Coccydynia: Symptoms, Causes, Treatment

The coccyx lies below the sacrum near the top of the buttock cleft. Its pain should be distinguished from lower-back pain, an infected pilonidal sinus or an anal problem through location and examination.

Related reading: Managing chronic pain in another region of the spine.

Localized aching and tenderness may worsen with sitting, rising or bowel movements, affecting sleep or work. Leg weakness should not be dismissed as an ordinary tailbone-pain symptom.

Pain can follow a fall, childbirth, prolonged sitting, repeated pressure or altered coccygeal joint movement. Sometimes no cause is identified; infection or another disorder occasionally requires different care.

Childbirth, previous injury, prolonged sitting, cycling pressure, high or low body weight and altered joint mobility are associated factors. No single factor identifies the cause without assessment.

Assessment reviews injury, childbirth, duration and examination findings. Imaging may be needed after trauma, persistent symptoms or unusual signs, but X-rays or MRI are not necessary for every case.

A tailored coccyx cushion, movement breaks and suitable pain relief may help. Physiotherapy or constipation treatment can be added; injections require specialist assessment, and removal surgery is uncommon after adequate conservative treatment.

Pain may become persistent and limit sitting or sleep, encouraging activity avoidance. Conservative approaches usually come first; invasive treatment does not guarantee success and requires a discussion of risks.

Avoid prolonged unbroken sitting, vary position, use comfortable support and increase activity gradually. Fall prevention and reducing repeated pressure help; no single cushion suits everyone.