Coccydynia

Relief for tailbone pain affecting sitting, movement, and daily comfort

Coccydynia refers to pain originating from the coccyx (tailbone) and surrounding structures. Symptoms often worsen with sitting, transitional movements, or direct pressure on the tailbone and may develop after trauma, repetitive strain, or biomechanical changes.

At Resolution Spine & Joint, we focus on identifying the underlying cause of coccyx pain and providing targeted treatments designed to reduce inflammation, restore mobility, and improve comfort with daily activities.

Common Symptoms

Coccydynia may present with:

• Localized tailbone pain

• Pain with sitting, especially on firm surfaces

• Discomfort when rising from sitting

• Tenderness with direct pressure

• Pain during prolonged driving

• Occasional radiation into the buttocks or pelvic region

Symptoms may be sharp during movement transitions and dull or aching during prolonged sitting.

Common Causes

Tailbone pain may develop due to:

• Falls or direct trauma to the coccyx

• Childbirth-related ligament strain

• Repetitive pressure from prolonged sitting

• Joint hypermobility or instability

• Degenerative changes of the coccyx joints

• Pelvic floor muscle tension

• Rapid weight loss reducing cushioning

Even subtle trauma can alter coccygeal alignment or ligament tension, leading to persistent irritation.

How Coccydynia Develops

Pain may arise from several structures:

• Coccygeal joint inflammation

• Ligament strain or instability

• Muscle tension in the pelvic floor

• Nerve irritation in the surrounding region

• Abnormal coccyx mobility (hypermobile or hypomobile segments)

Because the coccyx moves slightly during sitting and positional changes, abnormal mobility can perpetuate inflammation.

Diagnosis

Evaluation typically includes:

• Detailed history focusing on trauma and symptom triggers

• Physical examination assessing tenderness and mobility

• Imaging when necessary to evaluate alignment or exclude other pathology

• Assessment of pelvic floor and surrounding muscular contributions

Diagnosis often relies on clinical correlation rather than imaging alone.

Treatment Options at Resolution Spine & Joint

Treatment focuses on reducing inflammation and improving mechanical tolerance to sitting.

Conservative Management

• Activity modification and sitting posture adjustments

• Use of pressure-relieving cushions

• Physical therapy focusing on pelvic stability and mobility

• Anti-inflammatory strategies when appropriate

Interventional Treatments

• Image-guided coccyx injections to reduce inflammation

• Ganglion impar blocks targeting tailbone-related nerve pain

• Trigger point treatments for pelvic floor or gluteal muscle tension

• Treatment of contributing lumbar or SI joint dysfunction

Targeted injections can provide significant relief by calming both joint inflammation and nerve sensitivity.

Potential Consequences if Untreated

• Chronic sitting intolerance

• Reduced work and activity tolerance

• Pelvic floor tension and compensatory pain

• Sleep and quality-of-life disruption

Persistent tailbone pain can affect posture and lead to secondary spine or hip discomfort.

When to Seek Evaluation

Evaluation is recommended when:

• Tailbone pain persists beyond several weeks

• Sitting becomes increasingly uncomfortable

• Symptoms interfere with work or daily activities

• Conservative measures provide limited relief

Early treatment helps prevent chronic inflammation and pain sensitization.

Why Choose Resolution Spine & Joint

• Expertise in diagnosing less common spine and pelvic pain conditions

• Advanced image-guided coccyx and nerve-targeted procedures

• Comprehensive approach addressing joint, nerve, and muscular contributors

• Individualized care focused on restoring comfort and function

• Compassionate understanding of the functional impact of tailbone pain

Coccydynia is often minimized despite its significant impact — thoughtful evaluation can provide meaningful relief.

Frequently Asked Questions

Can coccydynia resolve on its own?
Some cases improve with time and activity modification, though persistent symptoms may require targeted treatment.

Do cushions help tailbone pain?
Yes. Pressure-relieving cushions can significantly reduce mechanical irritation.

Are injections effective?
Many patients experience meaningful relief with targeted coccyx or ganglion impar injections.

Is surgery ever required?
Surgery is rarely necessary and typically reserved for severe refractory cases.

References

• North American Spine Society (NASS)

• American Society of Interventional Pain Physicians (ASIPP)

• International Pelvic Pain Society