Tailbone Pain (Coccydynia): Why It Happens and What May Help

Tailbone pain in the very bottom of your spine ,which is called your coccyx, can make people feel embarrassed, which is unnecessary, because coccydynia, to give it its medical name, can be a miserable condition. Sitting becomes uncomfortable, long drives and office days make it sore and standing up and straightening up from a chair produces a sharp, catching pain. Patients tell me they put off seeking help because it seemed too small a thing to bother with, they felt embarrassed or because they presumed nothing could be done about it. None of these facts are true.

Tailbone pain, low in the tail of your spine is a recognised condition and most cases of it settle well and there is far more that may help than just waiting for it to get batter on its own.

“He is very professional in his work,”

“Leslie is an excellent chiropractor. He truly addresses the root cause of the problem, allowing for a quick recovery. He is very professional in his work, taking a genuine interest in the patient’s overall health. Without a doubt, he is the best you can find in this field.”

Angelica M

What is coccydynia?

The coccyx is the small, curved chain of three to five fused segments at the very base of your spine, the evolutionary remnant of a tail. It is not ornamental it has an anatomical use: it anchors pelvic floor muscles and ligaments and carries load when you sit, particularly when you lean back. Coccydynia simply means pain in and around the coccyx.

Research using dynamic X-rays, comparing the coccyx sitting and standing, shows that in many sufferers the segments move abnormally under load, either flexing too far or slipping slightly, which explains why sitting hurts and why the pain is so positional.[1] Women are affected far more often than men, partly for anatomical reasons and partly because childbirth is one of the major causes.[2]

what causes tailbone pain

The classic story is a fall, usually backwards onto a solid hard surface or falling down stairs and landing on your bottom or falling off a horse perhaps. Generally, slipping in anyway and landing on the your bottom where your tailbone is located.

The second classic story is childbirth, where the coccyx is pushed backwards during delivery and sometimes bruised or sprained in the process.

The third is: prolonged sitting, especially on hard or poorly shaped seats or an increase in cycling and rowing can each bring the pain on gradually. Body shape plays a part and rapid weight change in either direction alters how the coccyx is loaded in sitting.[2] In a minority no clear cause is found, which does not make the pain any less real or any less treatable.

Explore our hip and pelvic guides

Hip and pelvic pain: the main guide

Hip and groin

Side of the hip and buttock

Pelvis and tailbone

Sacroiliac joint pain
Tailbone pain and coccydynia (you are here)
Pelvic girdle pain in pregnancy

Related guides

When hip or buttock pain starts in the back

When the problem shows up further down the leg

Wear and tear, bones and staying active

When sport or training is behind it

Symptoms of tailbone pain and the coccyx

Patients point to one precise spot, right at the base of the spine between the top of the buttocks and describe it as “bruised”. Sitting aggravates the pain, leaning back while sitting aggravates it more and the single characteristic symptom is a sharp pain on standing up from a chair. Cushioned chairs are often worse than firm ones because soft seats let the pelvis roll back onto the coccyx.

woman standing with hands on hips, viewed from behind, with an anatomical overlay showing the sacrum and coccyx at the base of the spine showing the area affected by tailbone pain, coccydynia

The coccyx, or tailbone, sits at the very base of the spine just below the triangular sacrum. Pain in this small segment is known as coccydynia and is often felt when sitting or when rising from a seated position.

What tailbone pain is not: unlike much hip and pelvic pain, it does not usually radiate down the legs and it sits lower and more central than sacroiliac joint pain, which lives over the dimples either side of the spine’s base. Pain after childbirth may also overlap with pelvic girdle pain and the examination separates the three.

How chiropractic care may help

Conservative chiropractic care is the recognised first line for coccydynia and reviews report that most cases improve with treatment.[2][3] In clinic that means several strands working together. Chiropractic treatment may help ease the muscles and ligaments around the external area coccyx and pelvic floor attachments of the pelvis, along with mobilisation of the sacroiliac joints and lower back where stiffness there is adding to the load. Just as important is sitting management: a wedge or ring cushion when used correctly helps, adjusting your desk and car seat set-up will make things more comfortable and learning to sit slightly forward onto the sit bones rather than back onto the coccyx. There is some trial evidence that manual treatment directed at the coccyx externally can modestly help chronic long standing cases, though the effect was not dramatic and the research is limited.[4] Recovery is usually measured in weeks for recent injuries and a few months for more long-standing cases, a chiropractic treatment plan is built around your personal history, the hours you are required to saty seated every day and your progress. For the stubborn minority, onward referral for imaging or injection therapy can be an option.

If pain from your coccyx at the bottom of your spine in your tailbone area is causing discomfort and getting in the way of things you would rather be doing, come and talk it through. I offer a free 15-minute consultation, you can come in for a short no-obligation chat with no examination or treatment.

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red flags

The overwhelming majority of tailbone pain is mechanical and benign. See your GP first if the pain is constant and unrelieved by any position, if it comes with unexplained weight loss, fever or feeling unwell, if there is a new lump or swelling at the tailbone or if you have a history of cancer. New numbness in the saddle area or changes in bladder or bowel control need emergency assessment at A&E.

Those situations are uncommon. The familiar bruised-tailbone pattern that flares with sitting is appropriate for chiropractic assessment in clinic.

your first visit to Bournemouth Chiropractic

At your first full chiropractic appointment visit I take a full history, including any falls or births however long ago, then assess your coccyx externally along with your pelvis, sacroiliac joints and lower back and observe how you actually sit. I explain what I find and we agree a plan together, including referral onwards if your case needs it.

Frequently Asked Questions

Why does my tailbone hurt when I sit down and stand up?

Your tailbone hurts when you sit and stand because sitting loads the coccyx directly, especially leaning back and the movement of rising pulls on its irritated joints and ligaments. Dynamic X-ray research shows the coccyx often moves abnormally under sitting load in people with coccydynia, which fits that exact pattern.

Can a chiropractor help with tailbone pain?

A chiropractor may help with tailbone pain through external treatment of the muscles and joints around the coccyx and pelvis, combined with practical sitting advice and cushioning. Conservative care of this kind is the accepted first-line approach and most cases improve with it.

How long does a bruised tailbone take to heal?

A bruised tailbone from a simple fall typically settles over a few weeks, though it can feel very sore in the meantime. Pain lasting beyond six to eight weeks has moved into coccydynia territory and is worth assessing properly rather than waiting any further, because persistent cases respond better to active management than to time alone.

What is the best cushion for tailbone pain?

The best cushion for tailbone pain is usually a wedge shaped cushion with a cut-out at the back, which tilts you forward onto your sit bones and takes the coccyx out of contact with the seat. Ring cushions suit some people too. Soft, deep seats often make things worse, which surprises most sufferers.

When should I see a doctor about tailbone pain?

See a doctor about tailbone pain if it is constant day and night, comes with fever, unexplained weight loss or a new lump or follows major trauma. Saddle numbness or new bladder or bowel problems go to A&E. Outside those situations, the ordinary sitting-related pattern is safe to have assessed in clinic.

Whatever's behind your tailbone pain, come and find out

Tailbone pain that flares when you sit down or stand up again, often after a fall onto the base of the spine or after childbirth, can be wearing and hard to get comfortable with and most people want to know what is causing it and what will settle it. I'd happily see you first for a free 15 minute consultation, a short, no-obligation chat to talk through what's going on, not an examination or treatment. I'll answer your questions and be honest about whether chiropractic may help, and you can then choose whether to book a full visit for examination and treatment.

Tailbone pain like this is a common reason people book in to see me at my clinic in Bournemouth.

In many of the cases I see, chiropractic care is a very well-tolerated option worth considering and I'll explain clearly whether it's likely to help in your particular case. If I think you'd be better served by your GP, a specialist or another practitioner, I'll tell you and help point you in the right direction.

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