Tailbone pain, medically known as coccydynia, is a discomfort felt in the very bottom of your spine, right above your buttocks. If you’re experiencing pain specifically when you sit, you’re not alone. It’s a surprisingly common issue that can significantly impact your daily life. Understanding why your tailbone hurts when you sit is the first step towards finding effective relief and getting back to comfortable living.
Understanding Tailbone Pain (Coccydynia) and Sitting
Your tailbone, or coccyx, is a small, triangular bone at the base of your spinal column. It’s what remains of a vestigial tail and, despite its size, it plays a crucial role in supporting your weight when you sit and in anchoring several pelvic floor muscles. When you sit, especially on hard surfaces, pressure is placed directly on your coccyx. For some, this pressure leads to pain, a condition known as coccydynia. This pain can range from a dull ache to sharp, stabbing sensations, making sitting for extended periods incredibly uncomfortable.
Symptoms of Tailbone Pain When Sitting
The hallmark symptom of coccydynia is localized pain and tenderness directly over the tailbone. However, the pain often intensifies and exhibits specific characteristics when sitting:
- Increased Pain While Sitting: The most obvious symptom is pain that worsens the longer you sit, particularly on hard or narrow surfaces.
- Pain When Transitioning: You might feel a sharp increase in pain when you initially sit down or when you stand up after sitting for a while.
- Dull Ache with Sharp Episodes: Often, there’s a background dull ache that is punctuated by episodes of sharp, shooting pain.
- Pain with Pressure: Any activity that puts direct pressure on the tailbone, like leaning back in a chair, can exacerbate the pain.
- Pain During Bowel Movements: Straining during bowel movements can put pressure on the tailbone and surrounding muscles, increasing pain.
- Discomfort During Sex: Certain sexual positions can put pressure on the tailbone, leading to pain during or after intercourse.
- Menstrual Pain Aggravation: Some women find their tailbone pain is worse during their menstrual periods.
- Sleep Disturbances: Finding a comfortable sleeping position can be challenging, leading to interrupted sleep.
- Difficulty with Daily Activities: Simple tasks like driving, working at a desk, or even eating meals can become painful and difficult.
Why Does Sitting Make Tailbone Pain Worse? Common Causes
Several factors can contribute to tailbone pain that is aggravated by sitting. Understanding these potential causes is key to addressing the problem effectively:
- Injury to the Tailbone: A direct blow to the tailbone, often from a fall onto your buttocks (slipping on ice, falling down stairs), is a common culprit. Even minor trauma can bruise or fracture the coccyx, leading to pain that is significantly worsened by sitting.
- Repetitive Strain and Prolonged Sitting: Occupations or activities that involve prolonged sitting, especially on hard surfaces or in poor posture, can place excessive and repeated stress on the tailbone. Truck drivers, office workers with poorly designed chairs, and cyclists who spend long hours on narrow seats are at risk.
- Poor Posture While Sitting: Slouching or hunching over while sitting puts uneven pressure on the tailbone and surrounding structures. This poor posture can strain the ligaments and muscles around the coccyx, leading to pain that is most noticeable when seated.
- Weight Issues: Both being overweight and underweight can contribute to tailbone pain when sitting. Excess weight puts increased pressure on the coccyx. Conversely, being underweight and lacking sufficient buttock muscle and fat padding can leave the tailbone more vulnerable to pressure and friction against the chair.
- Pregnancy and Childbirth: During pregnancy, hormones relax the ligaments in the pelvic area to prepare for childbirth. This increased mobility can put extra stress on the coccyx joint. Childbirth itself, particularly vaginal delivery, can sometimes injure the tailbone or surrounding ligaments and muscles.
- Joint Hypermobility: Individuals with joint hypermobility syndrome (excessive flexibility) may have increased movement in the joint connecting the coccyx to the sacrum (the bone just above the tailbone). This instability can lead to pain, especially when sitting.
- Idiopathic Coccydynia: In some cases, the exact cause of tailbone pain remains unknown. This is referred to as idiopathic coccydynia. Even without a clear cause, the pain is very real and can be just as debilitating.
How to Ease Tailbone Pain When Sitting: Self-Care and Remedies
Fortunately, there are many things you can do at home to alleviate tailbone pain and make sitting more comfortable:
Practical Steps to Take:
- Optimize Your Sitting Posture: Good posture is crucial. Sit upright with your lower back supported. Use a lumbar support cushion if needed to maintain the natural curve of your spine. Avoid slouching or leaning too far forward or backward.
- Invest in a Coccyx Cushion: These specially designed cushions have a cutout section at the back, eliminating direct pressure on the tailbone when you sit. They are widely available and can make a significant difference. Experiment with different shapes and materials (foam, gel, air-filled) to find what works best for you.
- Consider Sitting on an Exercise Ball: For short periods, sitting on an exercise ball can engage your core muscles and reduce pressure on the tailbone. However, it’s not recommended for prolonged sitting as it can be tiring and may not provide adequate support for extended periods.
- Adjust Your Seating: Avoid hard, unpadded chairs. Opt for softer seating surfaces whenever possible. When driving, use a coccyx cushion and take frequent breaks to stand and stretch.
- Lie Down Strategically: When resting, lie on your side to take pressure off your tailbone. Avoid lying directly on your back, especially on a firm surface.
- Pelvic Floor Exercises: Strengthening your pelvic floor muscles can help support the coccyx and reduce pain. These exercises are especially important during and after pregnancy, but beneficial for anyone with tailbone pain. Consult resources online or a physical therapist for guidance on proper technique.
- Ice and Heat Therapy:
- Ice Packs: Apply an ice pack wrapped in a thin cloth to the tailbone area for 20-30 minutes at a time, several times a day, especially in the initial days after injury or when pain is acute. Ice helps reduce inflammation and numb the pain.
- Heat Packs: After the initial inflammatory phase, or for chronic pain, heat packs can be beneficial. Heat helps relax muscles and increase blood flow, promoting healing. Use a heat pack for 20-30 minutes at a time. You can alternate between ice and heat to see what provides the most relief.
- Over-the-Counter Pain Relief: Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help reduce pain and inflammation. Follow the recommended dosage and consult your doctor or pharmacist if you have any underlying health conditions or concerns about taking NSAIDs.
- Address Constipation: If bowel movements aggravate your pain, using a stool softener can reduce straining and pressure on the tailbone. Consult a pharmacist for recommendations on appropriate laxatives.
What to Avoid:
- Prolonged Sitting: Avoid sitting for extended periods without breaks. Set a timer to remind yourself to stand up, walk around, and stretch every 30-60 minutes.
- Tight Clothing: Avoid wearing tight pants, jeans, or belts that put pressure on your tailbone and surrounding area. Opt for looser, more comfortable clothing.
When to Seek Medical Advice for Tailbone Pain When Sitting
While many cases of tailbone pain improve with self-care, it’s important to seek medical advice in the following situations:
- Persistent Pain: If your tailbone pain does not improve after a few weeks of home treatments.
- Pain Worsening: If the pain is getting progressively worse despite self-care measures.
- Impact on Daily Life: If the pain is significantly interfering with your daily activities, work, or sleep.
- Red Flag Symptoms: If you experience any of the following along with tailbone pain:
- Fever: Could indicate an infection.
- Pain in Other Areas: Pain radiating to your abdomen, lower back, or legs could suggest a different underlying condition.
- Numbness or Weakness: In the legs or buttocks could indicate nerve compression.
- Bowel or Bladder Changes: New onset of constipation, incontinence, or difficulty urinating needs medical evaluation.
- Unexplained Weight Loss: Could be a sign of a more serious underlying condition.
- History of Trauma: If the pain started after a significant injury, even if it seemed minor at the time.
Medical Treatments for Tailbone Pain
If self-care measures are insufficient, your doctor may recommend further treatments:
- Physiotherapy: A physical therapist can teach you specific exercises and manual techniques to improve posture, strengthen pelvic floor and surrounding muscles, and reduce pain. They can also use modalities like ultrasound or TENS (transcutaneous electrical nerve stimulation) to alleviate pain.
- Corticosteroid Injections: Injections of corticosteroids and local anesthetics directly into the coccyx joint can provide significant pain relief by reducing inflammation. These injections are typically limited to a maximum of two due to potential side effects with repeated use.
- Surgery (Coccygectomy): Surgical removal of part or all of the coccyx (coccygectomy) is considered a last resort for chronic, severe tailbone pain that has not responded to conservative treatments. It’s a major surgery with potential risks and a lengthy recovery, so it’s only recommended in carefully selected cases.
Finding Help and Support
If you are struggling with tailbone pain, remember you are not alone. Seeking professional help is a sign of strength, and there are many resources available to support you. Talk to your doctor to get a proper diagnosis and discuss the best treatment plan for your specific situation. You can also explore online resources and support groups for people with chronic pain conditions. With the right approach, you can find relief from tailbone pain and improve your quality of life.
Page last reviewed: Based on original article review date: 15 March 2022
