What is tailbone (coccyx) pain and injury?

Tailbone pain, also known as coccyx pain, coccydynia or coccygodynia, is discomfort or soreness in the coccyx, which is the small bone at the lowest part of your spine.

This type of pain and injury can happen because of many reasons, such as falling directly onto the tailbone, sitting on hard surfaces for long periods of time, or trauma during childbirth.

If you fall on your coccyx, it can lead to bruising, swelling and pain in the tailbone area.

What are the symptoms of tailbone pain and injury?

Symptoms of coccyx (tailbone) injury can include sharp or dull pain in the lower back, specifically around the tailbone area. Sitting for a long period of time, especially on hard surfaces, can worsen the pain. Other symptoms may include tenderness, swelling and bruising around your tailbone.

If you've had a tailbone injury, you may find it painful to move or sit down, and the pain may worsen when you move between sitting and standing positions. Some people with tailbone injury find sex or emptying their bowels (pooing) painful.

What causes tailbone pain and injury?

Tailbone pain and injury can happen due to many reasons. Falling onto your tailbone, sitting on hard surfaces for long periods of time, or trauma during childbirth are common examples.

Tailbone pain can also happen without a specific injury to the area. Diseases of the joints in the back, infections and rarely, cancer, can also cause tailbone pain.

When should I see my doctor?

You should see your doctor if you have serious coccyx pain, meaning:

• your pain is getting worse over a few weeks
• you are in distress
• your ability to move is limited

Your pharmacist can also recommend ways to help manage your pain.

How is tailbone pain and injury diagnosed?

To diagnose coccyx pain or injury, your doctor may:

• ask you questions about your pain
• ask about any other symptoms or health concerns
• do a physical examination

Usually, you won't need x-rays, CT or MRI scans, since these aren't helpful when looking for the cause of coccyx pain. They also don't change how you manage your pain.

For more information about questions to ask your doctor before you get a medical test, treatment or procedure visit Choosing Wisely Australia.

How is tailbone pain and injury treated?

Around 9 out of every 10 cases of coccyx pain will resolve without medical treatment.

Here are some tips to help you manage your pain while you wait for your tailbone to heal:

• Use a special cushion, such as a wedge-shaped 'coccygeal cushion', to relieve the pressure on the coccyx, or a circular ('doughnut' cushion) if you have pain in your rectum (bottom).
• Ask a physiotherapist to check your posture, as poor sitting posture can contribute to your pain and slow down recovery.
• Apply heat and cold packs to your tailbone area. Try both and see which one works best for you.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) can help some people with coccyx pain, but first check with your pharmacist to be sure that they are right for you, especially if you have other health conditions or take other medicines.
• Ask your pharmacist to recommend a topical preparation (such as a cream or gel), since these tend to have fewer side effects than oral medicines.

Usually, tailbone pain resolves within weeks to months. Sometimes, the pain can become chronic (long term) and your doctor will need to help you manage your condition.

Can tailbone pain and injury be prevented?

You can't always prevent tailbone pain because it often occurs after accidents or as a symptom of an underlying condition. You might be able to reduce your risk if you:

• practise good posture, especially when sitting for long periods of time
• use a cushion or pillow to support your lower back while sitting to help reduce pressure on your coccyx
• avoiding sitting on hard surfaces for long periods of time
• take regular breaks from sitting, to stretch and move around
• try exercises that strengthen your muscles, improve flexibility and generally keep you healthy and strong

Complications of tailbone pain and injury

Complications of tailbone pain and injury can include chronic (long-term) pain that affects daily activities like sitting or standing for long periods of time. Chronic tailbone pain can be a sign of a more serious condition, and will need careful diagnosis and ongoing management by your health team. Depending on the cause, you may need physiotherapy, medicines, or rarely, surgery.

It's important to seek medical advice if your back pain doesn't start to resolve within a few weeks, or if you also have other symptoms like numbness, tingling, or difficulty moving your lower back and hips.

Resources and support

If you have a coccyx injury, see your doctor or call healthdirect on 1800 022 222 at any time to speak to a registered nurse (known as NURSE-ON-CALL in Victoria) for more information and advice.

• FIND A PHYSIOTHERAPIST — Use the Australian Physiotherapy Association search tool to find physiotherapists to prevent or treat lumbar spine injury.
• See the Musculoskeletal Australia website for information about back pain and tips to manage and prevent back pain.
• Learn about why it is important to be physically active at the Australian Physiotherapy Association website.