Tailbone pain (coccydynia) is a localized discomfort at the base of the spine that often increases with sitting, standing up or pressure applied to the coccyx. This page outlines likely causes, when specialist assessment may be helpful, and general measures to ease symptoms.
Pain around the coccyx can be sharp, aching or burning and is usually worse with prolonged sitting, rising from a seated position, or activities that press on the bone. Intensity ranges from mild irritation to pain that affects daily tasks.
Frequent causes include a fall or direct impact, prolonged sitting on hard surfaces, pressure during childbirth, and repetitive micro‑trauma. Pelvic floor muscle spasm, referred pain from lumbar spine issues, joint degeneration, or rarely infection and tumors may also be involved. In many cases no clear cause is found (idiopathic coccydynia).
Initial evaluation typically includes a clinical history and physical exam focusing on posture, palpation of the coccyx and functional movements. If needed, plain X‑rays, MRI or dynamic imaging can be requested. Patients are commonly referred to orthopedics, physical medicine & rehabilitation, or pain management specialists for further assessment.
Using a doughnut or U‑shaped cushion, avoiding long periods on hard seats, changing sitting positions frequently and modifying activities that increase pain often help. Gradual return to activity and supervised physical therapy to address muscle balance can be beneficial. Seek urgent care if pain suddenly worsens with neurological changes (leg weakness, numbness), loss of bladder or bowel control, or if you have a high fever.
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