Tail Bone Pain and Trauma Information


Tailbone pain is pain in the coccyx bone.
Tailbone pain is pain in the coccyx bone.

Tailbone Pain

Tailbone pain, technically called coccygodynia, is no picnic at the beach.  

Coccygodynia can result from a fall or other trauma onto the very bottom part of your spine. Such trauma can bruise the periosteum (connective tissue that surrounds the bone), causing pain. Falls onto the tail bone can also fracture the bone, dislocate it (at the sacroccygeal joint, which is the place where the coccyx and the sacrum come together,) or both.

Whatever the outcome of the trauma, getting pain relief for an injured tail bone is often difficult.

In fact, because sitting - a staple activity for most of us, and one that directly impacts the coccyx - can be very uncomfortable when you have coccygodynia, this condition is notorious for interrupting quality of life.

Related: Coccyx and Sacrum

Tail Bone Pain Causes

While most of the time coccygodynia does result from some type of trauma to the tail bone, there are other causes, as well.

Problems with your coccyx bone that can result in coccygodynia may include injuries (including but not limited to falls, as discussed above), disc degeneration at your sacrococcygeal (defined above) and/or intercoccygeal joints (joints between the tiny bone pieces that together comprise the coccyx), bone spurs at the coccyx (called coccygeal spicule), infection in the bone (called osteomyelitis) or a tumor on the bone.

Another cause of coccygodynia (in the mother) is a painful vaginal birth.

Coccygodynia may also be the result of referred pain, i.e. pain arising from organs in which disorders are present. Examples may include conditions or problems in the sigmoid colon, urogenital system and/or the rectum.

Not only that, pain in the tail bone region can sometimes be traced to problems occurring at, on or in nearby structures.

Examples include: Problems in the lumbosacral area of your spine, sacrum and sacroiliac joint issues, piriformis syndrome, diseases of the pelvic organs, hemorrhoids, and more.

Related: Piriformis Syndrome

Finally, your coccygodynia maybe be a case of "cause unknown." In a review of studies entitled "Coccygodynia: etiology, pathogenesis, clinical characteristics, diagnosis and therapy," published in the Jan-Feb 2012 issue of the Croatian medical journal Lijec Vjesn, author Grgić states that 30% of coccygodynia is idiopathic; in other words, the reason for the tail bone pain could not be found.

Do You Have a Hypermobile Tail Bone?

With that said, hypermobility of the coccyx (hypermobility refers to the tendency of the bone to subluxate) is the most common medical finding associated with tail bone pain. Grgić asserts that 70% of patients with coccygodynia showed signs of excess motion of this bone when dynamic X-rays were taken.

Along with injury (as mentioned above), overloading the coccyx during movement as well as when stationary can cause a hypermobile (and painful) coccyx.

Activities and states of being that might predispose you to overloading your coccyx include being obese and/or sitting for long periods of time (static overloading), and bicycling, rowing or riding (dynamic overload).

In their 2014 study published in the Ochsner Journal, researchers assert that obesity and being female are two risk factors for tailbone pain.

Symptoms of Coccygodynia

Symptoms of coccygodynia include discomfort and pain at the base of your spine (this is where the coccyx bone is located). It can also include pain in your lower back and/or hips. You may find you get shooting pain down your legs, too.

Coccygodynia intensity varies from person to person. The severity of your coccygodynia pain may worsen over time.

As I mentioned earlier, coccygodynia can be very disruptive to your lifestyle. It can ruin a good night's sleep and interrupt your ability to carry out activities in which sitting and/or bending is necessary. It can also make taking care of bodily functions excruciating.

This means that things you normally do - and perhaps take for granted - such as working at your computer or driving may become too painful. The fact is that when you put weight on your coccyx bone, even if the surface underneath you is a soft pillow or chair, your pain will likely increase. You may also find that getting up from a sitting position is difficult.

Diagnosing Coccygodynia

Doctors typically diagnose coccygodynia by taking a medical history, doing a physical exam (which involves palpation of the area) and taking standard and dynamic x-rays. Most likely, your doctor will ask you to sit and/or to do some cycling, to try to reproduce your pain and symptoms.

Related: Communicate Your Symptoms To Your Doctor

A coccygodynia diagnosis is often confirmed by means of an injection. In this case, a local anesthetic is injected into the specific place or places in the tail bone region from which, based on what you say about your symptoms and the results of your physical exam, as well as the x-rays and possibly an MRI (see below for more information), your doctor suspects the pain originates.

MRIs and Coccygodynia Diagnosis

Most of the time an MRI is not used in the diagnosis process. But in 2012, French researchers found that MRIs may provide details that can be used to determine the cause of a painful tail bone. Their study revealed that when the relative state of the mobility of the coccyx is known, an MRI may help further paint a picture of what's going on. For example, in the study, out of 172 cases being tested, 105 showed a mobile coccyx. Of these, most showed abnormal discs; in the 67 patients with a rigid (immobile) coccyx, abnormal features were found at the bottom part of the bone, called the tip.

Treatment for and Pain Relief of Coccygodynia

It is not at all easy to get pain relief for coccygodynia.

As with most spine problems, treatment is divided up into two main types: Conservative (non-invasive) and surgical (also called invasive). The surgery for tail bone pain is called a coccygetectomy. It can be either partial or total removal of the tailbone; this surgery is usually reserved for times when everything else has been tried without success. Generally speaking, results tend to be moderate at best, and by having a surgery, you run the risk of experiencing complications.

Conservative treatment for tail bone pain includes rest, medication, such as NSAIDs (especially at first), sitting on a cushion with a hole cut out of the middle (often jokingly called a "whoopie cushion"), acupuncture and physical therapy. Once you're in the chronic phase of the injury, physical therapy treatment may include hands on techniques to increase the flexibility of the pelvic floor - specifically the levator ani muscle, which in turn may release the coccyx bone if it is stuck.

The researchers mentioned above whose 2014 study was published in the Ochsner Journal say that a multidisciplinary approach to treatment tends to work best.  They also say that non-surgical treatment works about 90% of the time.

Related: Physical Therapy Modalities

Your doctor may suggest getting a steroid injection, or an injection of a local anesthetic, to help you deal with the pain. (Acupuncture may help with this, as well.) Sometimes a pain control procedure known as radiofrequency ablation is used for coccygodynia, but this is not generally recommended.


Grgić V. [Coccygodynia: etiology, pathogenesis, clinical characteristics, diagnosis and therapy]. Lijec Vjesn. 2012 Jan-Feb;134(1-2):49-55. http://www.ncbi.nlm.nih.gov/pubmed/22519253

Lirette, L., MD. Coccydynia: An Overview of the Anatomy, Etiology, and Treatment of Coccyx Pain Ochsner J. Spring 2014. Accessed: June 2016. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3963058/

Maigne JY, Pigeau I, Roger B. Magnetic resonance imaging findings in the painful adult coccyx. Eur Spine J. 2012 Oct;21(10):2097-104. doi: 10.1007/s00586-012-2202-6. Epub 2012 Feb 22. http://www.ncbi.nlm.nih.gov/pubmed/22354690

Moore, K., Dalley, A. Clinically Oriented Anatomy. Fifth. Edition. Lippincott, Williams & Wilkins. 2006. Baltimore. Pool-Goudz.

Patijn J, Janssen M, Hayek S, Mekhail N, Van Zundert J, van Kleef M. Coccygodynia. Pain Pract. 2010 Nov-Dec;10(6):554-9. doi: 10.1111/j.1533-2500.2010.00404.x. Epub 2010 Sep 6.

Vacarro, A. Spine: Core Knowledge in Orthopedics. Elsevier Mosby 2005. Philadelphia, PA.

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