Tailbone Pain: Triggers and Treatment

Karuna Anantharaman, MD, a family medicine physician at Indiana University Health, explains the common causes of tailbone pain and what you can do to ease the ache.

In many cases, the cause of tailbone pain is obvious: You fell and landed on your rear, and now the area around the base of your spine (where your tailbone, or coccyx, is located) really hurts. But other times, the pain emerges gradually, and the trigger may be related to lifestyle or occupational factors. “Anyone who has to sit on a hard, narrow surface for long periods of time is at risk of developing tailbone pain,” Dr. Anantharaman says. Cyclists and rowers are particularly prone to it, as are pilots, who spend hours strapped into seats that force them to lean back, which puts a great deal of pressure on the tailbone.

Women who have given birth vaginally or who required a forceps delivery may also experience persistent tailbone pain. “These deliveries can cause muscle spasms and arthritic changes around the base of the spine,” Dr. Anantharaman explains. “Moms might ignore the pain while they’re busy with their newborn, but a year later they realize it’s still there.”

Women are also more likely to injure their tailbone than men for structural reasons. “A woman’s pelvis is wider, which means the tailbone is more exposed and vulnerable,” Dr. Anantharaman says.

Fortunately, most tailbone injuries are merely bruises rather than breaks. Still, even if you feel certain that your tailbone is just bruised, it’s a good idea to check in with your doctor instead of simply self-treating, says Dr. Anantharaman. He or she may want to rule out rare causes of tailbone pain such as bone spurs, infection, and tumors. Recommended treatments include:

Rest. You may need to avoid activity and sitting on hard surfaces for a couple of weeks. You’ll likely feel best when lying down since there’s little pressure on your tailbone in that position.

Postural changes. Using a doughnut cushion (available at your local pharmacy) when you sit can ease pain and pressure by preventing your tailbone from touching the seat of your chair.

Over-the-counter pain medication. Unless you have severe pain that may require a steroid injection, non-steroidal anti-inflammatory drugs like ibuprofen and naproxen will manage the ache. Icing the area is also helpful.

Dietary changes. Because tailbone pain can make defecation uncomfortable, your doctor may advise you to consume more fiber and up your water intake so you’re less likely to strain.

Physical therapy. A therapist can teach you exercises that help ease tension and spasms in your pelvic muscles.

Tailbone pain is usually resolved within 6 to 8 weeks. If yours persists, Dr. Anantharaman recommends seeing your doctor for further evaluation and treatment.

-- By Jessica Brown