Pain in the Butt
Pain at the tailbone can be a real pain in the butt.
The tailbone, called the coccyx, attaches at the base of the sacrum and typically consists of 3 to 5 moveable segments. For some individuals, one or more segments may be fused. The tailbone is roughly a third of the size of your pinky finger, but don’t let the size fool you. Coccyx pain, called coccydynia, can be quite severe and disruptive to daily life. This structure is highly variable from person to person, making it challenging to diagnose.
The tailbone is an important stabilizer of the pelvis and a vital component of healthy sexual and bowel function, as this bony point serves as an important attachment site for many muscles and ligaments. It also serves as an anchor point for the entire spinal cord via the filum terminale. Therefore, many activities of daily living can aggravate tailbone pain, like sitting or getting out of chair, toileting, sexual activities, and for some women menstruation may also contribute to soreness. Most commonly, sitting in a slumped posture directly on the tailbone will elicit pain, while standing or walking usually alleviates pain. Tailbone pain itself can vary greatly, ranging from minor to severe. It can be felt as a deep dull ache or sharp stabbing sensations.
Tailbone pain may result from direct injury, trauma, or illness involving the coccyx:
- Bone bruises
- Dislocation
- Fractures
- Bone spurs
- Infection or tumors
Trauma directly to the tailbone occurs commonly through falls, prolonged sitting on a hard surface, or during childbirth. Pregnancy may also contribute to tailbone dislocation, as hormones during the 3rd trimester loosen ligamentous structures to help prepare for delivery. For this reason, women are 5 times more likely to experience tailbone pain.
Tailbone pain relief options:
- Try leaning forward to reduce pressure on tailbone in sitting
- Use a wedge or donut pillow
- Alternate ice or heat for pain relief
- Stretching for spine, hips, and pelvis
If tailbone pain persists or severely impacts quality of life, consult with a physician. Your doctor may order imaging like x-ray or MRI to rule out the possibility of fracture, degenerative changes, or in very rare cases a tumor. A pelvic floor physical therapist may perform an internal rectal exam to assess coccygeal alignment and to determine if pelvic muscles are too tight, which may contribute to pain.
Treatment options may included:
- Pelvic floor muscle relaxation exercises
- Postural re-education and ergonomic assessment
- Soft tissue manipulation and joint mobilization
- Behavior change strategies
- Medications for pain management and to reduce inflammation
- Surgery when conservative treatments have failed
We Can Help!
Body Harmony Physical Therapy offers one-on-one treatment sessions and provides individualized treatment programs for each patient.
This blog was created for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a health condition or before beginning a new exercise routine.
Written By: Victoria Garrett, PT, DPT
