Coccydynia (Tailbone Pain)

Coccydynia is pain arising from the coccyx, more commonly known as the tailbone. The coccyx is a small triangular bone located at the very bottom of the spine and forms an important attachment point for the pelvic floor muscles, ligaments and surrounding soft tissues.

Tailbone pain can make everyday activities uncomfortable, particularly sitting, driving or moving from sitting to standing. Although symptoms can be frustrating, many people improve with the right diagnosis and targeted treatment.

Pelvic health physiotherapy can play an important role in identifying the cause of tailbone pain and developing an individual rehabilitation programme.

Common symptoms

Symptoms may include:

• Pain directly over the tailbone
• Pain when sitting, particularly on firm surfaces
• Discomfort when standing up after sitting
• Pain during prolonged driving
• Tenderness around the coccyx
• Pain during bowel movements
• Pelvic floor discomfort
• Pain during sexual intercourse in some individuals

What causes coccydynia?

There are several possible causes of tailbone pain, including:

• Falls onto the buttocks
• Childbirth
• Prolonged sitting
• Repetitive strain
• Hypermobility or stiffness of the coccyx
• Pelvic floor muscle tension
• Previous surgery or trauma

In some cases, symptoms develop gradually without a clear injury.

Because the pelvic floor muscles attach to the coccyx, dysfunction within these muscles can sometimes contribute to persistent tailbone pain.

How is coccydynia diagnosed?

Your physiotherapist will take a detailed history and assess:

• Your symptoms
• Previous injuries
• Activities that aggravate your pain
• Sitting tolerance
• Exercise levels

Physical assessment may include:

• Examination of the lower back, hips and pelvis
• Assessment of pelvic floor muscle function (where appropriate)
• Assessment of movement and posture
• Gentle assessment of coccyx mobility where clinically indicated

Occasionally imaging or referral to a specialist may be recommended if symptoms suggest another underlying condition.

How can pelvic health physiotherapy help?

Treatment depends on the underlying cause of your symptoms.

It may include:

Manual therapy

Hands-on treatment can help improve movement around the coccyx, reduce muscle tension and improve surrounding tissue mobility.

Pelvic floor rehabilitation

If the pelvic floor muscles are contributing to your pain, treatment may focus on:

• Relaxation techniques
• Improving muscle coordination
• Reducing overactivity
• Restoring normal function

Sitting advice

Simple modifications such as sitting posture, cushions and activity changes can often make daily life more comfortable while symptoms improve.

Exercise rehabilitation

Your physiotherapist may provide exercises to improve:

• Hip mobility
• Core control
• Pelvic stability
• Functional movement

Recovery and outcomes

Most people experience gradual improvement with appropriate treatment, although recovery time varies depending on the cause and duration of symptoms.

Early assessment can often help identify contributing factors before symptoms become more persistent.

Expert assessment for tailbone pain

If tailbone pain is limiting your ability to sit comfortably, exercise or enjoy everyday life, specialist pelvic health physiotherapy may help.