Tailbone Pain (Coccydynia)

Medically Reviewed by Carmelita Swiner, MD on August 02, 2022
5 min read

Tailbone pain, or coccydynia, can be a dull ache or a sharp pain at the bottom of your spine. It might hurt when you stand up, have sex, or go to the bathroom. It usually goes away on its own in a few weeks or months.

Sometimes the cause is unknown, but common causes include injury from falls or childbirth infections or sitting too long on a hard surface. It’s rare, but tailbone pain may be caused by cancer. It may be bone cancer or another type that spreads to into your bone, which is called metastatic cancer.

Whatever the cause, if your aches don’t get better, see your doctor. The sooner you figure out what’s causing the problem, the sooner you can treat it and start to feel better.

Tailbone pain can result from bruising, dislocation, or a broken bone caused by a trauma or injury. It may happen if you fall backward or get hurt while playing sports like skating and gymnastics.

It can also result from repetitive strain that comes with activities like cycling or rowing. Doing these things over and over puts an ongoing strain on your muscles, ligaments, and spine, which leads to pain.

Signs that you’ve injured your tailbone include:

  • Pain and swelling
  • Numbness or tingling
  • Weakness in your legs
  • Bowel or bladder problems

If you are having any of these symptoms, especially weakness, numbness, tingling, or bladder or bowel problems, see a doctor right away.

If you’re injured, take time for rest and recovery. Over-the-counter pain relievers may help. If you have a lot of pain or it interferes with your regular activities, see your doctor.

Treatment may include:

If you sit on a hard chair or hard surface for too long, you may feel pain in your tailbone. It can also happen when you’re driving or if on a heavily cushioned surface if you’re in awkward position.

Standing up or walking may ease the ache. You can also try heat, massage, over-the-counter pain relievers, and sitting on a doughnut-shaped cushion.

To prevent tailbone pain, use good form when you sit down.

  • Sit upright.
  • Keep your back against the chair.
  • Keep your knees level with your hips.
  • Keep your feet on the floor.
  • Relax your shoulders.

Ligaments and muscles around the coccyx can get stretched and strained during delivery and cause pain. It’s rare, but the bones in your coccyx could break during delivery.

You may still feel pain months after giving birth. Talk to your doctor if it doesn’t get better. They may suggest:

  • Icing the area
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen and naproxen
  • Physical therapy
  • A U-shaped coccyx cushion

If you have hemorrhoids, the tissue that cushions and protects your anal opening gets inflamed and muscles pull on your coccyx. That can cause tailbone pain.

Other signs of hemorrhoids include:

  • Bleeding from your bottom
  • Burning or pain
  • Protrusion or prolapse
  • Itching
  • Swelling

To treat hemorrhoids, your doctor may suggest:

  • Over-the-counter medication
  • A high-fiber diet
  • Drinking more water
  • Sitz baths, or soaking the area in warm, shallow water

If it doesn’t get better, your doctor may be able to remove the hemorrhoid in their office.

Carrying too much weight puts extra pressure on your coccyx when you sit down. That can lead to tailbone pain.

But it can also hurt if you’re thin. When you don’t have enough fat on your buttocks, your tailbone can rub against nearby tissues and cause pain.

Talk to your doctor about managing your weight.

For pain relief, try:

  • A doughnut-shaped pillow when you sit down
  • Heat or ice
  • Over-the-counter pain relievers like ibuprofen, acetaminophen, or aspirin

Tailbone pain may stem from chordoma, a rare, cancerous tumor that develops in your spine, the base of your skull, or your tailbone. As the mass grows, it can cause pain.

Symptoms of chordoma include:

  • A noticeable mass
  • Numbness in your groin
  • Bowel problems
  • Bladder problems
  • Leg weakness, numbness, or tingling

If you have any of these symptoms, talk to your doctor.

If you have chordoma, your doctor may recommend treatment with:

Tailbone pain is sometimes related to prostate cancer, a common cancer in men. As prostate cancer grows, it can lead to bone pain.

Symptoms of prostate cancer include:

If you have these symptoms, talk to your doctor.

If you have prostate cancer, your doctor may recommend:

A vertebral tumor is a tumor in your spine that affects your bones or vertebrae. As it grows, it may cause pain in your tailbone.

Symptoms of a vertebral tumor include:

  • Back pain, especially at night
  • Pain that moves to other parts of your body
  • Weakness or loss of sensation in your arms or legs
  • Trouble walking
  • Less sensitivity to cold, heat, and pain
  • Loss of bladder or bowel function
  • Paralysis

See a doctor if your tailbone pain gets worse or doesn’t go away, you have other symptoms, or you have a history of cancer.

A tumor or cancer in your colon or rectum can cause tailbone pain. Your colon is your large intestine. Your rectum is the last 6 inches of your colon. Cancer in these areas is called colorectal cancer.

Symptoms of colorectal cancer include:

If you have these symptoms, talk to your doctor.

Treatment may involve:

  • Surgery
  • Chemotherapy
  • Radiation

Most pilonidal cysts, or abnormal pockets of hair and tissue debris in your skin, develop near your tailbone. When a cyst gets infected, it causes swelling and pain.

If you have a pilonidal cyst, you may notice:

  • Pus or blood draining from the skin opening
  • Skin redness
  • An odor or foul smell from the pus

If you have a pilonidal cyst, your doctor may numb the area and make an incision to drain the cyst. If it comes back, you may need surgery to remove it.