About coccydynia
The coccyx, or tailbone, is the small triangle of bone at the very bottom of the spine. Several ligaments and muscles attach to it, and it bears weight when you lean back while sitting.
When the tailbone or its joints are bruised, strained, or moving too much, sitting and rising from a chair can be painful. Coccydynia is more common in women and often settles over weeks to months. Tailbone pain with fever, a draining bump near the top of the buttock crease, or unexplained weight loss should be checked promptly.
Common symptoms
- Pain at the very bottom of the spine
- Pain that worsens with sitting, especially leaning back
- Sharp pain when standing up from a seated position
- Tenderness when pressing on the tailbone
- Pain with bowel movements in some people
Common causes and risk factors
- A fall onto the buttocks
- Childbirth, which can strain the tailbone and its ligaments
- Prolonged sitting on hard or narrow surfaces, including cycling and rowing
- Too much or too little movement at the joint between the tailbone and sacrum
How we diagnose it
Dr. Chen examines the area for tenderness and checks nearby joints and the low back to rule out other sources. Sitting and standing X-rays can show whether the tailbone moves too much or too little. Ultrasound helps evaluate the surrounding soft tissue and guides injections precisely when they are needed.
How Propel treats coccydynia
First steps include a wedge or cutout cushion, adjusting how you sit, and pelvic floor or hip work with a physical therapist. We aim to keep you training in ways that do not load the tailbone while it settles.
When pain persists, Dr. Chen may perform an ultrasound-guided injection around the painful joint or ligaments to calm inflammation. For tailbone pain related to strained ligaments, prolotherapy, which uses a dextrose solution to stimulate a healing response, is another option.
What to expect at your visit
- 1.
We listen first
Your visit opens with a real conversation: how the problem started, what you have already tried, and the activity you want back.
- 2.
Exam and in-office ultrasound
A hands-on exam, then ultrasound at the exam table, often while you move, so your physician can see the tendon, joint, or nerve involved.
- 3.
A clear diagnosis and plan
You leave knowing what is wrong and what your options are, from strength-based rehab to procedures, and why we recommend each one.
- 4.
Treatment and follow-through
Most procedures happen here in the office. We coordinate with your physical therapist and check progress against the goals you set.
Questions about coccydynia
- What kind of cushion helps tailbone pain?
- A wedge cushion with a cutout at the back removes pressure from the tailbone when you sit. Leaning slightly forward also shifts weight onto the thighs and sitting bones.
- Can a broken tailbone cause coccydynia?
- Yes. A fracture or dislocation of the tailbone after a fall can lead to ongoing pain, though bruising and ligament strain are more common. Most tailbone fractures heal without surgery.
- What is prolotherapy for the tailbone?
- Prolotherapy involves injecting a dextrose solution around strained ligaments to trigger a mild healing response. It is considered when tailbone pain has lasted for months despite cushions, posture changes, and therapy.