My Tailbone Hurts When I Sit, What's Wrong?
Where is my Coccyx?
The coccyx is the anatomical term used for tailbone which is the bone at the very bottom of your spine, so in your buttock region. The pelvic floor muscles as well the gluteus maximus muscle have attachments into the bone. There are also numerous fibrous ligamentous attachments in this area as well to the sacrum which help hold the bones together and keep them stable.
What causes pain in this region?
Pain in the tailbone region may be referred to as coccydynia and is most commonly is caused by a traumatic event. For example a fall onto the backside or during childbirth. This can cause bony bruising or a fracture of the bone. It can also cause inflammation which can lead to pain and discomfort. Other causes can be degeneration or wear and tear of the joint which links the coccyx to the sacrum or possibly other surrounding joints which can be often overlooked. Instability i.e excess or poorly controlled movement in the joint can also cause sensitivity and pain in the area. Pain in this area may also be referred pain from tight muscles containing trigger points for example the buttock or pelvic floor muscles. 'Sciatica' can also cause pain the tailbone region. In rare cases pain in the coccyx area can be due to tumors and infections.
Image courtesy ofWikipedia
What are the signs and symptoms?
Pain and tenderness around the coccyx area is one of the main signs. This pain can be aggravated by sitting or leaning against the buttock region.
Do I need an X-Ray?
If there has been a traumatic event an X-Ray is useful to determine if there is a fracture present or if the bone has become subluxed i.e not resting in the correct position.
Is Physiotherapy any help?
Manual therapy, medical acupuncture (including dry needling) and individualised exercises can help to relieve pain and sensitivity, restore mobility, deactivate trigger points, improve strength and support as well as and reduce inflammation. Exercises can help to strengthen up the core muscles and stabilise the joints in the coccyx region as well as exercises to help improve flexibility in the surrounding muscles.
Should I do anything else to help it?
Sitting on a rubber ring cushion will help to offload the bone and reduce inflammation. Anti-inflammatory medications can help to reduce inflammation as well, please see your pharmacist. Avoid any high impact activities such as running or jumping can help to offload the area.
How long will it take for symptoms to settle?
Depending on the extent of the injury it can take up to two months for symptoms to settle completely.
Do I need surgery?
Surgery in this region is very uncommon and is used as a last resort as most symptoms will settle with conservative physiotherapy treatment, a rubber ring and anti-inflammatory medications. If the pain is persistent generally a local cortisone injection can help to relieve symptoms. Surgery is most successful if there is significant instability in the area.