Symptoms A-Z

Tailbone Pain Symptoms, Causes & Common Questions

Understand your tailbone pain symptoms, including 5 causes & common questions.

This symptom can also be referred to as: coccyx pain

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Tailbone Pain Symptoms

The tailbone is common name for the last four vertebrae of the spine, which have been fused together into a single structure [1]. Like the appendix, it is vestigial, meaning you really don't need it in order to function normally but also like the appendix, if it is diseased or damaged the tailbone can cause significant pain and discomfort.

The tailbone is called the caudal vertebrae or the coccyx [1, 2] and tailbone pain is also called coccydynia or coccygodynia [3]. The tailbone is also somewhat difficult to feel from the surface, because it is located at the very base of the spine beneath the buttocks. Pain in this region can be caused by an injury to the tailbone itself, or to the muscles and ligaments that surround and support it, or both. It is important to determine exactly which structures are causing your tailbone pain.

Characteristics:

  • A deep, aching pain in the center of the low back, just above the rectum/anus [3, 4, 5].
  • The discomfort can vary widely in intensity, ranging from minimal to severe, immobilizing pain.
  • Because tailbone pain can be difficult to treat and often becomes chronic, it may be accompanied by the depression, isolation, and anxiety that so often appears with chronic pain [6].

Duration:

  • Sometimes tailbone pain comes on suddenly and then goes away on its own.
  • Often, however, the pain becomes chronic and tends to get worse instead of better.

Who is most often affected by tailbone pain symptoms?

  • Women are far more likely to have tailbone pain, since it can be caused by damage and overstretching of the ligaments surrounding the coccyx during childbirth [5].
  • Even when childbirth has not occurred, the construction of the female pelvis tends to leave the tailbone less protected and more prone to injury [1].

When is tailbone pain most likely to occur?

  • While sitting on a hard surface.
  • When going from sitting to standing.
  • When pressure is applied over the tailbone.
  • During sexual activity (both men and women.)
  • During a bowel movement.

Are tailbone pain symptoms serious?

  • A bruise to the tailbone, or some overstraining of its surrounding muscles and ligaments, is not serious and will heal with conservative treatment such as rest, sitting on a specialized cushion, and taking nonsteroidal anti-inflammatory drugs.
  • Other causes, such as a fracture, will not get better solely with rest. If such an injury is suspected, it should be treated by your medical provider as soon as possible.
  • In rare cases, tailbone pain can be caused by tumors or by a deep infection. Both of these are serious and must be treated immediately.

Tailbone Pain Causes

Many conditions can have tailbone pain as a symptom. The most common are those that damage or inflames the coccyx and/or its surrounding tissues because this leads to instability and pain.

Most common tailbone pain cause types:

  • Falls where you drop to the ground in a sitting position.
  • Falls where you land hard on your lower back with your knees drawn up.
  • Other trauma to the low back, such as a hard hit during an automobile accident or while playing sports.

Less common tailbone pain cause types:

  • Childbirth.
  • Obesity
  • Repetitive strain injury from activities such as competitive rowing or cycling.
  • Poor posture while sitting, which can throw the spine out of alignment and place too much pressure on and around the tailbone.
  • Loss of the natural cushioning material within the spine's discs, which often occurs due to aging [1].

Rare & unusual tailbone pain cause types:

  • An abscess, or infection, in the soft tissues surrounding the tailbone.
  • Tumors.
  • The cause is unknown in some cases.

5 Possible Tailbone Pain Conditions

The list below shows results from the use of our quiz by Buoy users who experienced tailbone pain. This list does not constitute medical advice and may not accurately represent what you have.

Piriformis syndrome

The two piriformis muscles, left and right, each run from the base of the pelvis to the top of the thighbone. The two sciatic nerves, left and right, are each attached to the spine and run down between the pelvic bone and the piriformis muscle to the back of each leg.

If the piriformis muscle is damaged through sudden trauma, or through overuse as in sports, the resulting inflammation or spasm of the muscle can trap the sciatic nerve between the pelvic bone and the muscle.

Piriformis syndrome is most often found in women over 30.

Symptoms include pain over one or both sides of the low back, and shooting pain (sciatica) down one or both legs.

Diagnosis is made through physical examination and sometimes imaging such as CT scan or MRI.

Treatment involves rest; over-the-counter, nonsteroidal anti-inflammatory drugs; physical therapy; therapeutic injections; and, rarely, surgery.

The best prevention is a good regimen of stretching before exercise, to help prevent damage to the piriformis.

Rarity: Common

Top Symptoms: pelvis pain, butt pain, pain when passing stools, leg numbness, hip pain

Symptoms that never occur with piriformis syndrome: involuntary defecation, leaking urine

Urgency: Primary care doctor

Coccydynia

The tailbone, called the coccyx, is the most bottom portion of the spine. Coccydynia is pain around the area of the tailbone, which is triggered by pressure on the tailbone such as during sitting on a hard chair. Symptoms get better with standing or walking. Doctors are not completely sure what causes this pain.

Rarity: Uncommon

Top Symptoms: back pain, lower back pain, painful sex, back pain that shoots to the butt, constant butt pain

Symptoms that always occur with coccydynia: constant butt pain

Symptoms that never occur with coccydynia: warm and red tailbone swelling

Urgency: Self-treatment

Tailbone Pain Symptom Checker

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Fibromyalgia

Fibromyalgia is a set of chronic symptoms that include ongoing fatigue, diffuse tenderness to touch, musculoskeletal pain, and usually some degree of depression.

The cause is not known. When fibromyalgia appears, it is usually after a stressful physical or emotional event such as an automobile accident or a divorce. It may include a genetic component where the person experiences normal sensation as pain.

Almost 90% of fibromyalgia sufferers are women. Anyone with rheumatic disease, such as rheumatoid arthritis or lupus, may be more prone to fibromyalgia.

Poor sleep is often a symptom, along with foggy thinking, headaches, painful menstrual periods, and increased sensitivity to heat, cold, bright lights, and loud noises.

There is no standard test for fibromyalgia. The diagnosis is usually made when the above symptoms go on for three months or more with no apparent cause.

Fibromyalgia does not go away on its own but does not get worse, either.

Rarity: Common

Top Symptoms: fatigue, arthralgias or myalgias, anxiety, depressed mood, headache

Symptoms that always occur with fibromyalgia: arthralgias or myalgias

Urgency: Primary care doctor

Tailbone bruise

A bruise is the damage of the blood vessels that return blood to the heart (the capillaries and veins), which causes pooling of the blood. This explains the blue/purple color of most bruises. Bruises of the tailbone are common, given the location on the body.

Rarity: Rare

Top Symptoms: constant butt pain, tailbone pain, tailbone pain from an injury, tailbone injury, butt bruise

Symptoms that always occur with tailbone bruise: tailbone pain from an injury, tailbone injury, constant butt pain

Urgency: Self-treatment

Spinal stenosis

The spine, or backbone, protects the spinal cord and allows people to stand and bend. Spinal stenosis causes narrowing in the spine. The narrowing puts pressure on nerves and the spinal cord and can cause pain.

Rarity: Common

Top Symptoms: lower back pain, back pain that shoots down the leg, back pain that shoots to the butt, difficulty walking, thigh pain

Urgency: Primary care doctor

Tailbone Pain Treatments and Relief

Seek immediate tailbone pain treatment in the emergency room or call 911 if:

  • You begin to experience numbness in your legs, and/or find that you cannot move them normally or also lose control of your bowel movements (incontinence) [4, 7].
  • Rarely, the tailbone can be surgically removed [8].

Schedule an appointment for:

  • Ongoing tailbone pain symptoms, so that imaging can be done and a definite diagnosis made [9].
  • Corticosteroid injections for pain management [10]
  • Chiropractic manipulation of the tailbone, which can help in some cases [11].
  • A referral to a physical therapist. The therapist can prescribe exercises to properly stretch the muscles and ligaments surrounding the tailbone, as well as offer treatments with heat, ultrasound, and therapeutic massage [12].

Tailbone pain remedies that you can try at home:

  • Use special cushions that take the pressure off of the tailbone while you're sitting.
  • Avoid prolonged sitting. Stand up and walk around frequently.
  • Alternate warm and cold packs to the low back.
  • Try over-the-counter oral or topical pain relievers [11].

FAQs About Tailbone Pain

Here are some frequently asked questions about tailbone pain.

Do hemorrhoids lead to tailbone pain?

No, hemorrhoids do not lead to tailbone pain. Hemorrhoids are engorged veins in your lower rectum or anus [13]. The hemorrhoid can be located inside the rectum these hemorrhoids are typically not painful. Alternatively, hemorrhoids can extend beyond the anus, and these hemorrhoids can cause pain with defecation.

Why does my tailbone hurt when I sit?

Tailbone pain, or coccydynia, is most often caused by falling on or receiving trauma to the tailbone [3, 4, 5]. It can also be caused by childbirth. More rarely, it may be caused by a tumor or infection in the tailbone. Tailbone pain is often worse when sitting due to the increased pressure placed on the tailbone. This is particularly true of women due to their broader pelvis.

Can menstruation cause tailbone pain?

No, menstruation does not cause tailbone pain. Tailbone pain is most often caused by trauma to the tailbone. Less commonly, it can be caused by a tumor or infection of the tailbone. Some women do note experiencing tailbone pain during and following childbirth.

Is my tailbone bruised or broken?

The tailbone, or coccyx, is located at the very bottom of the spine and is made up of a fusion of three to five vertebrae [1, 2]. If you recently received trauma to the area and are now experiencing localized tailbone pain that worsens with sitting, it is possible that this fused bone has broken. If so, you should visit your primary care physician for an appropriate checkup and treatment.

Questions Your Doctor May Ask About Tailbone Pain

To diagnose this condition, your doctor would likely ask the following questions:

  • Do your symptoms worsen when sitting?
  • Have you had any changes in your weight?
  • Are you sexually active?
  • Do your symptoms improve with activity (moving around and such)?

The above questions are also covered by our A.I. Health Assistant.

If you've answered yes to one or more of these questions

Take a quiz to find out what might be causing your tailbone pain

Tailbone Pain Symptom Checker Statistics

People who have experienced tailbone pain have also experienced:

  • 13% Lower Back Pain
  • 4% Hip Pain
  • 3% Abdominal Pain (Stomach Ache)

People who have experienced tailbone pain were most often matched with:

  • 42% Piriformis Syndrome
  • 42% Fibromyalgia
  • 14% Coccydynia

People who have experienced tailbone pain had symptoms persist for:

  • 31% Over a month
  • 27% Less than a week
  • 22% Less than a day

Source: Aggregated and anonymized results from visits to the Buoy AI health assistant (check it out by clicking on “Take Quiz”).

Tailbone Pain Symptom Checker

Take a quiz to find out what might be causing your tailbone pain

References

  1. Staehler RA. Anatomy of the Coccyx (Tailbone). Spine-health.com. Updated January 13, 2017. Spine-health.com Link.
  2. The Editors of Encyclopaedia Britannica. Coccyx. The Encyclopaedia Britannica. Updated September 10, 2014. The Encyclopaedia Britannica Link.
  3. Smallwood Lirette L, Chaiban G, Toiba R, Eissa H. Coccydynia: An Overview of the Anatomy, Etiology, and Treatment of Coccyx Pain. The Ochsner Journal. 2014;14(1):84-87. NCBI Link.
  4. Vorvick LJ. Tailbone Trauma. U.S. National Library of Medicine: MedlinePlus. Published January 14, 2018. MedlinePlus Link.
  5. Blocker O, Hill S, Woodacre T. Persistent Coccydynia - The Importance of a Differential Diagnosis. BMJ Case Reports. 2011;2011:bcr0620114408. NCBI Link.
  6. Robb-Nicholson C. The Pain-Anxiety-Depression. Harvard Medical School: Harvard Health Publishing. Harvard Health Publishing Link.
  7. Ma CB. Spinal Injury. U.S. National Library of Medicine: MedlinePlus. Updated April 18, 2017. MedlinePlus Link.
  8. Staehler RA. Anatomy of the Coccyx (Tailbone). Spine-health.com. Updated January 13, 2017. Spine-health.com Link.
  9. Lateef H, Patel D. What is the Role of Imaging in Acute Low Back Pain? Current Reviews in Muscoloskeletal Medicine. 2009;2(2):69-73. NCBI Link.
  10. Staehler RA. Lumbar Epidural Steroid Injections for Low Back Pain and Sciatica. Spine-health.com. Updated July 17, 2007. Spine-health.com Link.
  11. Staehler RA. Treatment for Coccydynia (Tailbone Pain). Spine-health.com. Updated January 13, 2017. Spine-health.com Link.
  12. Ray CD. Should I See a Doctor for Back Pain? Spine-health.com. Updated August 14, 2007. Spine-health.com Link.
  13. Hemorrhoids. National Institute of Diabetes and Digestive and Kidney Diseases. NIDDK Link.

Disclaimer: The article does not replace an evaluation by a physician. Information on this page is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes.