Tailbone Pain & Healing Coccydynia

Does that pesky “little” tailbone hurt when you sit for prolonged periods of time? Do you experience a deep ache around your tailbone? Is your tailbone sensitive to touch and painful with intercourse, bowel movements, and menstrual cycles? You could be suffering from coccydynia.

The anatomical term for your tailbone is called your coccyx. Coccydynia, by definition, means painful coccyx. Some causes of coccydynia can be from falling directly on your tailbone, cycling, snowboarding, skating, childbirth, and even undergoing a hysterectomy. The presentation of how you’re experiencing coccyx pain is usually dependent on what the cause is.

Believe it or not, the pictures above show all NORMAL variations of coccyxes. All bodies have some anomalies and the tailbone is no different. We can all have a structurally different looking coccyx, or one that is shifted to the right or left. They are all technically normal, unless the shifting of the coccyx is directly related to an injury and you knew beforehand that your coccyx used to lie differently.

To review a little further, your coccyx lies at the base of your sacrum. Your sacrum then meets up laterally with your pelvis, and your lumbar spine above it. In the case of movement, your coccyx and lumbar spine move together. What this means is that when your low back arches or you stick your butt out behind you, your coccyx is also extending back behind you. The same is true for flattening your low back in that your coccyx will curve inward or flex.

or what seems like a small, little bony structure, its importance is huge when it comes to our pelvic floor muscles. Your pelvic floor muscles span the space from your pubic bone to your coccyx, with the majority of the deeper muscle attaching directly onto your tailbone. What’s more is when our pelvic floor muscles become very tight (which can be due to increased stress, trauma, bladder, and bowel problems), they pull on our coccyx bringing it toward the pubic bone and inhibiting the natural movement of our coccyx.

Our coccyx has about 22 degrees of movement!

When the motion of our coccyx is impaired, this can result in low back and sacro-iliac joint pain and soreness, as well as constipation. Our rectum resides on the front side of our sacrum and coccyx; if our coccyx is flexed inward toward the pubic bone, this can affect how much space our stool has to move and therefore evacuate out of that space.

So – what can you do to alleviate this pain and improve your overall movement?

This is where a pelvic floor physical therapist can help! We evaluate the motion of not only your coccyx, but your low back and general alignment within your pelvic ring. This helps us determine where your restrictions are, what muscles are tight, and where to focus our attention to relieve symptoms. This will usually involve getting to the area right around your tailbone (accessed through the anus and rectum) due to all the connections of your pelvic floor muscles. In the meantime, things you can focus on to help your symptoms are listed below:

  • Relax your bum! Some people tend to squeeze their glute muscles constantly – this can pull on and irritate the area, so relax your tooshy muscles as much as possible when standing and walking.
  • Focus on overall posture. Proper posture doesn’t mean having our chest and butt pushed out; instead it’s stacking our ears over our shoulders (with a slight chin tuck vs chin jutting forward), shoulders over hips (avoid pushing your hips out in front of you or pushing your hip out laterally as if supporting a babe), hips over knees, and knees over ankles.
  • To go along with posture, it’s important to free up your perineal and tailbone space. Purchasing a cushion with the center cut out allows for more space, but also feedback to try and relax those muscles and let them “hang down” a bit. You can also try using towels/a towel roll to create a U-shape to sit on, where the pressure is on your sit bones and not soft tissue.

If you have been suffering from coccydynia, know that we are here to help. We will be able to focus on where you need the treatment to decrease pain and improve overall comfort. Give us a call or seek out a local pelvic floor physical therapist to get started with your relief.

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