Coccydynia: Causes, Symptoms, and Treatment
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Coccydynia?
An orthopedic doctor (a bone and joint doctor) or a pain medicine doctor often treats coccydynia, which is tailbone pain. Tailbone pain is pain in the bone at the base of the spine, called the coccyx. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is coccydynia?
Coccydynia, also called coccygodynia, is pain in the region of the coccyx. The coccyx is the last segment of the spine, and it is a triangular bone. Tailbone pain may improve after a few weeks, but it can sometimes last longer.
Symptoms
The main symptom 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 are sitting down.
- When you sit down or stand up.
- When you bend forward.
- When you are having a poo, or bowel movement.
- With long periods of sitting, leaning back while sitting, or standing for a long time.
The pain can also happen during sex. You may also find it hard to sleep and carry out daily activities.
Causes and who gets it
Common causes of tailbone pain include:
- Pregnancy and childbirth.
- An injury or accident, such as a fall onto your coccyx.
- Repeated or long strain on the coccyx, for example after sitting for a long time while driving or cycling.
- Poor posture.
- Being overweight or underweight.
- A joint that bends too much or too little where the coccyx attaches to the bottom of the spine.
Sometimes the cause of tailbone pain is unknown. The most common cause is trauma (injury), from outside the body, such as a backwards fall, or from inside it, such as during childbirth. Obesity and being female are linked to a higher risk of coccydynia.
How doctors diagnose it
A physical exam will reveal tenderness over the coccyx. A rectal exam allows the coccyx to be grasped between the forefinger and thumb. Moving it will cause pain and may show a joint that moves too much or too little. Other causes of tailbone pain, such as infections (for example, a pilonidal cyst), masses, and pelvic floor muscle spasms, should be ruled out. Imaging tests, including dynamic x-ray and magnetic resonance imaging (MRI), can help diagnose a joint that moves too much or too little.
Treatment
Conservative treatment is successful in 90% of cases, and many cases resolve without medical treatment. A wedge-shaped coccyx cushion, sold over the counter, can relieve the pressure on the coccyx while you sit. Round donut cushions have been suggested, but they can place pressure on the coccyx. Learning to sit with proper posture can correct poor postures that contribute to the pain. You can lie on your side to reduce the pressure on your coccyx and try pelvic floor exercises. You can use an ice pack wrapped in a towel for 20 to 30 minutes, or a heat pack for longer. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen may help reduce the pain. If simple steps do not help, the 2 treatments that may be recommended first are physiotherapy and injections. In physiotherapy, the muscles around the coccyx can be manipulated to help ease the pain. The injections are a corticosteroid and a local anaesthetic, given into the joint that attaches the coccyx to the bottom of your spine. If physiotherapy and injections do not help, surgery to remove part or all of your coccyx may be recommended. Surgery is used only as a last resort once all other treatment options have failed. The surgery can be associated with a high complication rate and failure to relieve the pain.
When to see a doctor
Get medical help if tailbone pain does not get better after a few weeks. See a doctor if the pain is affecting your daily activities. See a doctor if you have a high temperature, tailbone pain, and pain in another area, such as in your belly or lower back.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either kind of doctor can do a physical exam, which can reveal tenderness over the coccyx. They can also talk with you about simple steps, such as sitting correctly and using a coccyx cushion.
Common questions
Is coccydynia the same as tailbone pain?
Yes, coccydynia is pain in the region of the coccyx. The coccyx is the bone at the base of the spine that people call the tailbone.
How long does tailbone pain last?
Tailbone pain may improve after a few weeks, but it can sometimes last longer. Most cases of coccydynia resolve within weeks to months with or without conservative treatment.
Do I need surgery for coccydynia?
Most people do not need surgery, because conservative treatment is successful in 90% of cases. Surgery is used only as a last resort once all other treatment options have failed.
Can sitting cause tailbone pain?
Yes, repeated or prolonged strain on the coccyx, such as sitting for a long time while driving or cycling, is a common cause. Sitting for a long time on hard, narrow, or uncomfortable surfaces can also cause minor injury.
Who is more likely to get coccydynia?
Women are 5 times more likely to develop coccydynia than men. Obesity is also linked to a higher risk.
Sources
- NHS - Tailbone (coccyx) pain
- National Library of Medicine (PubMed Central) - Coccydynia: An Overview of the Anatomy, Etiology, and Treatment of Coccyx Pain
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
