Coccydynia is pain in and around the tailbone (coccyx), the small bone at the very bottom of the spine. It is felt most when sitting, especially when leaning back, and when standing up from a chair. It often follows a fall onto the bottom or childbirth, although sometimes no cause is found. Most cases improve within weeks to months with simple measures such as a specially shaped cushion.
Also known as coccyx pain, coccygodynia, tailbone pain
Anatomy: where the problem is
Front view of the pelvis and hips. Highlighted in the diagram: tailbone (coccyx).
Symptoms
- Pain and tenderness at the base of the spine, just above the buttock crease
- Pain that is worse when sitting, particularly on hard surfaces or leaning back
- A sharp pain when standing up from sitting
- Pain during bowel movements or sex in some people
- Relief when standing or walking
Causes and risk factors
- A fall onto the bottom
- Childbirth, particularly a difficult or assisted delivery
- Prolonged sitting on hard or narrow surfaces, such as cycling or rowing
- A tailbone that moves too much or too little
- Being overweight, or losing a lot of weight quickly
- Often no clear cause
What the evidence says helps
- Most people get better with conservative treatment. A review reported that about 9 in 10 cases respond to non-surgical care.1
- First-line measures are a wedge or cut-out cushion that takes pressure off the tailbone, changes to sitting, and simple pain relief such as anti-inflammatory medicines.12
- Manual treatment of the muscles and ligaments around the tailbone is used, and a small trial found a modest benefit over a dummy treatment in long-standing cases.2
- An injection of local anaesthetic and steroid around the tailbone can help if pain persists for several months.12
- Surgery to remove the tailbone is a last resort for severe cases that have not responded to anything else.2
Things you can try at home
- Use a coccyx cushion with a cut-out at the back, at home, at work and in the car
- Lean slightly forward when sitting, and avoid slumping back onto the tailbone
- Get up and move around regularly
- Use heat or ice over the area for short-term relief
- Avoid constipation by drinking enough fluid and eating enough fibre, as straining can aggravate it
- Ask a pharmacist about suitable pain relief
When to get urgent help
Contact your GP urgently, call NHS 111, or call 999 in an emergency if you have:
- Loss of bladder or bowel control, or numbness around the genitals or back passage: go to A&E
- Tailbone pain with a fever, or a hot, red, swollen area near the buttock crease: get same-day medical help
- Bleeding from the back passage, or a change in bowel habit lasting more than three weeks: see your GP
- Constant pain that is not affected by sitting, or pain with unexplained weight loss or a history of cancer: see your GP
- Severe pain after a heavy fall: go to a minor injuries unit
How Apollo can help
We assess the tailbone, pelvis, hips and lower back, and how you sit and move. Treatment includes advice on cushions and sitting, gentle external techniques for the muscles and joints around the pelvis and tailbone, and exercises for the hips and pelvic floor area. We explain each step and work only with your consent. Coccydynia after childbirth is common, and we can fit your care around life with a new baby. If the pain persists, we write to your GP about an injection or further investigation.
No GP referral needed. Clinics in Sheringham, Coltishall and Norwich.
Related reading
Frequently asked questions
How long does tailbone pain last?
Many cases settle within a few weeks to three months. Some last longer, particularly after a significant fall or a difficult birth, and most of these still improve with conservative treatment.
What is the best cushion for coccydynia?
A wedge-shaped cushion with a cut-out section at the back takes the pressure off the tailbone. Ring-shaped cushions are less suitable, because they can still put pressure on the area.
Can childbirth cause tailbone pain?
Yes. The tailbone moves backwards during delivery, and it can be strained or occasionally injured, particularly in a long or assisted birth. It usually improves over the following weeks and months with the same measures as for other causes.
References
- Nathan ST, Fisher BE, Roberts CS (2010). Coccydynia. The Journal of Bone and Joint Surgery. British volume 92-B:1622-1627. View source
- Elkhashab Y, Ng A (2018). A Review of Current Treatment Options for Coccygodynia. Current Pain and Headache Reports 22. View source
This page is general information, not a diagnosis or a substitute for medical advice. If you are worried about your symptoms, speak to your GP or a registered healthcare professional. Content prepared from the sources above, November 2026.
