close to the anus, and people don’t always like going there. But it is SO important as a clinician to actually touch the tailbone to help determine why the person is experiencing pain! No one would examine shoulder pain without touching the shoulder! So, please clinicians, palpate the tailbone. Soapbox over.)

I know you would think that most people would “know” if their tailbone was painful…but like we discussed above, many people do not even realize where the tailbone is! Also, it is important to note that tailbone pain can be radicular in nature, meaning that nerves in the area are contributing to the symptoms or it can be “referred pain” meaning that it is coming from a different structure. Some of the muscles that can contribute to tailbone pain are the pelvic floor muscles, the obturator internus ( a deep hip rotator) and the gluteus maximus. I have seen several patients that felt pain in their tailbone that was actually coming from tenderness in these muscles. That’s why an exam with palpation is so important.

Sphincter Ani, Levator Ani, Coccygeus, Obturator Internus (2)

Image from Travell and Simon, Trigger Point Manual

– How is the coccyx examined? Examination with a physician typically will include a subjective history, physical exam and may also include some type of diagnostic imaging (x-ray, MRI). Typically, when a person comes into my office seeking physical therapy for coccydynia or tailbone pain, my initial assessment includes the following:

  • A comprehensive history to understand what the person believes is causing the pain, what makes pain better/worse, obstetric history, bladder/bowel history and symptoms, sexual history and symptoms
  • A movement exam– basically taking a person through movements of the spine, sitting, standing, squatting to see how the person moves and what movements (if any) bring on the pain, worsen it, or alleviate it. I also will feel the coccyx in sitting vs. slumping to feel the movement of the coccyx and identify pain.
  • An external assessment of the spine– Mobilizing the segments of the low back, the sacrum and then the coccyx helps me identify which structures may be involved in the person’s discomfort.
  • An external muscle assessment– feeling the muscles of the low back, buttocks, pelvic floor and thighs to see if the muscles are tender and if that tenderness contributes to tailbone pain.
  • An internal assessment of the pelvic floor muscles and coccyx- For patients experiencing significant pain, I will often defer this to the 2nd visit or even later depending on the person. The best way to assess the coccyx is by an internal rectal assessment by a very skilled practitioner. This examination allows a clinician to feel the movement of the coccyx and assess the muscles around the coccyx for tenderness. (Note: examination and treatment should always be a “team” decision. If a person feels uncomfortable with an internal exam and does not wish to have one, the practitioner should respect that and treat the person as well as she can with external approaches)

1115_Muscles_of_the_Pelvic_Floor

How is tailbone pain treated and what can you do NOW to make it better? Stay tuned next week for Part 2… 🙂 

As always, I love to hear from you! Please let me know if you have any questions or comments! Happy Friday!

~ Jessica

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69 responses to “A Pain in the Tail…bone (Part 1- What is it? How does it happen? How does it feel?)

  1. Joanie Lehman, MPT, NASM-CES

    Great post Jessica! I really look forward to Part 2!

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    • Thanks so much Joanie! Glad you enjoyed and look forward to adding Part 2 next week! Feel free to let me know any suggestions or comments you have! 🙂

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    • So relieved to read this article! Ive been having bottom pain which I initially thought it was actual “rectal” pain. It never hurt when I used the bathroom or wiped, but then I realized it might be my tailbone. Ive had a rectal exam, and had an xray of my tailbone. Both showed nothing. Ive got terrible health anxiety so of course I’m worried that it could be something terrible. I workout five days a week and think that I could’ve possible hurt it doing a large amount of situps and never rested to help it get better. Any help or advice is greatly appreciated!!

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      • Hi Ashley! Glad you found the post helpful! I would encourage you to contact a pelvic floor physical therapist near you to be evaluated! A comprehensive evaluation should help you identify your problem, and together you can come up with a plan to get it resolved! Wish you the best in your healing! ~Jessica

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  2. Pingback: A Pain in the Tail…bone (Part 2: Treatment) | Jessica Reale, PT, DPT, WCS

  3. Hi Jessica, just found your post and are considering the information for our 17 year old son. He is studying to be a programmer and also enjoys gaming. This equates to entirely too much time sitting in a chair. Over the past week he has complained of tail bone pain, most notable when he goes to bathroom and has a movement. We will begin the recommended stretches and fit his chair with a cushion. He is not terribly excited about sharing his symptoms nor is he anxious to see our family doctor about it. We have noticed that his interest in gaming and programming will cause him to sheild us from discomfort or bad behaviors associated in fear we will curb these behaviors. So goes raising a teen.

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    • Hello, hope the information was helpful! If your son is having pain with bowel movements, make sure he is using a proper “squatting” posture, and check out a few of my posts on bowel health! If his symptoms don’t resolve with the stretches, cushion, etc. I would definitely recommend seeking a professional opinion!

      Best of luck!

      Jessica

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  4. So I have developed bowel outlet dysfunction and it’s ruining my life :/ I’ve been seeing a PT to help correct tight levator ani muscles and it’s not helping. I have to digitally push muscles in the area to have a bowel movement which is embarrassing and also annoying. I have noticed some discomfort in my tailbone area. Any tips or suggestions for someone with a extremely tight Levator Ani? I just want to go to the bathroom like I use to 😦

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    • Hello,

      I’m so sorry you’re having problems with bowel movements and your pelvic floor! Without knowing all of your specifics, and examining you myself, I can only offer some general thoughts. First, remember that bowel function is a combination of what is happening within the colon, your stool consistency and what is happening at the outlet (pelvic floor). Stool consistency, bowel habits, and toilet positioning have to be a top priority. From a muscle standpoint, it does take time to help retrain the pelvic floor muscles to lengthen and relax. Typically, treatment is a combination of addressing the muscle tenderness with internal vaginal and/or rectal techniques, teaching the patient proper coordination of diaphragm and pelvic floor to encourage pelvic floor lengthening, and addressing any myofascial/connective tissue/neural restrictions around the pelvis. We also never want to ignore the rest of the body. It’s important to assess abdominal wall, hips, spine–and even down to the feet!

      Typically, you should see improvements gradually in treatment. If you have only been working with your PT for a short time, try to be patient and keep working on it! If it has been a while and you are not getting the results you want, don’t be afraid to seek a second opinion with an additional PT or MD. As with any pelvic problem, make sure the person you are seeing is skilled and trained in treating pelvic pain and pelvic floor muscle problems. I hope that helps!! Good luck!!

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  5. Thank you so much. You’ve been very helpful. I do have to be more patient. It’s difficult dealing with this especially since it just arose out of nowhere. I’m going to blame my jillian michaels workouts. The workouts really did a number in my pelvic floor muscles. Sigh 😦

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  6. Hi Indigovox, I’m glad my comments/blogs have been helpful. Very interesting that you would mention your problems starting after the Jillian Michaels workouts. I often see pelvic floor problems develop with higher level exercise–actually just wrote a blog about it 🙂 https://jessicarealept.com/2015/07/09/pelvic-floor-pain-athletes/ I’m sure your PT is already doing this, but make sure she is looking at you from a whole-body standpoint (your spine, hips, etc) and not just looking at your pelvic floor. Often times in cases like yours, the pelvic floor muscles are responding to a problem elsewhere. Hope that helps! Feel free to be in touch with any other questions! ~ Jessica

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  7. Hi there – I have just come home from a bike ride (6+hours) and feel pain in that area – first time this has happened after a long bike ride. Do you think coccydynia could be caused by this sort of activity? Of course if the pain continues I will consult a GP – but found this article interesting and thought I might ask nonetheless.

    Cheers

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    • Hello- If this is the first time you are having pain, it is likely just some irritation from the very long ride. I would start with resting, and possibly sitting on an ice pack for a few days to see if it calms down on its own. If it doesn’t, I’d seek professional advice. Good luck! And let me know if you have any questions! ~ Jessica

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  8. Sounds Interesting… It is very informative and I Like this Post….

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  9. Hello , last week i fell form my bike and got hurt in my tail-born but the X-ray report is ok according to my physician but the pain is so much and i cant even work , sit and sleep properly ….. kindly advice

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    • Hello Deepak! I’m sorry about your tailbone. After an injury like that, rest and ice will likely help it to improve. You may want to try a cushion like the one mentioned in this post to off- load your tailbone. I would recommend seeing a physiotherapist near you specialized in pelvic health for further evaluation. He or she would be able to give you better modifications to help you sit, sleep and work, and should also be able to help you slowly improve your movement and get that tailbone feeling better! Hope that helps!!

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  10. In October of 2013 I gave birth to my amazing daughter. Ever since giving birth I’ve had horrible tailbone pain. I’ve had several x-rays (all while laying flat) and an MRI of my lower lumbar spine and one of my tailbone. All these tests have been negative! Today I was pretty much told there was nothing else anyone could do and released from my Dr. with the response “you don’t need to come back”. She told me the last resort would be to schedule an appointment with my gynecologist. I plan on doing that, although, I really don’t see any point in it. I have never been offered an internal exam, and I’ve seen a couple of PCPs, physical therapist, orthopedic, and been in pain management. I have tried EVERYTHING I can on my own. Too much cushion hurts like crazy, not enough cushion hurts like crazy, taking a bath, sitting in the floor to play with my daughter, going to the movies, race track, graduations, plays, ball games, going out to eat, doing pretty much anything that requires me to sit longer than 5-10 minutes is horrid. I can’t even enjoy family time anymore because I’m always dreading it knowing I’m going to be in too much pain to enjoy it. I spend 90% of my time shifting and turningand looking for excuses to just get up and walk for a few minutes. This is ridiculous! I have tried cushions, they help slightly but not for very long. I can barely even take a drive more than 15-20 minutes before I’m ready to pull over to walk around and get relief. I couldnt even take a vaxation right now if i wanted to. I have asked more than one Dr. about the sit/stand x-rays , and have been told its too hard to do or they simply can’t do it. I’ve asked about having my tailbone removed because I cannot stand having to take medication for pain management and was told they won’t do it without proof of a problem and that it probably wouldn’t help anyways. I do not want to know what this is going to be like facing it alone and being left to “suffer” with this pain. I have already stopped making plans and doing a lot of things I love over this, to avoid making the pain worse, and that’s with pain management. I don’t know what to do from here except “suffer in silence” and avoiding even more of my life. Its been over two years now, and nobody seems to take me seriously. Could you suggest anything else that could help me?

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    • Oh Desiree, my heart just breaks for you! I’m so sorry you have been hurting for so long, and haven’t been offered helpful treatment! 😦 unfortunately, I hear cases like yours way more frequently than I should. My initial thoughts are—YES! There is so much that can be done for you! I would strongly recommend seeking out a skilled pelvic PT who has experience working with both women postpartum and tailbone pain. I see you’ve done PT before, but if it was a general PT without training in internal techniques, I am not surprised that you didn’t see benefit. Where do you live? I can help you seek out someone close who is skilled! I would also encourage you to definitely follow up with your gynecologist- they can rule out a medical issue, and that’s important. Before going down the road of tailbone removal, you really really should work with a skilled pelvic PT. Tailbone pain is often multifactorial, so removing the tailbone can feel like a solution, but for many is often not the quick fix they want and can even worsen the problem. Please feel free to e-mail me if you want to chat further! Hoping you find some help soon!! – Jessica

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      • Desiree Bertram

        Thank you so much for the information! I’m at my breaking point, and its really feeling like a hopeless battle! I know Drs have to be careful because a lot of people do go looking for prescription medication for made up injuries,  so I don’t hold any grudges or have hard feelings toward them. I’m just not sure why they won’t order the proper tests. I tried every medication I could before I would even accept a prescription for narcotics. I even made my stomach bleed accidentally by taking BC powders to get relief because its the one thing that came the closest to making the pain bearable. I am going to make an appointment with my gynecologist after the first of the year. I live in Scott County Tennessee. Its a small town but I usually travel to Knoxville, Oakridge, or Crossville to see specialists. Those are the closest cities, but for the right answers and help I may travel further if someone will drive me (driving hurts way too much to go very far). I have access to the MRI results i just had done. It mentioned abrupt angulation in my tailbone but said it may be normal. It also said something about fluid and cysts on my overies, neither was mentioned in my visit. I can screenshot a pic to send you if you would like to see it? It honestly confuses me and all i was told is “it was negative”. I’m so thankful for your help! 

        Sent from Yahoo Mail on Android

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      • Hi Desiree, looking at the directories I know, there are a few pelvic PTs in the Knoxville area. I just spoke on the phone to Emily Pace, PT with Results Physiotherapy, and they seem to have a strong program. Check out them here: https://resultsphysiotherapy.com/location/physical-therapy-knoxville-tn-pelvic-health-specialty-clinic/ I hope that helps! Merry Christmas! ~ Jessica

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    • Desiree, have you found someone to help you? Where do you live? Your story matches mine word for word and I found an answer with the most amazing website and physical therapist. Let me know if you need info.

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  11. Pingback: 2015 in Review! Happy New Year! | Jessica Reale, PT, DPT, WCS

  12. Hi Jessica. I have been having tailbone pain for a couple weeks now and it is not getting better. What I have found causes the most pain is when I step off laterally with one foot, in either direction. So if I am standing with both feet facing forward, then lift a foot and step off to the side, externally rotating that foot in the process. That sparks immediate and significant pain. Does that sound like connective tissue damage in that area?

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    • Hi Brian, I wish I could be more help. Pain with moving laterally could be indicative of many different things, so it’s hard to say without examining you. I would recommend seeking treatment by a pelvic PT soon who can evaluate you comprehensively. Hope that is helpful! – Jessica

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  13. Hi Jessica,

    I have had increasing tail bone pain in the last few months. I have uterine fibroids and have read they could be causing it. The other thing is I have been doing more sitting of late for my job but still do quite a bit of walking too. When I poke my stomach out or squeeze my bowel muscles I can feel it hurt my coccyx. Any thoughts on what’s going on? When I was a child I also fell on my coccyx on a street gutter when my feet went from under me on roller skates, although this issue has not really affected me that I know of (at the time I could not walk properly for days)

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    • Hi Liz, I apologize for not responding sooner, but thank you for commenting! Uterine fibroids could definitely be a factor in your pain. It sounds like your pelvic floor muscles are involved as well since contracting them seems to worsen your symptoms. Without examining you myself, I can only guess :). I would definitely recommend seeking care by a skilled gynecologist (due to your fibroids) as well as pelvic floor physical therapist who is skilled in treating tailbone pain. I hope that is helpful and that you find relief soon! Kind regards,
      Jessica Reale

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  14. hi I have pain in my tailbone and with the right leg and buttock I don’t ride a bike and I didn’t but I do workout (gym) it can cause with lifting weight ?

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  15. Nancy Whitfield

    Hi Jessica, I’ve experienced pain when sitting only, which began while sitting with babies on my lap in a rocking chair about 6 or 7 years ago. I have gotten it adjusted for a long time now by a chiropractor. I since have noticed it just continues to be painful and doesn’t allow me to sit long or without padding. I try to sleep on my side which alleviates some pain. I wonder if you could suggest a doctor who specializes in the tail bone conditions. A few years ago my L5 went out after doing some exercises from a Roman Chair. I don’t know if the 2 correlate or not. I have some degeneration going on in my neck area and wonder if there could be degenerating in my tail bone and discs. I would love to go to someone who is well suited in this area. Can you advise? I am in perfect weight, a nanny, and 56 years of age. I eat extremely healthy and live healthy too. Just an FYI. Thank you!

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    • Hi Nancy, I’m so sorry I missed your comment!! Sounds like you have had a difficult few years. Where do you live? I could likely make a recommendation for someone to see near you with my contacts… Feel free to e-mail me directly if that’s easier (jessica@onetherapy.com). Hoping you have been able to find relief!
      ~ Jessica

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  16. Nancy Whitfield

    Thank you Jessica. I currently taking turmeric for pain. Not really helping these days. I would love a good specialist near Everett, Kirkland, Monroe area of Washington state. Thanks so much for your help. I’ll leave my email information below.

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  17. Hello Jessica, I’ve had a chronic coccydynia for 4 years. I’m 40 years old. I did not fell or had any accident or delivery, it just happened. I started with a cushion, then on year with medication, cortisone injections, ganglion impar blocks… PT for 3 years!! Pt have been helpful, but it all depend on the person. My PT left to now I’m not following any treatment. I have different tailbone pain cushions (for travel, to be seat at home), and special chairs with a cut off in my work. Tailbone pain changes everything. My social life become cero, as well as my travel. I live in the US but I’m from Spain, and I could not go home for 2 years due to my pain. I’ve done group therapy and visited a psychologist due to a depression caused by the chronic pain. All in all I am in my best moment after 4 years… but the pain is still there. Myofascial massages, deep tissue, coccyx mobilization for one year… I also have a few collateral pains due to the chronic bad seating postures, such as sciatica, pelvic pain, ligaments and piriformis muscle inflammation, an a long etc. I’ve tried everything, but I’ve just had a partial relief. At this point I know my coccydynia is here to stay, and in some way I’ve accepted. I have good an bad days, but pain could be soooo debilitating. My advice is to believe that pain is just pain, and try to see ourselves in a positive way. I feel fortunate for so many things in my life, even if I have this damn tailbone pain.

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    • Hi T.Martin,

      Thank you for commenting and sharing your experience. It sounds like you have had such a difficult journey with your tailbone pain. I’m so sorry that your physical therapy has been so varied and often less than helpful. Unfortunately, like you have found, all physical therapists practice a little bit differently. If you need help finding a new PT, let me know where you live and I’ll see what I can do! Best of luck on your journey!

      All my best,

      Jessica

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  18. Hi Jessica,

    This may seem like a silly question, how can I tell the difference between tailbone pain and pain in the anus!? Sometimes I feel as though it is tailbone pain and other days that maybe I am constipated/pressure in the anus.

    I am 30years old. Have a history of lower back pain/ prolapsed L4-5 and have two children aged 4 and 2. The back pain has been much worse since baby number 2.

    I have seen a Dr who has prescribed me medicine to insert into the anus which is for haemorrhoids, which I’m not sure are doing much of anything. While reading this post I have had a bit of a prod of the tailbone which although not tender when touching has now produced a tender feeling in the area.

    I have a pelvis that is quite out of line (seen a specialist after giving birth), this does cause lower back pain and sometimes pubic symphysis pain too. This has been an issue for about 2 1/2 years although the tailbone pain since Feb this year. Actually, the pain does co-incide with a bout of constipation and anal sex (which was the first time for about 6 months) and I wondered if maybe this triggered it.

    Well, the main reason I decided to write to this thread is because I am having trouble describing this to my GP/DR. I was hoping that by writing here you maybe able to help a little with deciphering where the pain is coming from/possible causes. The only thing the DR asked was if I had a history of haemorroids of which I answered only after giving birth (which I think is normal) and then prescribed haemorroids sepositaries!

    Thank you in advance!

    Vicky

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    • Hi Vicky, I thought I had responded to you sooner, but must have missed it! Many people with tailbone pain may also have some of the other symptoms you are mentioning! I would recommend seeking an evaluation by a pelvic physiotherapist to really help you figure out what’s going on. Wish I could help more, but I’m limited without examining you myself!

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  19. If it is truly the tailbone causing the psin, would lying on one’s side ease the psin? That how ever only lasts for a brief amount of time so I am constantly moving to new positions. Even sitting for a very brief time cause great discomfort. Maybe it is my siadic nerve. I do know where the tailbone is. I fractured it as a child 30+ years ago. This pain seems to encompass all of my bottom sometimes one side worse than the other and I also feel like my legs are locked at the hips and don’t have free range of motin. Is that even a thing? Please advise. How would cancer or a tumor be determined.

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    • Hi Kay,
      Often times, the tailbone may be involved but may not be the only factor in your pain experience (in fact, most of the time that’s the case!). If you are having pain all around your bottom and hips, there are likely many factors involved. I would encourage you to seek out an evaluation by your physician as well as a skilled pelvic physical therapist where you live. They can help rule out anything scary, and get you on the right treatment path. Feel free to email me if you have any additional questions.
      ~ Jessica

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  20. Advice please! Back in February was on a road trip and the coccyx pain was so bad I could barely get out of the vehicle and walk. Well haven’t had issues with it again till last week. I have coccyx pain again at times can hardly stand, keeps me awake, also have left leg pain and lower back pain. I can’t get comfortable to save myself.

    A couple things about me… I was told 10 yrs agoish that I had a slight bulging disk in my lower back and also I have fatty cysts from about my waist down and not far from my spine. I have 1 that’s about a golf ball size that feels like it’s in the muscle not the surface. When pushing on a couple of them it hurts.

    Well my Dr is on vacation this week so I saw some other Dr. I thought for sure he would order some sort of imaging to see what could be going on. NOPE… he gives me a muscle relaxer saying taking these that all will be fine?!? I asked him if a tight muscle in my back causes coccyx pain and his reply was not really.. Mind you I’ve had tight muscles in my back and never has the pain gone South!

    I’ve read where cyst could push against a nerve causing such pain as well as disk issues.

    I’m getting ready to take a pain pill because everything hurts… Should I be satisfied with this outcome or get a second opinion.

    Thank you for your time and advice.

    Recap… Coccyx pain, left leg pain, lower back pain

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    • Hi there! I’m so sorry you are hurting. Unfortunately, it’s very difficult to give advice online without having examined someone. I will say that coccyx pain is complicated, and there are so many factors that could be involved in the pain you are experiencing. If you are not pleased with your physician’s assessment, I would really encourage you to seek a second opinion. It may also be worth seeking an evaluation from a pelvic floor physical therapist in your area– they should be able to help you sort through what could be going on. I hope this is helpful, and wish you all the best in your recovery! ~ Jessica

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  21. Jessica, thank for this great information. I wish you were in Dallas! Do you happen to know someone as knowledgeable as you in the Dallas/Plano area?

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    • Hi Monique! Glad you enjoyed the article! I believe Valerie Bobb is in Dallas and does a great job! Shoot me an email if for some reason you have a hard time finding her, and I can get her info for you! Best of luck in your recovery! – Jessica

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  22. Thanks to everyone who shared their story. Hello Jessica! 16yrs ago I had a accident while on active duty while serving in the us Army over in Germany (gonna give u the short version). The 5ton truck I was driving went over an overpass I wasn’t wearing my seatbelt I fell 150 ft. On my back. I have no spleen, after being hospitalized in 2 different hospitals for nearly 3 weeks I finally had a x-Ray to find out I had my C5-C6 broken. I to have that fused, beforehand they tested me for pregnancy and “yes” I was she 16 now. Lasers lascersted lug, broken ribs, broken bone fragments off my spine. I have I have hip, low back sharp pain, sharp pain in my buttocks area, and nerve pain down my legs, chronic sciatic, Neuropathy. I feel cold on one side of my body which will come on from no where. Etc….. I have tried explaining my pains in my tailbone area and nothing. I have had injection after injection and nothing. I refuse to take anything anymore I was nearly killed from giving narcotics Meds through an IV from the ER. No medical office I have ever seen has ever looked into my symptoms other than looking at my back and neck. Tailbone “no” I have even had to pull over driving I was in tears because of the pain- I have even lost feeling in my driving leg but do my foot often. I was suppose to have a Spinal cord Stimulator put in from Duke on the 26th this month yet I have disk buldging causing bad Chest pain may have to have surgery before hand.
    I told them though I felt I was covering more up than they knew about and wanted everything to be taken care of before this Stimulator was implanted for my chronic pain. Where can I go from here.

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    • Hi Shelly, I’m so sorry you’ve been hurting for so long. Have you seen a pelvic health physical therapist? A good pelvic PT may be a good place to start to take another look at what is going on. It sounds like your problems are multifactorial, so I would recommend trying to find someone with a strong orthopedic background as well. Let me know if you need help finding someone! Best of luck in your recovery! ~ Jessica

      Like

  23. Thank you for all that info. My tailbone pain started after I had my baby. I know that when you have a baby your bones around that area are stretched out. After the birth of child I started school maybe it was a month or 2 later. The class I had was 3hrs long and the chairs were metals After I got up I started having pain in that area. As u mentioned I ignored it for a while till it was difficult to bear. I went to the doctor he did an X-ray and said it was bended inward a little and he referred me to a physical therapist I did about 2-3 weeks of therapy and the Therapist recommend I put my finger inside and try pulling my bone out ward but I couldn’t do it. After the therapy she said she noticed improvement as my tailbone was out a little at that time I didn’t feel the improvement as I was still having pain with sitting down. She said she will send me to someone who will physically pull my tailbone outward. I got scared and stop going to the therapy I still had pain but it wasn’t so bad but I just recently started having a lot of pain again. I think my tailbone is push toward my colon that sometimes I have pain around that area and when I’m having bowl movements. I’m planning on getting another referral to start the therapy again but I’m very busy not sure if I can fit that into my schedule. Do you think that physically pulling out the tailbone will even help?

    Like

    • Hi Sarah, thanks for sharing your story and I’m so sorry you have been hurting! Internal mobilization of the coccyx can be a very helpful component of treatment, but it’s very difficult to say what you would most benefit from without examining you myself. I would encourage you to see a physical therapist specializing in pelvic health who would have advanced training in treating tailbone pain and pelvic floor dysfunction. The person you see could then evaluate you and discuss all of your treatment options to get you the help you need. If you need help finding someone, let me know!! Wishing you a speedy recovery! ~ Jessica

      Like

  24. Hi. I started having tailbone pain about 6 months ago. Nothing serious just a bit sore when sitting too far back but always tender if I touched it. Went to an orthopedic who ordered an MRI which showed a bit of inflammation in the area. I’ve since been doing regular PT with a wonderful group of therapists however there has been no progress. It was suggested I see a pelvic health physical therapist. I live in the Atlanta area but south of the airport. Any suggestions on someone in my area? Thanks.

    Like

    • Hi Maria, thanks for e-mailing. I would agree that if you aren’t making progress with traditional physical therapy, seeing a pelvic health specialist would be the best way to go. Unfortunately, there really aren’t any pelvic PTs (from my knowledge) in south Atlanta. I am likely the closest to you at this time, with my clinic located right off I-285 at South Cobb Drive. If you’d like to schedule, I would of course be happy to see you! Please give my office a call at 770-989-1405.

      Like

  25. After being severely constipated, and literally for over 2 years trying to remove feces from inside rectum, like inside some pockets in there, I have now ended up with burning and discomfort like something is stuck in my rectal area. This is going on for 6 months, and my doctors don’t know what the heck to do. I am in pain with burning and discomfort 24/7. Nothing relieves it. Was told to see a prudenal nerve entrapment dr. after getting to see an anesthisilogist who will see where the pain is coming from — a nerve, and then have an mri called 3t mri, or t3 mri. I know you are not a doctor, but if any one else has this and sees my post, please let me know they have done. Thank you. Lee

    n

    Like

    • Hi Lisa,
      Thanks for commenting. Burning/discomfort as well as a sensation of “something stuck in the rectum” are actually fairly common symptoms that we tend to see with people having chronic constipation and pelvic pain problems. Have you been evaluated yet by a skilled pelvic physical therapist? That would probably be an important place to start, especially if you’re going down the pudendal n. entrapment road. A skilled pelvic PT should be able to evaluate you in more detail, and make some recommendations based on what they find. Let me know if you need help finding someone in your area! Wish you all the best in your recovery!

      Kind regards,

      Jessica Reale, PT, DPT, WCS

      Like

  26. Hi Jessica,
    I am so happy I found your website. I’ve been experiencing tailbone pain for the last 9 months. It is painful when sitting (car rides and airplane rides are awful – or any time I have to sit back on something soft), some pain when laying in certain positions in bed and very tender to the touch. Otherwise, during the day, walking or doing things around the house, I feel no pain. I had an X-ray and MRI done and they found nothing. I even had a sigmoidoscopy but found nothing. I went to a pain specialist who said that I should try a pelvic floor physical therapist and that my pain is likely due to a childbirth related injury even though my youngest child is 7 yrs old (I had 2 children natural birth). I first noticed the pain after a 3 hr car ride in our new car, but I had also started exercising (playing tennis) regularly about 3 months prior to the pain, so I thought perhaps my body was somehow injured after not having exercised in any form for years. I am thin, so there is no weight issue, but I’m sure my core muscles are quite weak and was wondering if that has anything to do with my issue (and whether pilates might also help). I live in the Boston area, and I am sure that there are many skilled pelvic floor physical therapists in the area, but I was wondering if you have anyone that you know of that you might recommend for my particular tailbone issue. Thanks in advance for any advice that you may have!
    Corinne

    Like

    • Hi Corinne,

      Thanks for commenting and sharing your story. It’s so hard to say what exactly is going on without evaluating you. I have several amazing colleagues in Boston who I think would be great at helping with your particular situation. They are: Jessica McKinney with Marathon Physical Therapy, Liz Rummer with the Pelvic Health and Rehabilitation Center and Holly Herman in private practice. All should be easily found online, but let me know if you have any problems! I’m confident any of them would be able to help you! Best of luck in your healing journey! ~ Jessica

      Like

  27. I’ve been dealing with severe tailbone pain for over two years. Had a laminectomy this past summer but tailbone pain is horrendous. I also happen to have a prolapsed uterus and bladder and have been using a pessary for several years. I was researching tonight and came across this article and I’m in shock. I had never put the two together. Always thought it was my back.
    I have my yearly check up to tomorrow with my pelvic floor specialist and I’m going to ask about this. I’m so worn out from the pain from sitting.
    Thank you for this information. Debi

    Like

  28. I have.tailbone. Pain my rectom trobs lumber has pain.I go to to let.fell like a knife My legs.have pain pain sitting had a fall down steps.no treatment in North Jersey

    Like

    • Hi Stanley,
      So sorry to hear you’re hurting so much! There are actually so many excellent pelvic PTs in New Jersey. Check out hermanwallace.com/practitioner-directory to find someone close to you! Hope that helps! Best of luck in your recovery!
      – Jessica

      Like

  29. Hi Jessica- I’ve woken up w extreme soreness in the lowest portions of my tailbone.. no fall, no impact, just extreme soreness.. pain is constant if I have to go to the bathroom which is now very difficult, almost unbearable. I had a slight similar pain last year that was on and off so I had a colonoscopy which showed nothing at all. Today’s pain is significantly worse.. having to leave work BC of it. I can’t think of what might have caused this.. I started biking again last week but Friday morning was the last time I rode and the pain did not start until late Sunday ..
    What kind of doctors should I see for this?

    Like

    • Hi Jay! I’m sorry you are having so much pain. If it was sudden onset, and is causing extreme pain with an urge to use the bathroom, I would start with seeing physician (possibly the one who did your colonoscopy last year? or your primary care provider?). It’s so hard to say would could be causing the pain…honestly, it could be many things, so I think you need a thorough exam. Could be something like constipation (backed up stool pressing against structures) or could be something musculoskeletal…or other things. I would start medical, then go from there. Seeing a pelvic physical therapist would be helpful if medical pathology is ruled out. I hope that helps and that you get to feeling better soon! ~ Jessica

      Like

      • Thanks for responding Jessica. I woke up the next morning with only about 15% of the pain remaining.. still vein concerned I held my appt w a spine specialist at orthopedic surgery group here in town. Nothing was found from the X-rays or exam though. The Doc was baffled why this would be so extreme with out an impact. I have noticed that although I can press on my tailbone now w little or no pain, that if I apply the same pressure to the dog tissue just to the right side of the tailbone, it is still extremely tender. What organs are in this area that I should be concerned about?
        I had a colonoscopy in Jan BC I was having some vague soreness in the area and everything came back normal.. I’m at a loss of what to do..

        Like

      • Hi Jay, it’s really hard to give you clear advice without examining you. In terms of the tissue you pressed on, it could be the pelvic floor musculature…but again, we wouldn’t know until examining. Why don’t you make an appointment with a pelvic health physical therapist to be examined? He or she could examine you thoroughly and help you understand what is going on. Could also refer you to appropriate medical specialist if needed. That would probably be my best recommendation at this point. Check out this post for info on how to find one: https://jessicarealept.com/2015/02/24/find-a-pelvic-pt/ Hopefully that is helpful! All my best, Jessica

        Like

  30. Allyson Norton Browning

    Ok, I feel I have this coccydynia. It a new thought to me but the systems are
    sure present. My medical history was boring until about 20 years ago. I developed Type 2 Diabetes and sinse then I have been on a roller coaster of illness and debillataing conditions. At present I have diabetic neuropathy, the worst my neurologist has seen in his practice. And that’s just the start. I have a hairy hypertension, pain in the back being diagnosed as arthritis and bulging desk, gained over 250 in the last eight years. For the last several years I have felt bad hemorrhoids or something but out of embarrassment just never said anything. After all, don’t have enough wrong with me, surely, they would find something if there was something else wrong.

    I am in tears just thinking about it. So with great hesitation, i’m asking you where I could find a part two, to this article. I know that you said one would follow up with what to do about it, I guess I need to know if I want the pain to end.

    Like

    • Hi Allyson,

      I am so sorry for my poor response. As you may have been aware, I gave birth to a healthy baby girl on 10-26, so have been taking time away from work (and from the blog) to be with my family.

      I hope you found part two to this article! I am so sorry you are having so much difficulty! I think seeing a skilled pelvic physical therapist would be so helpful for you in your journey. Please feel free to be in touch via email if you have any questions! Wishing you a quick recovery and happy holidays! – Jessica

      Like

  31. Hi Jessica
    Thank you so much for the site. I have done 2 anal fissures surgery 4 months ago. One of them was near the tailbone and it was hurting me before the operation. But things have turned ok and my bowel movements are much better without laxatives. The problem is that I developed a tailbone pain that sticks with me four months and a half now. It is right on the tip of the bone. I feel it radiates to my buttocks. Though I use a foam pillow to sit on, I still feel the sharp pain coming after 10 min of sitting and feel a heaviness in this place if I stand for too long. I have done x-rays and it shows things are normal in the coccyx area. No trauma happened except that I used to sit sideways a lot after the surgery since the place was too sensitive including my tailbone. No boils or redness in the area but the pain , no constipation or diarrhea, the pain aggravates after a short time of sitting. The dr advised me to have cortisone injections but I am too scared of these. Would you help me what to do? Thank u so much

    Like

    • Hi Ola,

      I’m so sorry you’re hurting! I apologize for my slow response. As you may be aware through the blog, I gave birth to a healthy baby girl on 10/26 so have been taking time away from work (and the blog!) to spend time with my family.

      It is difficult to say without evaluating you what specifically is going on. My first recommendation would be to see a skilled pelvic physical therapist for a complete comprehensive evaluation. Remember, pain in the tailbone can have so so many causes. Please feel free to be in touch via email if you have other questions, and I’m happy to help! Best of luck in your recovery! – Jessica

      Like

  32. Hi
    I have been having lower back pain for a few years now have had injections have been told that my S5 is sacralised I have been experiencing wheight loss in the last two years and realized that the pain is actually in my tailbone I can’t sit probably coming from a sitting to a standing position is very difficult bending over the pain is becoming unbearable I am too scared to go to my orthopedic doc as the injection is very sore so the one in my tailebone will be even worse as if you just touch it it is extremely painful I get injections in my hip to as the pain raidiats down my right leg sometimes and see has become extremely painful can this be due to my weight loss when from 70kg to 44kg and I am 156cm thank you
    cherri

    Like

    • Hi Cherrilee, I’m so sorry you’ve been hurting! I have seen tailbone pain creep up after someone loses a large amount of weight. My best recommendation would be to seek out a skilled pelvic physiotherapist to help you with the problems you are having! If you need help finding someone, feel free to e-mail me directly and I can help you find someone near where you live! Wish you all the best for a quick recovery!
      ~ Jessica

      Like

  33. I just fell down the stairs and now my lower back hurts really bad it feels like I have to use the restroom (bowel movement) but I don’t I feel pressure in the lower back, I don’t have insurance so that’s why I having gone to the doctor any suggestions ?

    Like

    • Hi Monica,

      I’m so sorry you fell! I wish I could offer you some advice, but unfortunately, it’s really hard to say without evaluating you. If you are continuing to have low back pain and bowel pressure, I would go ahead and seek a medical evaluation if you are able! I’m sorry I can’t be of more help!

      Wish you the best for recovery!

      Jessica

      Like

  34. Heather Margretz

    I had lower back surgery in Oct. L5 S1 disectomy…
    My doctor has now recommend a fusion at that level due to Degenerative Disc Disease.
    This was a work comp so I’ve had to wait for months now. Last Mon I woke up with horrible tailbone pain Which has now traveled in to my butt and back of thigh..this pain is constant.better when standing but there.could this be sciatica?

    Like

    • Hi Heather,

      It’s difficult to say without examining you. The sciatic nerve does run down the back of the leg, so pain there could be coming from that nerve, or referred by other structures. Your best bet would be to go see someone who can do an exam and help you find out what is going on with your pain. Wish you all the best in your recovery! – Jessica

      Like

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