It Hurts When I Sit: Tailbone Pain

Understanding Tailbone Pain

Coccydynia or coccygodynia, generally called tailbone pain, is a common condition. In some cases, pain resolves without conservative management; however, many presentations will benefit from conservative management; such as physiotherapy; in the resolution of pain and dysfunction (1).

Why is my tailbone important?

The coccyx, or tailbone, is the final or end segment of the spinal column. There are lots of nerves and blood vessels associated with the tailbone region. Although we have lost out tails through the evolutionary process the tailbone continues to be an important site for muscles and ligaments. Many muscles of the pelvic floor and your gluteus maximus attach to your tailbone. If there is dysfunction in these muscles your tailbone may become affected. Furthermore, the tailbone assists to distribute weight evenly while you sit (1).

Why does my tailbone hurt?

Tailbone pain can be related to a distinct cause such as a fall on you buttock, pregnancy, or a vaginal delivery. Indirect tailbone pain may be a referral pain process extending from your back. In many cases the cause of tailbone pain is unknown or insidious in nature.Why does my tailbone hurt?

How do I know if my pain is tailbone pain?

Generally, if you have pain located over your tailbone, your tailbone is likely involved. If you are experiencing pain after sitting or standing for longer periods of time, leaning backwards, changing positions from sitting to standing or painful intercourse, your tailbone may be involved. If you are aware of a traumatic incident to your tailbone there is good indication that it is involved. It is best to come in for a physical assessment by a physiotherapist, so they can identify the structures involved in you tailbone pain to treat your pain effectively (1).

How Do I manage tailbone pain at home?

The most important step is to relieve pressure on your tailbone by purchasing a wedge shaped cushion. Donut cushions are ok, but the shape of the donut cushion can sometimes increase pressure on the tailbone. Home tools such as heat or ice can also be used; try both heat and ice and see which form reduces pain and then use that for home management (1).

How will physiotherapy help?

As previously outlined, your physiotherapist can identify which structures are involved and then create a specific strengthening program for you to complete at home. Furthermore, your physiotherapist will conduct manual therapy such as joint and soft tissue mobilization to manage your injury and facilitate a full recovery. In some cases, internal manual therapy completed by a trained pelvic floor physiotherapist may be required to mobilize tissues such as the pelvic floor and tailbone as these tissues are not accessible to mobilize externally (1).

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Tailbone Pain Treatment at Burnaby PhysioCare

This blog was created by Heather Baker, Physiotherapist at Absolute PhysioCare and Sports Rehabilitation in Burnaby BC
If you are experiencing tailbone pain, please contact us at 604-558-CARE (2273), or touch with us online.

References:
1) Smallwood Lirette, L., Chaiban, G., Tolba, R, & Eissa, H. (2014). Coccydynia: An Overview of the Anatomy, Etiology, and Treatment of Coccyx Pain. The Ochsner Journal. 14(1): 84–87