Tailbone pain or coccydynia can be caused by structural anomalies or by falling, although the cause of pain is unknown in about a third of cases. Tailbone pain often develops when sitting for a long time. In some cases there is an acute pain when the patient moves from sitting to standing. There can also be pain during sexual intercourse or while having bowel movements. Read on to learn how to relieve tailbone pain.
Diagnosing the Tailbone Pain Problem
Know the symptoms associated with pain in the tailbone. Knowing the symptoms of this condition will help you diagnose the problem. They could also give your doctor valuable information. Look for these symptoms:
- Pain in the tailbone or coccyx without pain in the lower back.
- Pain when rising from a seated position to a standing position.
- Frequent need to defecate or pain while defecating.
- Relief of pain when sitting on legs or only on one buttock.
- The pain is generally worse when sitting for prolonged periods of time, or with direct pressure to the tailbone area.
Visit your physician for an examination. Your doctor will know what to look for when evaluating tailbone pain. He may take x-rays or order CT scans or an MRI. The two most effective tests in diagnosing tailbone pain are the injection of a local anesthetic into the tailbone area, to see if that temporarily relieves the pain, and comparing x-rays taken sitting and standing, to see if the coccyx is dislocating when you sit.
- Your doctor could also look for pilonidal cysts, which are cysts that occur only in the tailbone region, and are caused by infection of ingrown hair follicles. Successful treatment of these kinds of cysts may help relieve pain or remove pain altogether.
Understand that tailbone pain is more common in women than it is in men. The coccyx is smaller and lower down in the pelvis in women than it is in men. By some estimates, tailbone pain is roughly five times more common in women than it is in men.
How to Relieve Tailbone Pain with Nonsurgical Treatments
Improve your posture. Poor posture may be contributing to your tailbone pain. Try to sit upright, with your core engaged, your neck straight, and your back slightly arched. If you get a sharp pain when getting up from a sitting position, lean forward and arch your back before rising.
Correct your sleeping position. Many people with tailbone pain find sleeping on their sides most comfortable. However, if you have severe pain, you may find it better to sleep on your front. You could also try sleeping with a pillow or cushion between your knees.
Choose the right clothing. Clothing, such as tight jeans, may make your tailbone pain worse. Wearing loose-fitting clothes that will not squeeze the tissues around your coccyx is recommended.
- Wearing flat, comfortable shoes can also help relieve tailbone pain.
Walk. Normally the coccyx gets pushed in a wrong position which provokes a muscle spasm. The spasm then blocks the coccyx which gets stuck by the muscles. This situation gets worse over time, with increasing problems in the area including sometimes nerve entrapment. It is essential to relax the muscles and unblock the coccyx as soon as possible. The best way to do it is to walk fast many hours a day. Not strolling, but proper fast walking. Walking relaxes the same muscles that trap the coccyx. Sometimes the coccyx position can cause pain when walking even short distances. In these cases you should try to build up your walking gradually with short breaks.
Sit on a hard surface with a straight back, knees at a ninety degree angle. Slowly turn to your right, then back to center, then to the left, and repeat while keeping a good posture.
Sit on a cushion. Special cushions, with a section cut out underneath the tailbone, are designed especially for patients with tailbone pain. This may help relieve some of the pain associated with sitting down. There are different kinds of coccyx cushions being sold out there in the market. Two of the most common kinds are the doughnut and the wedge. These are available in surgical supply stores or at drug stores. It is uniquely designed with a hole at the center corresponding to the area where the coccyx comes into contact while in a sitting position thus eliminating direct pressure on the tailbone area. Regular use of the said cushion will aide in decreasing the pain and soreness. This will eventually lead to full recuperation from the coccyx pain.
- Cushions shaped like a doughnut are not found helpful by most patients, as they are designed to relieve pressure on the genitals rather than the tailbone. Talk to your doctor about use of such a pillow.
Lie face down or on your side. When you sit upright or lay on your back, you apply more pressure to your tailbone. By situating yourself face down or on your side, you can temporarily relieve pain in your tailbone area.
Apply a heating pad. Applying heat to the tailbone area may decrease pain. Use a heating pad up to 4 times per day for 20 minutes each time.
- Use hot baths or warm compresses to achieve a similar result. Instead of sitting down, try to lie down, so as to not apply direct pressure to the tailbone.
Refrain from straining during bowel movements. If necessary, take stool softeners while your tailbone is healing.
Avoid sexual intercourse if it causes pain. Muscle movements in the pelvic area often exacerbate tailbone pain. Relieve tailbone pain by avoiding activities that cause pain.
Get a massage. Professional massage therapists help relieve pressure in strained muscles and joints that may affect tailbone pain. Tell the massage therapist about your pain prior to the massage so s/he knows what areas to massage.
Injection. A local injection of a numbing agent (lidocaine) and steroid (to decrease inflammation in the area) can provide some relief. Fluoroscopic guidance is recommended. Relief can last from 1 week up to several years. No more than 3 injections per year are recommended.
Use medication to relieve the pain. Take non-steroidal anti-inflammatory drugs (NSAIDS) to reduce pain and swelling. These over-the-counter (OTC) products, such as ibuprofen or acetaminophen, can be purchased at any pharmacy or drugstore.
Consult a physical therapist, osteopath, or chiropractor. He or she may direct you to perform exercises that will strengthen your tailbone’s supporting muscles and stretch ligaments near the pain. Some therapists manipulate the muscles pulling on the coccyx to relieve the tension in the joints. Therapists may perform a combination of:
- Levator ani massage. The levator ani sits near the pelvic floor, near the tailbone. Massage of this muscle alone in patients suffering from pain in the tailbone resulted in a 29% success rate for alleviating symptoms, according to one study.
- Levator ani stretching. Stretching of the levator ani muscle by a physical therapist saw a nearly 32% success rate in the same study.
- Sacrococcygeal joint mobilization. Mobilizing the sacrococcygeal joint has about a 16% success rate in alleviating pain. Three sessions of sacrococcygeal joint mobilization, however, have been found to be twice as effective as external physical therapy in reducing pain.
- Ultrasound. Physical therapy with ultrasound can also help relieve tailbone pain.
Exercises for Tailbone Pain
Try Cobra Stretch. The purpose of this stretch is to open the chest, keep the back supple and healthy while regenerating the muscles of the torso and relieving lower back pain.
Try Mula Bandha exercise. Mula Bandha is the “root lock” in yoga practice which is an energy technique, involving the contraction of the perineum, the section of the pelvic floor between the anus and genitals. Contract these muscles as if you are stopping the urge to urinate or have a bowel movement. Hold for 10 seconds and repeat this three to four times. The purpose of this exercise is to stimulate nerves in the sacral and coccyx region while toning and strengthening the pelvic area. This exercise also eases pain in the sacrum and coccyx.
Try Yoga Child’s Pose exercise. The purpose of this exercise is to tone the muscles of the pelvis, stimulate blood flow to the pelvic organs, and stretch the ankles, knee joints, and back. Hold this stretch for one minute.
Try the Bridge exercise. The purpose of this stretch is to massage the abdominal muscles and organs and stimulate blood flow through the spine and into the coccyx. It keeps the spine supple, elastic, and revitalized. It keeps the pelvic organs healthy, and tones the legs and glutes. Hold this position for one minute. Continue to breathe deeply as you hold the bridge position.
Try Spinal Twist Stretch. The purpose of this stretch is to release the lower back and stimulate blood flow to the internal organs and spine. Hold stretch for one minute.
Surgical Treatments for Tailbone Pain
Know that surgery is usually reserved for patients who have already tried nonoperative treatments. Most patients who undergo surgery to relieve coccygeal pain have already tried nonoperative treatments with little effect. Exhaust the nonoperative options before you move on to painful, and sometimes debilitating, surgery.
Be vigilant about healing after any surgery. In many cases, infection of the surgical site presents a significant problem for patients who are trying to recover from a coccygectomy. Other problems include:
- Skin flora in the perineal area resulting in local contamination.
- Wound aggravation and tension brought on by sitting and standing up.
Ask your doctor about coccygeal instability. Coccygeal instability is one of the most common reasons for deciding on surgery. Patients who suffer from an unstable coccyx may find systematic relief from an excision of the mobile segment of the coccyx, or a total coccygectomy (removing the entire tailbone).
- Patients with coccygeal instability who get a total coccygectomy have very high success rates (anywhere from 60% to 90%). Patients with normal coccygeal mobility who undergo coccygectomy have much lower success rates associated with their surgery.
- Contact your physician or other medical providers as soon as possible if you experience unbearable pain associated with your tailbone, or if you incur pain without a known cause or injury.
- Tailbone pain may persist and cause discomfort for patients for long periods of time. Doctors report that many patients experience some degree of pain for several months after experiencing trauma to their tailbones.
- After attaining sufficient pain relief so that movement is not too painful, daily low-impact aerobic activity is beneficial, as the increased blood flow brings healing nutrients to the area and encourages the body’s natural healing abilities.
- Tailbone pain may be indicative of issues with the SI Joint. It is possible that the hips and tailbone have become misaligned. This is indicated by pain on the tailbone, or to either side of the tailbone.