The coccyx is at the base of the spinal cord, below the sacrum
The coccyx, located below the sacrum, can be severely damaged in a fall

What is tailbone pain (coccydynia)?

Tailbone pain, called “coccydynia,” is pain in and around the small triangular bone at the very bottom of your spinal column, above the cleft of your buttocks.

The term “coccyx” comes from the Greek word for “cuckoo” as it resembles a bird’s beak with the tip pointed down. “Dynia” means “pain,” and so “coccydynia” literally means “pain of the coccyx.” And because the bone corresponds to the location of an animal’s tail, it’s called the “tailbone.”

What is the tailbone/coccyx?

Your coccyx is made up of three to five fused vertebrae (bones). It lies beneath the sacrum, a bone structure at the base of your spine. Several tendons, muscles and ligaments connect to it. Both the coccyx and the ischial tuberosities (two bones that make up the bottom of your pelvis) bear your weight when you sit down. Two-thirds of adults have a coccyx that curves a bit instead of pointing straight down, but one that is curved too far is abnormal and, therefore, painful.

Why does my tailbone hurt?

Tailbone pain ranges from a dull ache to a fierce stab. It can last for weeks, months or sometimes longer. There are three types of events that cause tailbone pain:

  • External Trauma: A bruised, broken or dislocated coccyx caused by a fall.
  • Internal Trauma: Trauma caused by a difficult childbirth or from sitting on a narrow or hard surface for too long.
  • Others: Infection, abscess and tumors.

Interestingly, for one-third of those with coccydynia, the cause is unknown.

Is tailbone pain (coccydynia) permanent?

No. Tailbone pain is rarely lifelong.

How common is tailbone pain (coccydynia)?

Tailbone pain is common.

Women are five times more likely than men to develop coccydynia. Adults and adolescents get it more often than children. Obese persons are three times more susceptible than those at the ideal weight according to the BMI (Body Mass Index) scale. You’re also more vulnerable if you lose weight too quickly.

What causes tailbone pain (coccydynia)?

Falling

Who hasn’t fallen backwards onto their behind? Maybe your feet slipped out from under you on the ice. Maybe you fell off a ladder. Or, maybe you were leaning too far back in your office chair and took a tumble. If you take a really bad fall you can bruise, break (fracture) or dislocate (knock out of place) your tailbone (coccyx).

Repetitive Strain Injury (RSI)

Sports like bicycling and rowing require you to lean back and forth and stretch your spine. Too much of that repeated motion can strain the tissues around your coccyx.

Pregnancy/Childbirth

During the third trimester of pregnancy, a woman’s body secretes hormones that soften the area between the sacrum and the coccyx. This enables the coccyx to move as necessary during childbirth. This is a natural process but, unfortunately, such movement may stretch the muscles and ligaments around the coccyx too far, causing additional pain. Such a strain on those soft tissues keeps them from supporting your coccyx at the correct angle.

Obesity

Extra weight applies additional pressure to the coccyx. This can cause the coccyx to lean backward. Your tailbone will hurt if it is out of position.

Underweight

If you don’t have enough fat in your buttocks to prevent your coccyx from rubbing against the muscles, ligaments and tendons, that can cause. The rubbing inflames the soft tissues.

Sitting

Just this simple act can increase coccyx pain, especially if you’re sitting on a hard or narrow surface. Do your best to get up often, stretch and take a short walk. Better yet, find yourself a softer, more comfortable place to sit or use a cushioned seat.

Cancer

Only in rare cases is tailbone pain a sign of cancer. It is extremely unlikely.

What are the symptoms of tailbone pain (coccydynia)?

  • The symptoms of coccydynia include:
  • Achy or piercing pain in the tailbone.
  • More severe pain when changing from sitting to standing up.
  • More severe pain when sitting for long periods of time.
  • Pain during bowel movements.
  • Pain during sex.

Other related symptoms that may occur with coccydynia include:

  • Depression.
  • Anxiety.
  • Poor sleep.
  • Painful buttocks.
  • Back pain.

Is tailbone pain (coccydynia) a sign of pregnancy?

As the fetus grows, its weight does put pressure on your pelvic space, causing pain in that general area.

Can tailbone pain (coccydynia) cause rectal pain?

Yes, chronic coccydynia is one of the causes of rectal pain.

Does menstruation cause tailbone pain (coccydynia)?

Tailbone pain is typically worse when a woman is menstruating.

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