What Is Coccydynia?
Coccydynia is pain at or around the coccyx (tailbone). It can be a sharp, stabbing pain when sitting, a deep ache, or a constant low-grade discomfort. For some patients it's mild and intermittent; for others, sitting through a workday becomes nearly impossible.
Common Causes
- Falls onto the buttocks or tailbone
- Childbirth (particularly long or difficult deliveries)
- Prolonged sitting on hard surfaces
- Chronic constipation and straining
- Direct trauma during sport
- Poor posture (especially slouched sitting)
- Hypermobile or hypomobile coccyx joints
- Pelvic floor muscle dysfunction
- Unknown / idiopathic (no clear cause)
Why the Pelvic Floor Matters
Many of the pelvic floor muscles attach directly to the tailbone. When they become tight, overactive, or imbalanced, they pull on the coccyx and cause pain. When the coccyx is irritated, the pelvic floor often guards in response, creating a self-reinforcing cycle.
Treating coccydynia without addressing the pelvic floor is like treating a TMJ problem without looking at the jaw muscles. It is the missing piece in most coccyx pain treatment.
Symptoms
- Pain at the very base of the spine, between the buttocks
- Worse with sitting, especially on hard surfaces
- Worse when transitioning from sitting to standing
- Pain with bowel movements
- Pain with sex (in some cases)
- Sometimes radiating pain into buttocks, hips, or low back
How We Treat It
1. Comprehensive Assessment
We evaluate posture, sitting mechanics, hip and core function, gait, pelvic floor muscle tone, and coccyx mobility. The full picture tells us what's driving your specific pain.
2. Pelvic Floor Muscle Release
Internal and external manual therapy releases the muscles that pull on the coccyx. Most patients feel meaningful relief within the first 1-3 visits.
3. Coccyx Mobilization (When Indicated)
For coccyx joint stiffness or malposition, gentle internal mobilization can restore joint mobility. This is done only when clinically appropriate, only with your consent, and only when more conservative options haven't fully resolved symptoms.
4. Posture and Sitting Modifications
Coccyx wedges, posture cushions, and sitting strategies can dramatically reduce daily aggravation. We help you find what actually works.
5. Bowel Habits
If straining is a factor, we address constipation through pelvic floor coordination work, positioning, hydration, and diet basics. Reducing the daily strain on the coccyx is often what allows the pain to fully resolve.
What to Expect
Most patients with coccydynia see significant improvement in 4-8 visits. Acute cases (recent fall, recent childbirth) often respond very quickly. Long-standing chronic coccydynia may take longer but is still very treatable.