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Coccydynia Causes, Symptoms & Treatment Options

Causes, Symptoms & Treatment

Coccydynia is a condition characterized by pain and inflammation at the tip of the coccyx, commonly known as the tailbone. The coccyx sits at the base of the spine and forms part of the pelvis. A tailbone injury or prolonged pressure on this area can lead to pain and tenderness between the buttocks, especially when sitting or changing positions.

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Overview
Causes
Symptoms
When to see a doctor
Non-operative treatment
Surgical Treatment
Recovery

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Overview

Coccydynia refers to pain originating from the coccyx, the small triangular bone at the very end of the spine. This area supports body weight while sitting and serves as an attachment point for muscles, ligaments, and tendons. When the coccyx becomes inflamed, bruised, or unstable, it can result in persistent tailbone pain that interferes with daily activities such as sitting, standing, and bending.

What causes Coccydynia?

The most common cause of coccydynia is direct trauma to the hip tailbone, such as a fall onto a hard surface. However, other factors may also contribute.

1. How the Injury Occurs

Falling backward and landing on the tailbone
Direct impact during sports or accidents
Childbirth-related stress to the coccyx

2. Common Everyday Causes

Prolonged sitting on hard or narrow surfaces
Poor sitting posture
Repetitive strain from daily activities

Chronic stress or an unstable coccyx can lead to ongoing inflammation and pain. In some cases, no clear cause is identified, making coccydynia a common source of unexplained sitting pain.

Sports Commonly Associated with Coccydynia

Activities that place prolonged pressure or repetitive stress on the tailbone increase the risk of coccydynia, including:

Cycling, due to sustained pressure on the saddle
Rowing, which involves repetitive seated motion and strain

Symptoms

The primary symptom of coccydynia is pain localized at the tailbone, particularly when sitting. Other common symptoms include:

Severe pain when standing up from a seated position
Pain that improves with standing or walking
A deep, aching sensation at the base of the spine
Pain during bowel movements due to pressure on the coccyx

While most cases are related to injury or mechanical stress, persistent or worsening pain should be evaluated to rule out rare causes, including infections or other serious medical conditions.

When to see a doctor

If you experience tailbone pain that lasts more than a few days, or if you’ve had a recent tailbone injury, you should see your doctor. Medical evaluation is especially important if pain is severe, worsening, or accompanied by unusual symptoms.

Your doctor can often diagnose coccydynia through a detailed medical history and physical examination. Imaging tests such as X-rays or MRI scans may be ordered to rule out fractures, joint instability, or other conditions that could be contributing to your symptoms.

Non-operative treatment

In many cases, coccydynia improves on its own with time. Conservative tailbone pain treatment focuses on reducing inflammation and minimizing pressure on the coccyx.

Common non-surgical treatments include:

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen
Corticosteroid injections to reduce inflammation and pain
Using a wedge-shaped or donut cushion to shift pressure away from the tailbone
Activity modification, including limiting prolonged sitting
Physical therapy to strengthen supporting muscles and improve posture

Exercise Program

Targeted exercises can help improve flexibility and support the lower back and pelvis.
(Refer to the PDF Exercise Program below.)

Coccydynia

Surgical Treatment

Surgery is rarely required for coccydynia. In cases where conservative tailbone pain treatment fails and pain remains severe and disabling, surgical removal of part or all of the coccyx (coccygectomy) may be considered. This option is reserved for carefully selected patients after thorough evaluation.

Recovery

Recovery from coccydynia requires patience and activity modification. Most people experience gradual improvement over several weeks. Returning to strenuous activity too soon can delay healing. Your doctor may recommend starting with light exercise and gradually increasing activity as pain improves.

Reviewed By

Jay Kimmel

Dr. Jay Kimmel is a board-certified orthopedic surgeon specializing in sports medicine, arthroscopic surgery, and shoulder and knee disorders. He completed his orthopedic training at New York-Presbyterian/Columbia University Medical Center and a Sports Medicine Fellowship at Temple University.

Dr. Kimmel previously served as the Director of the Connecticut Sports Medicine Institute at Saint Francis Hospital and has held faculty appointments as Clinical Assistant Professor in the Departments of Orthopedics and Family Medicine at the University of Connecticut. He has extensive experience caring for athletes as a team physician for high school and collegiate programs and continues to teach in the athletic training departments at Westfield State University and Springfield College.

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