Tailbone Pain [Coccydynia]: How does Physiotherapy help?
Tailbone pain – medically also known as Coccydynia, Coccygodynia and Coccalgia is a type of pain in the deep of buttock. Tailbone pain occurs around the small triangular bone at the very bottom of the spinal column at the tailbone or Coccyx. Patients seek tailbone pain treatment for immediate pain relief as it causes piercing pain when sitting.
Tailbone Topics covered:
Coccydynia | Tailbone Pain Causes | Symptoms: Tailbone pain when sitting | Tailbone Pain Treatment home remedy | Tailbone pain physiotherapy treatment | Tailbone pain during Pregnancy | Coccydynia FAQs
Why is my bum hurting when I sit down?
Tailbone pain ranges from a dull ache to a fierce stab. Physiotherapists at ReLiva clinics treating tailbone pain find that majority of the patients report the worst tailbone pain when sitting. However, the pain may also occur when the individual changes from a sitting to standing position. Most patients with coccydynia describe their pain as a “pulling” or “cutting” sensation in the buttock area.[1] Individuals will also report tenderness on palpation of the coccyx.
It can last for weeks, months or sometimes longer.
Tailbone Pain Symptoms:
Most patients with tailbone pain present the following symptoms:
- Piercing pain in the tailbone
- Severe pain when shifting from sitting to standing up
- Severe pain when sitting for long period of time
- Depression and anxiety
- Poor sleep
- Painful buttocks
- Back pain
What causes tailbone pain?
Coccydynia may be classified into 3 categories based on what is causing the tailbone pain:
- External trauma: A bruised, broken or dislocated coccyx caused by a backward fall.
- Internal trauma: Trauma caused by a difficult childbirth or from repetitive sitting on a narrow or hard surface for too long.
- Non-traumatic or idiopathic [1][2]: This will include tailbone pain caused by Infection, abscess, tumor, degenerative disc disease, obesity and cancer in rare cases.
Now you know that an infection or degenerative disease can cause tailbone pain without injury
Related Reading: Buttock Pain? Is your heavy wallet to blame
Which doctor to consult for tailbone pain?
Majority cases of tailbone pain can be managed by a family physician. Idiopathic coccydynia will need medicine for treatment of tailbone pain. Physiotherapy treatment will work alongside for tailbone pain relief as a physiotherapist will help with modified seating postures, suggest proper use of cushion and methods to relax muscles and ease pain. In case of traumatic coccydynia, physiotherapy will include specific tailbone pain exercises for timely recovery and pain relief.
Physiotherapist will help relieve tailbone pain irrespective of its cause and will work alongside medicine (which works to reduce swelling and infection, if any).
How do you relieve tailbone pain at home?
Tailbone pain treatment at home remedies include:
- Reduce sitting time. Lean forward if you have to sit.
- Use hot water pack or cold pack to relax muscles and ease pain (RICE protocol)
- Use donut cushion or coccygeal cushion when sitting
- Avoid constipation. Use stool softeners to reduce pain during bowel movement
- Stretching and strengthening exercises for lower back and pelvic muscles
- Avoid activities that stress the tailbone, including cycling
Related Reading:
Does physiotherapy help tailbone pain?
Physiotherapy treatment for coccydynia helps reduce pain immediately while working on tailbone area for long term relief. ReLiva physiotherapist will include one or more of the following to treat tailbone pain:
- Pelvic floor physical therapy [3] may be particularly helpful for patients who have substantial muscular pain within the adjacent para-coccygeal muscles. Pelvic Floor Relaxation Exercises help to get the coccyx into better alignment. This can relieve the pain experienced during urinating and defecating
- Physiotherapy Modality [3]: TENS or Transcutaneous Electrical Nerve Stimulator units has been established to be very effective in relief from this kind of pain.
- Tailbone pain Exercises specifically targeted on the muscles in this area for stretching and strengthening
- Manipulation: Patient may also find pain relief through manual manipulation of the coccyx. Manipulation may be helpful in relieving ligamentous pain or pain due to muscular spasm.
- Tailbone Massage and Mobilization: Coccydynia may be reduced or alleviated by massaging tense pelvic floor muscles that attach to the coccyx. Different manual treatments have been reported in the literature, including levator ani massage, levator ani stretch, and joint mobilization.[4]
- Dry needling. It is surprisingly comfortable and very effective for specific conditions such as pelvic pain
At ReLiva, the physiotherapist will take a detailed assessment of your condition and symptoms in order to plan an appropriate treatment regime best suited for you. This will include physiotherapy techniques, tailbone pain exercises as well as postural changes for immediate pain relief.
Do not confuse your tailbone pain with Sciatica pain: Read about Sciatica Pain and its Treatment
Coccydynia: FAQs
How to treat tailbone pain during pregnancy?
Tailbone pain is very common among pregnant women as the growing foetus puts pressure on organs and bones pushing them from their original position. Pain may come from sitting for long periods of time, but can also occur when standing and walking.
Physiotherapists from FabMoms Prenatal Class for Pregnancy follow specialised prenatal physiotherapy which brings tailbone pain relief for the expecting mother in a manner that is safe for the foetus too. They also recommend postural and lifestyle changes to help relieve some of the pain by taking pressure off the coccyx of the pregnant women. These include:
- Pregnant women should sleep / lie on their side specially when they have tailbone pain
- Use a coccyx cushion – a specially designed gel or donut pillow to sit in case of acute tailbone pain
For tailbone pain exercise ball is increasingly used as an exercise equipment by physiotherapists for treating women with tailbone pain after childbirth as well as during pregnancy.
How to sleep with Coccydynia: What helps tailbone pain while sleeping?
One is suggested to sleep / lie on their side specially when they have tailbone pain. This reduces the excess pressure on the coccyx relieving the tailbone pain.
Does walking help tailbone pain?
Standing up and walking around reduces the pressure on your coccyx, reducing pain. Sitting, driving, bending and sleep on back – all these affect the tailbone. Avoid these activities that aggravate stress on tailbone.
For specific rehabilitation advice regarding your tailbone pain, call us at +91 99209 91584 or ask for call back and we will connect you with a physiotherapist near you. If you, or someone you know would benefit from physiotherapy treatment and you do not have access to it right now, please register for an online physiotherapy session here
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This post is based on the contribution from Dr Kritika Dwivedi (PT). Dr Kritika is a very senior physiotherapist (11+ years experience) who ensures patient care and rehabilitation using a variety of techniques including Manual therapy, Exercise therapy and Mobilization.
Scientific References:
[1] Kerr EE, Benson D, Schrot RJ. Coccygectomy for chronic refractory coccygodynia: clinical case series and literature review. Journal of Neurosurgery: Spine. 2011 May 1;14(5):654-63.
[2] Lirette LS, Chaiban G, Tolba R, Eissa H. Coccydynia: an overview of the anatomy, etiology, and treatment of coccyx pain. Ochsner Journal. 2014 Mar 20;14(1):84-7.
[3] Coccyx Pain Mabrouk A, Alloush A, Foye P. Coccyx Pain. [Updated 2021 Jan 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan
[4] Maigne JY, Chatellier G. Comparison of three manual coccydynia treatments: a pilot study. Spine (Phila Pa 1976). 2001 Oct 15;26(20):E479-83; discussion E484. [PubMed]
