Tailbone pain can be caused by trauma to the coccyx during a fall, prolonged sitting on a hard or narrow surface, repetitive strain, degenerative joint changes, or childbirth. It can feel dull and achy but typically becomes sharp during certain activities, such as sitting, rising from a seated to a standing position, or prolonged standing.
Tailbone pain usually goes away on its own within a few weeks or months. If your tailbone pain is chronic and doesn’t improve, it is time to consult your doctor.
Lateral x-ray images, CAT scans and MRI scans may be used in diagnosis, but imaging of the coccyx is always tricky, and images are often unclear.
Physical examination can help determine whether the coccyx is loose, out of its normal position, angled backward or forwards, or to one side.
A diagnostic injection of a local anesthetic can enable your doctor to make sure that the pain is actually caused by the coccyx, not referred pain from somewhere else. If the injection makes the pain disappear until the local anesthetic wears off, your doctor will know that it is the tailbone causing the pain.
Tailbone pain can usually be treated conservatively. This treatment may include non-steroidal anti-inflammatory drugs to reduce inflammation, as well as the use of a therapeutic sitting cushion to take the pressure off the tailbone when sitting.
Manipulative massage of the muscles attached to the tailbone has also been effective for some to help ease the pain. It might take many weeks or months of conservative treatment before significant pain relief is felt.
An injection of a local anesthetic into the tailbone can relieve pain for a few weeks.
Your doctor may also consider physical therapy to treat tailbone pain. This therapy might include exercises to stretch and strengthen the supporting muscles.