Low Back & Pelvis

What It Is

A coccyx injury is usually caused by a fall onto your tailbone (NHS Grampian, 2022). It is possible to fracture, dislocate or bruise the coccyx (Cleveland Clinic, 2023). Even though they may be slow to heal, most coccyx injuries can be managed with pain relief and simple measures (NHS Grampian, 2022).

The coccyx is the small triangular bone at the base of the spine. It is made up of three to five segments and is held in place by ligaments and joints (Lirette et al., 2014). Tailbone pain is about five times more common in women than in men (Cleveland Clinic, 2023).

The most common cause of a coccyx injury is a fall onto your tailbone in a sitting position, usually against a hard surface (NHS Grampian, 2022). Examples include falling down steps, where the step catches your tailbone, or slipping on ice, where your feet slip forwards very quickly and you land on your tailbone.

A coccyx fracture is not easy to tell apart from bone bruising without an X-ray or CT scan (Cleveland Clinic, 2023). However, whether the coccyx is bruised or broken, most injuries are managed in the same way, with pain relief and by avoiding pressure on the tailbone (NHS Grampian, 2022). A doctor can tell you whether you need a scan.

Coccyx Fracture Anatomy

Coccyx fractures are broken tailbones. The coccyx is the lowest part of the spine (backbone). It is small and triangular, and is made up of three to five fused segments (Lirette et al., 2014). It usually has a little bit of movement and curves gently from the end of the spine into the pelvis (NHS Grampian, 2022).

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

Treatment

Self-Care & Treatment

How to Treat a Coccyx Fracture

Alongside the steps below, I can help with hands-on work for the muscles around your lower back and hips, and advice on sitting and getting back to activity. See the My Approach tab for how I work.

1. Avoid Prolonged Sitting

Avoid sitting down for long periods of time. Avoid very soft chairs, because sinking into a soft surface can increase the pressure on the coccyx. Alternate between sitting on one side of your bottom and the other. Leaning forward (slouching) moves your weight off the tailbone; only do this until you are well enough to sit properly again (NHS Grampian, 2022).

2. Ice

For a traumatic injury, you can use a cold pack or a bag of frozen peas, always wrapped in a towel, for 10 to 15 minutes, four times a day, for the first few days after the injury (NHS Grampian, 2022). Do not put ice directly on your skin or keep it on too long, as you can get an ice burn.

3. Pain Relief Medication

NHS Grampian (2022) advises that paracetamol and ibuprofen are effective painkillers when taken regularly, helping to reduce pain and keep you mobile, and that you should check whether there are any reasons you cannot take them. (This medicine information comes from NHS Grampian, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

4. Doughnut Cushion

Sitting on an air cushion or "doughnut" pad can make sitting less painful (NHS Grampian, 2022). Some people find a specially designed coccyx cushion with a cut-out at the back more comfortable, as it avoids pressure on the coccyx (NHS, 2025; Lirette et al., 2014).

5. Avoid Constipation

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

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 tailbone pain does not improve with home treatment.
Injections or surgery: for tailbone pain that does not get better with other treatments, a steroid injection or, rarely, an operation to remove part or all of the coccyx may be considered (NHS, 2025; Cleveland Clinic, 2023).

How I can help (see the My Approach tab)

Hands-on work for the lower back, hips and thighs

Help with sitting positions and cushions

Gentle mobility and strength work as it settles

Tips

Direct blows to the tailbone, such as falling down the stairs, slipping on ice or during contact sport, can cause the coccyx to become injured.
Childbirth can cause the coccyx to become injured (NHS, 2025; Cleveland Clinic, 2023).
Falling onto the tailbone in a seated position, often against a hard surface, is the most common way to injure the coccyx (NHS Grampian, 2022).
Coccyx pain without an injury can have other causes, such as wear in the joint, too much or too little movement in the joint, infection, pain referred from the spine or, less commonly, a tumour (Lirette et al., 2014).
Repeated strain or friction on the coccyx, such as from rowing or riding a bike, can cause the coccyx to become injured (Cleveland Clinic, 2023).
Sometimes the cause of tailbone pain is not known (NHS, 2025).

Treatment

My Approach

A bruised or broken tailbone is usually managed with pain relief and by taking pressure off it, and it can be slow to settle. Your doctor decides whether you need a scan and how the injury is treated. I work alongside that plan, never press on the tailbone itself, and need your doctor's okay first if you had surgery or the injury is stopping you from getting through your normal day.

Please bring any X-ray or scan reports and notes from your medical team to your first visit. They're an important part of planning safe treatment for you.

I start by assessing how you sit, stand, walk and bend, and how your lower back and hips move.

While It's Sore

Hands-on work for the lower back, hips and thighs, which tighten up and guard when sitting and moving hurt
Buttock (gluteal) work only with your informed consent and a signed consent form
Warm applications in the clinic, and I'll show you how to use ice safely at home in the first few days
Help with sitting: cushions, positions and breaking up long spells in a chair

As It Settles

Gentle mobility work for the lower back and hips
Strengthening for the hips, legs and trunk, including gym-based lifts adjusted so nothing presses on or strains the tailbone
A gradual return to activities such as cycling, rowing or contact sport, building up step by step

If the muscles of the pelvic floor seem to be involved, I'll point you to a pelvic health physiotherapist. If you have loss of feeling around your genitals or anus, changes in your bladder or bowels, or tingling, weakness or numbness in both legs, call 911 or go to the emergency room (see When to Get Help).

What to Expect

Typical Course

Typical course: Short visits once or twice a week usually help most while sitting is very sore, then weekly, spacing out as you manage more on your own, with a reassessment at about 4 to 6 weeks and always following your doctor's plan. Most people find the pain eases gradually over a few weeks, though a broken coccyx can take around 8 to 12 weeks to settle; if it hasn't improved after a few weeks of home treatment, check back in with your family doctor or nurse practitioner.

What I Focus On

Working Within Your Doctor's Plan

Hip & Lower-Back Release

Sitting Comfort

Gentle Mobility

Return to Strength

Please read

When to See a Doctor First

When to Get Help

See your family doctor or nurse practitioner if your tailbone pain has not improved after a few weeks of home treatment, or is affecting your daily activities (NHS, 2025).
Call 911 or go to the emergency room at your nearest hospital if the pain started after a serious accident, such as a car accident, or if you have back or tailbone pain 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 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).
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).
NHS (2025) Tailbone (coccyx) pain. Available at: https://www.nhs.uk/conditions/tailbone-coccyx-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 (2026) Back pain. Available at: https://www.nhs.uk/conditions/back-pain/ (Accessed: 8 October 2026).

Massage therapy · Kitchener–WaterlooCoccyx Fracture

What It Is

Coccyx Fracture Anatomy

Self-Care & Treatment

How to Treat a Coccyx Fracture

1. Avoid Prolonged Sitting

2. Ice

3. Pain Relief Medication

4. Doughnut Cushion

5. Avoid Constipation

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

Tips

My Approach

While It's Sore

As It Settles

Typical Course

When to See a Doctor First

When to Get Help

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooCoccyx Fracture

What It Is

Coccyx Fracture Anatomy

Self-Care & Treatment

How to Treat a Coccyx Fracture

1. Avoid Prolonged Sitting

2. Ice

3. Pain Relief Medication

4. Doughnut Cushion

5. Avoid Constipation

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

Tips

My Approach

While It's Sore

As It Settles

Typical Course

When to See a Doctor First

When to Get Help

References

Related Conditions

Ankylosing Spondylitis (AS)

Cervical Spondylotic Myelopathy

Coccydynia

Laminectomy of the Lumbar Spine

Book a session