NHS Factsheet

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Tailbone (coccyx) pain

Find out about tailbone (coccyx) pain, including how to ease the pain yourself and when to get medical help. Read about symptoms, causes and treatments.

23 March 2022

Introduction

Tailbone pain is pain in the bone at the base of the spine (coccyx), near the top of your bottom. There are things you can do to ease the pain, but get medical help if it does not get better after a few weeks.

Check if you have tailbone (coccyx) pain

The main symptom of tailbone (coccyx) pain is pain and tenderness at the base of your spine, near the top of your bottom.

It may feel dull and achy most of the time, with occasional sharp pains.

The pain may be worse:

  • while you're sitting down
  • when you sit down or stand up
  • when you bend forward
  • when you're having a poo
  • during sex
  • during your period

You may also find it difficult to sleep and carry out daily activities.

How you can ease tailbone (coccyx) pain yourself

Tailbone (coccyx) pain may improve after a few weeks, but it can sometimes last longer. There are some things you can do to help ease the pain.

Do

  • sit correctly ↗ – maintain good posture with your lower back supported

  • use a specially designed coccyx cushion when sitting – sitting on an exercise ball can also help

  • lie on your side to reduce the pressure on your coccyx

  • try pelvic floor exercises ↗ (particularly important during pregnancy)

  • use an ice pack (or a bag of frozen peas) wrapped in a towel on the affected area for 20 to 30 minutes – you can also use a heat pack for longer

  • use non-steroidal anti-inflammatory drugs (NSAIDs) ↗ like ibuprofen ↗ to help reduce the pain

  • use a laxative ↗ to soften your poo if the pain is worse when pooing – ask a pharmacist for a laxative that softens poo

Don't

  • do not sit for a long time

  • do not wear clothes that are tight around your bottom and lower back, like some types of jeans

See a GP if:

  • tailbone (coccyx) pain has not improved after a few weeks of trying treatments at home
  • the pain is affecting your daily activities
  • you have a high temperature, tailbone pain and pain in another area, such as in your tummy or lower back

Treatments for tailbone (coccyx) pain

Further treatments are available if simple things like pelvic floor exercises and ibuprofen have not helped your tailbone (coccyx) pain.

The 2 treatments that may be recommended first are:

  • physiotherapy – the muscles around the coccyx can be manipulated to help ease the pain
  • corticosteroid and local anaesthetic injections – into the joint that attaches the coccyx to the bottom of your spine; you'll usually have a maximum of 2 injections given on consecutive months

If physiotherapy and injections do not help reduce the pain, surgery to remove part or all of your coccyx may be recommended.

Causes of tailbone (coccyx) pain

Common causes of tailbone (coccyx) pain include:

  • pregnancy and childbirth
  • an injury or accident, such as a fall onto your coccyx
  • repeated or prolonged strain on the coccyx – for example, after sitting for a long time while driving or cycling
  • poor posture
  • being overweight or underweight
  • joint hypermobility ↗ (increased flexibility) of the joint that attaches the coccyx to the bottom of the spine

Sometimes the cause of tailbone pain is unknown.