Tailbone Pain: Common Causes, Symptoms, Diagnosis and Relief Strategies

First, let us see what a tailbone is. The coccyx, commonly known as the tailbone, is a small, curved bone located at the base of your spine. The coccyx is made up of vertebrae that are fused together. Though it is often called the tailbone, it helps support your weight and keep you balanced when you are sitting.

The coccyx is also where various tendons, ligaments and muscles in your body come together. If your tailbone starts to hurt, it can be a real pain, and it can affect your daily activities and overall well-being.

Symptoms

The symptoms of tailbone pain include:

• Feeling a dull and achy or sharp and piercing tailbone pain
• Tailbone pain that gets worse when you move from sitting to standing
• Discomfort while using the bathroom
• Pain during sexual activity

Other symptoms include:

• Back pain
• Sciatica
• Sleep disorders
• Depression
• Anxiety
• If a tumour is responsible for tailbone pain, other tailbone cancer symptoms may include:
• Feeling of numbness or tingling in the arms, legs or groin
• Trouble with urination or bowel movements
• A noticeable lump around the tailbone area

Tailbone pain causes

There are a few different reasons you might feel pain in your tailbone. Some common tailbone pain reasons include:

• Falls: An unexpected fall can hurt, fracture or even dislocate the tailbone.
• Repetitive strain injuries (RSI): Activities like cycling and rowing involve leaning back and forth, and performing this motion repeatedly can put a strain on the tissues around the tailbone.
• Pregnancy or childbirth: Your body releases hormones as the third trimester approaches.  
• They provide cushioning for the area between your legs, specifically the space between your sacrum and tailbone, which is the part of your pelvis just above your tailbone. This allows your tailbone to become more flexible, making it easier for childbirth. Even if this is a natural process, it can sometimes stretch the muscles and ligaments around your tailbone too much and cause additional pain. When these soft tissues are strained, they may struggle to properly support your tailbone, which can affect its alignment and angle.
• Carrying extra weight: Carrying excess weight can put added pressure on your tailbone, causing it to shift backwards and leading to discomfort or pain.
• Not carrying enough weight: If you have more body fat, you also have less padding around your butt, which means your tailbone might press against your muscles, ligaments and tendons. This can lead to irritation and inflammation.
• Prolonged sitting: Sitting on hard surfaces can put extreme pressure on your tailbone, leading to pain and discomfort.
• In rare instances, tailbone pain could indicate cancer near the coccyx or metastatic cancer that has spread to the bones. However, this is extremely uncommon. Tailbone cancer refers to the abnormal growth of cells in the coccygeal area. This type of tailbone cancer can also metastasize, meaning it can spread from other areas of the body, such as the lungs.  
• Chordoma: This tumour occurs in the spine and often occurs in the tailbone.
• Vertebral tumour: The majority of cancerous vertebral tumours are metastatic, meaning they originate from cancer in other parts of the body. While any type of cancer can spread to the spine, the most common sources include:
• Lung cancer
• Breast cancer
• Kidney cancer
• Prostate cancer
• Colon cancer: Individuals with colon cancer may experience tailbone pain.

Diagnosis

Your healthcare provider will review your medical history and inquire about any prior injuries or trauma to your tailbone, such as falls or a difficult childbirth. They will then conduct a physical examination to assess the area for signs of fractures, lumps or abscesses (infection pockets). This thorough assessment helps the provider identify the underlying cause of your tailbone pain and determine the most appropriate course of action for treatment. By understanding your history and conducting a careful evaluation, they can better address your symptoms and recommend effective solutions to relieve your discomfort.

To see if there is a fracture, your healthcare provider might suggest the following tests:

• X-rays
• CT (computed tomography) scan
• To check for inflammation, abscesses or tumours, your healthcare provider may perform:
• MRI (magnetic resonance imaging)
• Bone scan

Treatment

The treatment for tailbone pain is typically aimed at providing tailbone pain relief. The treatment for tailbone pain depends on what is causing it and how severe the pain is. In many cases, home remedies may do the trick. However, if they do not help, your healthcare provider might suggest nonsurgical options or, in some cases, surgery.

Home tailbone pain remedy:

• Sitting on a doughnut pillow or a wedge-shaped gel cushion relieves pressure on the tailbone.
• Taking hot baths relaxes muscles and eases pain.
• Applying hot or cold packs to the lower back for 20 to 30 minutes several times a day relieves pain.
• If you experience pain while using the bathroom, consider taking stool softeners to make it easier.
• Nonsurgical treatments: If home remedies do not help or if the pain keeps returning, your healthcare provider may suggest nonsurgical treatment such as:
• Non-steroidal anti-inflammatory drugs (NSAIDs): These are commonly prescribed to help relieve pain and reduce inflammation.
• Coccygeal nerve block: This is used to relieve pain and inflammation with a numbing injection and steroids.
• Massage therapy: It is used for temporary relief from the pain.
• Physical therapy: Here, muscles are stretched, and posture is improved.
• Acupuncture
• TENS (transcutaneous electrical nerve stimulation)
• Surgical treatments: In very rare instances, your healthcare provider might suggest:
• Partial coccygectomy: It is the removal of a part of the coccyx.
• Total coccygectomy: It is the removal of the entire coccyx.
• Recovery from a coccygectomy can take several months. Even after the bone is removed, there is no certainty that the pain will completely resolve. For this reason, healthcare providers typically recommend a coccygectomy only when other treatment options have been ineffective.

Prevention

Tailbone pain is not always preventable, as it often results from accidents or an underlying condition. However, you may be able to lower your risk by:

• Avoid prolonged sitting, especially on hard surfaces.
• Take care when cycling or engaging in activities that could strain your tailbone.
• To reduce the risk of falls, consider these precautions:
• Keep floors and walkways clear of obstacles.
• Install handrails on stairs if possible.
• Ensure stairways are well-lit.
• Avoid looking at your phone while walking.

Conclusion

Tailbone pain typically improves within a few days, but it can linger longer than expected. If the pain persists for more than a few weeks or begins to interfere with your daily activities, it is advisable to consult a healthcare provider. They can help determine the underlying cause and recommend appropriate treatments to alleviate the discomfort. Seeking medical advice is a good next step to finding the most effective ways to manage the pain and prevent it from affecting your quality of life. Do not hesitate to reach out for help if the pain becomes chronic or increasingly bothersome.