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What causes tailbone pain, and how can I ease it? Answer From Margaret Moutvic, M.D.

Tailbone pain — pain that occurs in or around the bony structure at the bottom of the spine (coccyx) — can be caused by trauma to the coccyx during a fall, prolonged sitting on a hard or narrow surface, degenerative joint changes, or vaginal childbirth.

Tailbone pain 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. Defecation and sex also might become painful. For women, tailbone pain can make menstruation uncomfortable as well.

Tailbone pain, also called coccydynia or coccygodynia, usually goes away on its own within a few weeks or months. To lessen tailbone pain in the meantime, it might help to:

Lean forward while sitting down

Sit on a doughnut-shaped pillow or wedge (V-shaped) cushion

Apply heat or ice to the affected area

Take over-the-counter pain relievers, such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) or aspirin

If your tailbone pain doesn't improve (chronic coccydynia), consult your doctor. He or she might do a rectal exam to rule out any other conditions. Your doctor might recommend using magnetic resonance imaging (MRI) to find out if you have a fracture, degenerative changes or, in rare cases, a tumor.

Possible treatments for chronic tailbone pain might include:

Physical therapy. A physical therapist might show you how to do pelvic floor relaxation techniques, such as breathing deeply and completely relaxing your pelvic floor — as you would while urinating or defecating.

A physical therapist might show you how to do pelvic floor relaxation techniques, such as breathing deeply and completely relaxing your pelvic floor — as you would while urinating or defecating. Manipulation. Massaging the muscles attached to the tailbone might help ease pain. Manipulation is typically done through the rectum.

Massaging the muscles attached to the tailbone might help ease pain. Manipulation is typically done through the rectum. Medication. An injection of a local anesthetic into the tailbone can relieve pain for a few weeks. Certain antidepressants or anti-epileptic medications might relieve tailbone pain as well.

An injection of a local anesthetic into the tailbone can relieve pain for a few weeks. Certain antidepressants or anti-epileptic medications might relieve tailbone pain as well. Surgery. During a procedure known as a coccygectomy, the coccyx is surgically removed. This option is typically only recommended when all other treatments fail.

With Margaret Moutvic, M.D.



