Low Back & Pelvis

What It Is

Coccydynia is pain in the coccyx (tailbone), the small bone at the base of the spine near the top of your bottom (NHS, 2025). It is often associated with tenderness at the tip of the tailbone. The pain may feel dull and achy most of the time, with occasional sharp pains. It is often worse when sitting, when going from sitting to standing, when bending forward or when having a poo (NHS, 2025). It commonly occurs after an injury, but there are times when it comes on for no known reason. Coccydynia can also be referred pain from the lower back (Lirette et al., 2014).

Coccydynia Anatomy

The coccyx sits at the lowest part of the spine and is thought to be what remains of a tail. The name comes from the Greek word for cuckoo, because from the side the coccyx looks like a cuckoo's beak (Lirette et al., 2014). It is a small triangular bone made up of three to five fused segments (Lirette et al., 2014; Cleveland Clinic, 2023). The front of the coccyx is slightly concave (curved inward), while the back is slightly convex (curved outward). The coccyx joins the sacrum (the bone above it) at a joint, and several muscles and ligaments attach to it, including the coccygeus muscle and fibres of the gluteus maximus (buttock) muscle. These help to support the pelvic floor (Lirette et al., 2014).

One of the most common ways to cause coccydynia is a fall, typically when you land on your backside. A common example is slipping down some stairs, where the step catches your tailbone. Another is slipping on ice and landing on your tailbone. Other common causes include pregnancy and childbirth, and repeated or prolonged strain, for example from sitting for a long time while driving or cycling (NHS, 2025). If you fall heavily, a coccyx fracture may need to be ruled out. Even if a fracture is found, most coccyx injuries are managed with pain relief and by avoiding pressure on the tailbone (NHS Grampian, 2022).

Tailbone pain may improve after a few weeks, but it can sometimes last longer (NHS, 2025). Most people get better with simple home treatment (Cleveland Clinic, 2023), so it is worth sticking with the steps below.

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Treat Coccydynia

Physiotherapy is one of the first treatments recommended if simple measures have not helped (NHS, 2025). It can include stretching and posture work (Cleveland Clinic, 2023) and pelvic floor exercises (NHS, 2025), and massage therapy can help some people, although the relief is usually temporary (Cleveland Clinic, 2023). I can help with hands-on work for the muscles around your tailbone, buttocks and low back, stretching, exercises and advice on sitting and posture. See the My Approach tab for how I work.

1. Anti-Inflammatory Medication

The NHS (2025) suggests non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, to help reduce tailbone pain. (This medicine information comes from the NHS, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

2. Ice

Use an ice pack (or a bag of frozen peas) wrapped in a towel on the affected area for 20 to 30 minutes (NHS, 2025). Lying on your side or on your front while you do this keeps the pressure off your tailbone. Never put ice directly on your skin. Both cold and heat may help, and neither has been shown to work better than the other, so it is worth trying both (Lirette et al., 2014).

3. Heat

As well as ice, heat can be used. A heat pack can be used for longer than an ice pack (NHS, 2025), and a hot bath may help relax your muscles and ease pain (Cleveland Clinic, 2023). Be careful to avoid burns: do not apply heat or ice directly to the skin.

4. Avoid Pressure

Avoid sitting for a long time (NHS, 2025). Make sure you get up and move about every so often to take the pressure off your tailbone. When you do sit, keep a good posture with your lower back supported, and try lying on your side to reduce pressure on your coccyx (NHS, 2025).

5. Customised Pillow

A specially designed coccyx cushion can help take some of the pressure off the coccyx when you are sitting down (NHS, 2025). Wedge-shaped cushions with a cut-out at the back are often recommended, because the open back means nothing touches the coccyx. Some people find a donut-shaped (ring) cushion helps, but others find it still places pressure on the coccyx (Lirette et al., 2014; Cleveland Clinic, 2023). Any type of seating or cushion that takes pressure off your coccyx is worth trying.

6. Stool Softeners

If your tailbone pain is worse when you have a poo, the NHS (2025) suggests asking a pharmacist for a laxative that softens poo, and Cleveland Clinic (2023) also lists stool softeners. (This medicine information comes from the NHS and Cleveland Clinic, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.) Eating foods high in fibre to soften your poo and avoid constipation can also help (NHS Grampian, 2022).

Treatments you may want to discuss with your family doctor or nurse practitioner

Options outside my scope

Manipulation: some physiotherapists, osteopaths and chiropractors manipulate the coccyx and the muscles around it, occasionally from inside the back passage (Lirette et al., 2014; NHS, 2025). This should always be explained and agreed with you first.
TENS or acupuncture: Cleveland Clinic (2023) lists TENS (a small device that delivers mild electrical pulses through the skin) and acupuncture among the options a provider might suggest if home treatment has not worked.
Steroid injection: an injection of corticosteroid and local anaesthetic into the joint that attaches the coccyx to the bottom of the spine (NHS, 2025).
Surgery: an operation to remove part or all of the coccyx (coccygectomy) is rarely needed, and is only considered when other treatments have not worked (NHS, 2025; Cleveland Clinic, 2023).

How I can help (see the My Approach tab)

Hands-on work for the muscles around the tailbone, buttocks and low back
Stretching and gentle pelvic floor and movement exercises
Advice on sitting, cushions and posture

Tips

Coccydynia is often caused by childbirth or a fall.
Repeated or prolonged pressure, such as from riding a bicycle or sitting for long periods while driving, can bring on coccyx pain (NHS, 2025; Cleveland Clinic, 2023).
Poor posture when sitting may be a contributing factor (NHS, 2025).
Being overweight or underweight can also contribute to tailbone pain (NHS, 2025).
Women are about five times more likely than men to get coccydynia (Lirette et al., 2014; Cleveland Clinic, 2023).

Treatment

My Approach

Most tailbone pain settles with home care, and your family doctor or nurse practitioner leads if you need tests, injections or surgery. My aim is to ease the muscles that attach around your tailbone and help you get back to sitting, driving and your usual activities comfortably. After surgery, I need your surgeon's okay before we start hands-on treatment.

I start by assessing your low back, pelvis and hips, since tailbone pain can come from the low back, and looking at how you sit and move. If you've had an X-ray or scan, please bring the report.

Hands-On Treatment

Massage and myofascial work for the low back, buttocks and hips, working around the tailbone rather than pressing on it
Work near the tailbone and buttocks only with your informed consent and a signed consent form, and you stay draped throughout
Warm or cool applications in the clinic, and I'll show you how to use ice and heat safely at home
I teach pelvic floor exercises but don't do hands-on pelvic floor treatment; if that might help, I'll refer you to a pelvic health physiotherapist

Movement and Daily Habits

Gentle stretches for the hips, buttocks and low back
Learning to relax the pelvic floor, then gentle pelvic floor exercises
Advice on sitting, cushions, posture and regular breaks
If your pain started after childbirth, care adapted to the postpartum period

If you have numbness around your genitals or anus, bladder or bowel changes, or weakness in both legs, call 911 (see When to Get Help).

What to Expect

Typical Course

Typical course: Early on, visits are usually once or twice a week, then weekly, spacing out as you manage more on your own, with a reassessment at about 4 to 6 weeks. Tailbone pain often improves after a few weeks but can sometimes last longer, and if you're having injections or surgery, we follow your medical team's plan.

What I Focus On

Assessment

Muscle Release Around the Tailbone

Pressure Relief

Pelvic Floor Relaxation

Sitting & Posture Advice

Please read

When to See a Doctor First

When to Get Help

See your family doctor or nurse practitioner if your pain has not improved after a few weeks of home treatment, if it is affecting your daily activities, or if you have a high temperature along with tailbone pain and pain somewhere else, such as your tummy or lower back (NHS, 2025).
Call 911 or go to the emergency room at your nearest hospital if you have pain in your back or at the base of your spine together with loss of feeling around your genitals or anus, changes in your bladder or bowels (such as difficulty peeing, or peeing or pooing yourself), or tingling, weakness or numbness in both legs (NHS, 2026).

Sources

References

NHS (2025) Tailbone (coccyx) pain. Available at: https://www.nhs.uk/conditions/tailbone-coccyx-pain/ (Accessed: 7 October 2026).
Cleveland Clinic (2023) Tailbone pain (coccydynia): causes, symptoms & treatment. Available at: https://my.clevelandclinic.org/health/diseases/10436-coccydynia-tailbone-pain (Accessed: 7 October 2026).
Lirette, L.S., Chaiban, G., Tolba, R. and Eissa, H. (2014) 'Coccydynia: an overview of the anatomy, etiology, and treatment of coccyx pain', The Ochsner Journal, 14(1), pp. 84–87.
NHS Grampian (2022) Coccyx (tailbone) injury: information for patients and carers. Available at: https://www.nhsgrampian.org/globalassets/foidocument/foi-public-documents1---all-documents/1596.pdf (Accessed: 7 October 2026).
NHS (2026) Back pain. Available at: https://www.nhs.uk/conditions/back-pain/ (Accessed: 8 October 2026).

Massage therapy · Kitchener–WaterlooCoccydynia

What It Is

Coccydynia Anatomy

Self-Care & Treatment

How to Treat Coccydynia

1. Anti-Inflammatory Medication

2. Ice

3. Heat

4. Avoid Pressure

5. Customised Pillow

6. Stool Softeners

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

Hands-On Treatment

Movement and Daily Habits

Typical Course

When to See a Doctor First

When to Get Help

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooCoccydynia

What It Is

Coccydynia Anatomy

Self-Care & Treatment

How to Treat Coccydynia

1. Anti-Inflammatory Medication

2. Ice

3. Heat

4. Avoid Pressure

5. Customised Pillow

6. Stool Softeners

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

Hands-On Treatment

Movement and Daily Habits

Typical Course

When to See a Doctor First

When to Get Help

References

Related Conditions

Ankylosing Spondylitis (AS)

Cervical Spondylotic Myelopathy

Coccyx Fracture

Laminectomy of the Lumbar Spine

Book a session