Tailbone Pain: A Thorough Review

Have a pain near your rear you can’t get rid of while standing? Have an extremely tender or sore lower back when sitting down? Have you tried itching, stretching, massaging, and everything else you can think of to the point of exhaustion? Sometimes, all it takes is a shower and a fresh change of clothes. Just kidding. Well, only partially.

That being said, if you think (or know) you have tailbone pain or just feel like learning more about tailbone pain, this is the article for you.

Tailbone Pain: A Case Study
What’s A Tailbone? Humans Don’t Have Tails…
What Are Causes Of Tailbone Pain?
What Other Effects Can Tailbone Pain Cause?
How Can You Reduce Tailbone Pain Today?
How Can You Prevent Tailbone Pain From Returning?
References

Tailbone Pain: A Case Study

Scott is a 32-year-old freelance software engineer who prefers to work from home. He played sports as a kid, but stopped once he graduated from college and focused his energy on growing his career and businesses. Scott enjoyed a relatively social lifestyle, eating healthy meals and running a few times a week.

About 1 year ago, Scott developed severe tailbone pain that negatively affected his abilities to work effectively, accomplish his goals, and enjoy life. The pain was not crippling but was serious enough to the point where he considered medical intervention, as it took a huge impact on his social and financial life.

The face of pain doesn't look fun — The face of pain doesn’t look fun

Scott decided to search the internet for some knowledge to better his situation. His research led him to adopt better ergonomic habits and improve his posture. After 4 months of improving his habits, Scott experiences almost no pain, feels amazing, and is back on track to accomplishing all of his goals.

What’s A Tailbone? Humans Don’t Have Tails…

The tailbone, also known as the coccyx, is a small triangular bone at the base of our spines that looks like a shortened tail. It’s a structure that humans maintained as tailed mammals evolved and lost their tails.

The tailbone is not useless in humans, even though we don’t have tails – the coccyx has attachments to many ligaments, muscles, and tendons that serve as a support to maintain structural integrity and well being of the human body. If you’re interested in a more in-depth overview of the tailbone anatomy, check out Wikipedia’s Coccyx article.

Sometimes, these ligaments, muscles, and tendons can get damaged, inflamed, over-stretched, or tight which leads to a sore or bruised tailbone region. It’s also possible for the coccyx itself to be broken or fractured through various ways. The broad, catch-all medical term for tailbone pain is coccydynia.

What Are Causes Of Tailbone Pain?

Now we know what a tailbone is, and have defined tailbone pain. How does one put themselves in a position for this to happen? Some factors are listed below:

Aging

As we age, our cartilage deteriorates and some people develop varying degrees of osteoarthritis. This is an unfortunate fact, and nothing can really prevent this from happening. The coccyx is made up of three to five spinal bones, that are all cushioned by cartilage. When this cartilage deteriorates, the bones rub against each other more frequently and irritate local nerves to cause inflammation. This leads to tailbone pain.

Poor Posture and Slouching

Sitting for prolonged periods of time with poor posture and in awkward positions applies unnecessary stress to our tailbone. This leads to uneven wear and tear of joints, and contributes to localized inflammation. Humans can’t really change positions of the tissues supporting the coccyx, in a manner similar to performing a tire rotation for our car, so it’s important to maintain effective sitting biomechanics to prevent tailbone pain.

Slouching: Comfortable in the moment, painful down the line

This site was built to promote knowledge of proper posture and the hugely positive impact it has on your health and well-being. Our upcoming posts will simplify the concept of posture, and how to use it to transform the quality of your life– feel free to drop us your email address if you want to be notified when they’re posted.

Pregnancy and Childbirth

Towards the end of pregnancy, the coccyx becomes flexible to allow for childbirth – this is done through hormonal release which changes the properties of the local cartilage and tendons. During childbirth, the tissue surrounding the coccyx can overstretch, leading to inflammation and tailbone pain. The cases of coccydynia are nearly 5x higher in women than men, particularly due to pregnancy-related issues.

Abdominal pressure from a growing infant reduces pelvic mobility and pushes the coccyx backwards, potentially causing tailbone pain

Repetitive Strain Injury

Ligaments, musculature, and tendons near the coccyx can overstretch and become strained when repeated extensively. Repetitively leaning forward and backwards, through sports (such as rowing and biking) or at a computer desk, can damage the local muscles and tendons and cause the misalignment or inflammation of the tailbone.

This child's pose yoga position helps to reverse the effects of repetitively leaning forward — This child’s pose yoga position helps to reverse the effects of repetitively leaning forward

Weight and Muscular Weakness

In obese individuals, the coccyx is subjected to greater forces/stress when sitting from intrapelvic and spinal pressure – this reduces pelvic rotation, and pushes the tailbone backwards and out of alignment. In a similar manner, individuals who are underweight may not have enough musculature or fat in their glutes (buttocks) which would adequately cushion the coccyx.

Tailbone pushed backwards, through bad posture or weight issues — A tailbone pushed backwards, through either bad posture or weight issues

Having a strong posterior chain, and adequate hip + spine mobility goes a long way in reducing tailbone pain, no matter if you are over- or underweight. If you’re interested in learning more about this, we have an upcoming post on mobility coming out soon. Stay tuned for updates!

Cancer and Infection

Sometimes, infections can occur in the tissue surrounding the coccyx, creating a tailbone cyst or abscess that causes serious pain. This could be as a result of poor hygiene or complications resulting from medical procedures. In rare instances, tailbone pain is caused by bone or metastatic cancers. Both of these causes apply unnecessary pressure to the coccyx.

Injury

A hard impact to the lower back region can cause traumatic injury to the coccyx, through fracture or breaking. Falling backwards also causes tailbone injury. This is particularly common in the elderly population, and action sports such as surfing, skateboarding, and snowboarding; improving your balance may prevent this from happening.

What Other Effects Can Tailbone Pain Cause?

Short term symptoms associated with coccydynia include pain during the following activities:

Bowel Movements
Having Sex
Switching between standing and sitting

If left unaddressed, tailbone pain could cause long term effects that can be broken down into the following three categories:

Mental Health
- Depression and anxiety are mental illnesses often associated with chronic pain. They greatly reduce one’s response to treatment and exacerbate the perception and sensation of pain, relative to patients without these mental illnesses. For individuals with chronic pain, psychiatric treatments have shown effectiveness in reducing pain and improving mood. Accordingly, it’s in an individual’s best interest to alleviate tailbone pain as soon as possible.
Physical Health
- Coccyx pain could spread out from the tailbone area to the upper back, hamstrings, and calves if left unchecked. Individuals have reported instances of sciatica, and pelvic pain, after extended periods of leaving tailbone pain unchecked.
Financial Health
- Inability to address issues with tailbone pain leads to unnecessary headaches and money spent in the long run. Many conservative treatment options are available if the pain is not debilitating. Surgical intervention is expensive, so it would make sense to try a self-directed pain relief program or consult an allied health professional firstly, if able.

How Can You Reduce Tailbone Pain Today?

The good news is that most cases of tailbone pain can (and will) be resolved within a treatment period of a few weeks to months. This, of course, depends on adherence to proper rehabilitation and main management efforts. Action can be taken on two fronts to achieve immediate results:

Stretch Tight Muscles And Strengthen Weak Ones
- The coccyx has attachments to various muscles, including those in your hip complex, glutes, and low back. Stretch names are below, with a future post covering them in detail
  - Muscles to Stretch
    - Hips: Lunge Stretch, Pigeon Pose, Hip Circles/Abductions
    - Glutes: Single Leg Knee Hug, Piriformis Stretch
    - Low Back: Cat and Camel, Child’s Pose
  - Muscles to Strengthen
    - Core: Planks, Dead-Bugs
    - Glutes: Glute Bridges, Hip Thrust, Clamshell, Hip Hinge, Banded Leg Walks
Improve Your Posture and Stop Slouching
- Stop slouching. Really. It puts extra pressure on an already stressed coccyx and surrounding tissues, leading to additional misalignment and tailbone pain. Stand tall and take a deep breath and see the difference it makes instantly.
- When sitting at a desk, try to prevent a forward hunch as much as possible, and engage your glutes and core. Proper seated posture is just as important as proper standing posture, and we will cover this in an upcoming post.
- Various tailbone cushions have been designed to reduce pain while seated.
  - Many great products are sold through online retailers
  - We’ll post our favorites soon.
Taking Non-Steroidal Anti-Inflammatory Medications
- Ibuprofen, Acetaminophen, Naproxen, and other COX-2 inhibitors help to temporarily reduce inflammation, relieving tailbone pain

How Can You Prevent Tailbone Pain From Returning?

An estimated 90% of tailbone pain cases can be resolved without surgery. Surgery or invasive medical procedures: have been effective to an extent, but with high risk of infection and post-operational complications, such as the formation of a tailbone cyst. Fun fact – surgical interventions were used ubiquitously to treat low back pain in the early 1900s, before scientific research concluded that a patient didn’t need their tailbone removed every time there was inflammation or bruising in the area. Times have come a long way…

That being said, afflicted individuals have found long-term relief from a combination of the following:

Exercise Routines

Various stretches and strengthening exercises were mentioned in the previous section. Adopting a consistent routine, with those exercises, will lead to much less tailbone pain in the long run.

Stretching the thoracic spine through mobilization routines

Thoracic spine = thoracic vertebrae; Think a tailbone pain exercise guide would be useful? Let us know below!

Modifying Diet

Researchers at Yale have found that being in extreme caloric surplus or deficit (ultimately leading to being over- or underweight) creates issues with our metabolism, leading to inflammation and risk of metabolic disease. If an individual is experiencing tailbone pain, it is guaranteed that there is localized inflammation at the site of pain – having a poor diet would serve to increase overall inflammation and worsen pain that they’d be feeling. Accordingly, a proper diet reduces risk of extra inflammation, and can contribute to a reduction in pain felt.

The biological origin of all pain is inflammation, and it holds true for coccydynia as well. Accordingly, it makes sense to supplement a good diet with anti-inflammatory foods to get the most long-term relief. Some of these foods include berries, fatty fish such as Salmon & Chilean sea bass, avocados, dark leafy greens, and tomatoes. A particular favorite anti-inflammatory addition to our diet is fresh juice. Cherry juice and green juices have strong anti inflammatory properties, and would provide some degree of tailbone pain relief. Check out our article on juicing for more information.

Ergonomic Assessment And Optimization Of Work Stations

Ergonomics is a relatively lengthy topic that we plan to devote a series of articles towards in the near future. With a greater proportion of desk jobs and home offices in the 21st century, even greater considerations need to be given to the impact a seated workstation has on health and well being.

A proper ergonomic sitting position helps to engage the appropriate stabilizing muscles in the core and buttocks, and relieve pressure in the spine and tailbone. Notice how there’s no slouching in the picture below? Correct ergonomic positions relieve tailbone pain when sitting.

This image from the Mayo Clinic provides tips on how to sit properly at a desk

Taking regular breaks every 20-40 minutes to stand and stretch (and drink water) helps remove pressure from the lower back and hips, giving you physical and mental relief. Proper posterior support from a chair is extremely important as well.