Coccyx Pain – A Pain in the Butt

Georgie Palmer (Physiotherapist – Burnie)

The coccyx or tailbone is a triangular bone which forms the final part of the vertebral column (spine). Tailbones vary between people, they can have 3, 4, or 5 vertebrae which can be fused, or separated via small joints.

The tailbone has lots of ligament and muscle attachment, including the pelvic floor and glute maximus. It provides support to the pelvic floor muscles, contributes to bowel function, stabilizes the pelvis in sitting (along with your “sitz” bones) and supports the anus.

The coccyx does have a degree of movement and this occurs when changing positions from sit to stand and vice versa. It can also move when we empty our bowels and with childbirth.

Some risk factors for coccyx pain include:

  • Obesity
  • Being female
  • Age (30-50 years old at greater risk)
  • History of rapid weight loss
  • Trauma to the coccyx (including vaginal birth)
  • Prolonged sitting

Some post-partum risk factors include

  • Instrumental delivery (use of forceps)
  • Multiparity (having more than one baby)
  • Short perineum
  • Birth position

Physiotherapy is considered first line management for coccyx pain along with the use of pharmacological management (non-steroidal anti-inflammatories, analgesics, topical creams, rectal suppositories). When you see a Physio about your coccyx pain you can expect to be asked a series of questions about your symptoms, they may also ask you about bladder/bowel/sexual function due to the relationship between the coccyx and the pelvic floor. The Physio will then perform a physical examination which may include assessment of

  • Pelvic girdle/hip/lower back
  • External coccyx
  • Internal coccyx (via the rectum) only if needed and you feel comfortable to do so
  • Pelvic floor muscles and deep hip muscles
  • Functional assessments (e.g. sit to stand)

Treatment of coccyx pain will likely include a combination of education, manual (hands on) therapy, sitting modification, pain management, mindfulness, and home exercises.

If you have any coccyx issues, Georgie at our Burnie clinic has a special interest in women’s, men’s and pelvic health and has completed extra training in managing coccyx pain. Give the Burnie clinic a call on 64314586 to book your appointment.