Coccyx or the tailbone is the last bone at the bottom of the spine or backbone, that is present above the cleft of the buttocks. Any pain felt in the region of the coccyx bone is termed coccydynia. The tailbone bears the weight of your body when you sit down and, as a result, it is prone to pain or inflammation. It is a common condition and usually self-limiting (gets better on its own).

The pain could range from a mild or dull ache to acute stabbing. It may become more severe as you change from sitting to standing up. The pain may also be felt during bowel movements and sex.

Causes of coccydynia

The pain can occur due to external or internal injury and other conditions such as infections or tumours. However, the cause behind one-third of the coccydynia cases remains unknown. Some known causes are:

• Fall on to the back can cause fractures or dislocation of the bone
• Repetitive strain injury (cycling, riding bike or rowing)
• Childbirth can cause stretching of the muscles or ligaments around the bone
• Obesity, since it puts extra strain on the bone
• Being underweight, as there isn’t enough fat around the bone then
• Sitting on a narrow and hard surface for a long time
• Cancer (very rare)

Treatment of coccydynia

Most coccydynia cases resolve on their own. However, a few cases may require minimal medicinal intervention or home remedies.

1. Medicinal

A doctor may prescribe you the following after your consultation:

• Pain-relieving medication such as NSAIDs.
• Nerve blocking anesthetic medications can be used to numb the coccygeal nerve.
• Steroids to reduce inflammation that reduces pain.

2. Physiotherapy

A physical therapist may recommend pelvic floor relaxation exercises and stretching techniques.

3. Massage and manipulation

Massaging around the tailbone muscles may help reduce the pain. Manipulation of the bone can be done through the rectum to correct the malalignment of the bone by a practising chiropractor.

4. Surgical

Coccygectomy is the procedure where the coccyx is surgically removed. This is usually not recommended unless all of the other treatments fail.

Home remedies and prevention

• Take a hot or warm bath to relax the muscles and relieve pain
• Apply a hot or cold pack (depending on the pain response) 2-3 times a day
• Take over-the-counter pain-relieving tablets (Ibuprofen and paracetamol) or ointments for temporary relief.
• Be careful while walking to avoid falling as much as possible
• Practice stretching and back muscles strengthening exercises
• Avoid sitting or riding for long hours
• Sit on a wedge shape or donut-shaped (coccygeal) cushion
• Avoid looking at a mobile while walking or riding for the same purpose