Coccydynia - Why Does My Tailbone Hurt?

Coccydynia is defined as pain felt in or around the coccyx, also known as the tailbone. A lot of times coccydynia can happen if you injure or strain your coccyx or the surrounding muscles and ligaments.

Possible Causes of Coccydynia:

• Childbirth: During delivery, the baby's head passes over the top of the coccyx, and the pressure against the coccyx can sometimes result in injury to the coccygeal structures (the disc, ligaments, and bones). While uncommon, the pressure can also cause a fracture in the coccyx. Many new mothers deal with coccydynia after birth and it is important to seek treatment as early as possible!
• Local trauma: A direct injury to the coccyx is probably the most common cause of coccydynia. A fall on the tailbone can inflame the ligaments and injure the coccyx or the coccygeal attachment to the sacrum. Coccygeal trauma usually results in a bruised bone, but may also result in a fracture or dislocation either in the front or back of the coccyx.
• Repetitive stress: Activities that put prolonged pressure on the tailbone, such as horseback riding and sitting on hard surfaces for long periods of time, may cause the onset of coccyx pain. Tailbone pain from these causes usually is not permanent, but if inflammation and symptoms are not managed, the pain may become chronic and cause long-term altered mobility of the sacrococcygeal joint.
• Tumor or infection: Rarely, coccydynia can be caused by a nearby tumor or infection that puts pressure on the coccyx.

            These are some of the most common causes of tailbone pain and inflammation, but what a lot of people don’t know is that this can relate directly to possible back pain and you might not even be aware of it. Because Coccydynia is a pain resulting from injury or trauma to the tailbone, which is located within the pelvic floor, this can relate to all kinds of issues in different parts of the body. The pelvic floor can hold a lot of trauma, but it may show itself in places that you would not expect. Since the tailbone is located at the very end of the spine, trauma to this area can be a direct link to lower back pain in particular. The pelvic floor is made up of tendons, ligaments, and muscles that are attached to the bottom of the pelvis and extend along the front of the pubic bone, around the sides of the hip bones, and to the lower back where the tailbone is located. Additional muscles that are attached to the tailbone and pelvis include vaginal, anal, abdominal, gluteal (buttocks), and hip muscles. This means that issues affecting the pelvic muscles can cause problems for other areas of the body such as the lower back and hips.

            If you are currently experiencing Coccydynia or back pain that you think may be related to a somewhat recent tailbone injury, there are different exercises that you can try at home to ease the pain. Here are some examples of these exercises that you can start trying today:

• Piriformis and glute cross leg stretch (thread the needle)

This stretches the piriformis as well as the glutes. The glutes are attached to the tailbone and walking or running can cause them to pull on it.

1. Lie down on the back.
2. Raise the knees toward the ceiling, keeping the feet flat on the floor.
3. Bend the left leg closer into the body and rest the left ankle across the right knee.
4. Loop the hands around the right thigh and gently pull it toward the chest for 30 seconds.

Repeat on the other side.

●      Single leg knee hug

This stretches the piriformis and the iliopsoas muscles, both of which can become tight and limit mobility in the pelvis. The piriformis originates from the tailbone and can irritate the sciatic nerve if it becomes inflamed.

Gently increasing the stretch over time will allow the range of movement to expand.

1. Lie down on the back and extend the feet straight out.
2. Bend one knee toward the chest.
3. Hold onto the bent knee and pull it gently down into the chest.
4. Hold for 30 seconds, then repeat on the other side.

These stretches may help with some temporary relief, but they will not fix the problem at its source. If you feel that you may have coccydynia or any other back pain that you can not pinpoint, it’s best to reach out to a pelvic floor therapist.