For many people, tailbone pain can be chronic – lasting more than a month or two. Some people have experienced it for years. While every case of coccydynia is different, we’d like to share some general principles to help you navigate this pain. This information is geared towards tailbone pain that has lasted for a long time. For information about acute (new onset) tailbone pain, see this page!
CHRONIC TAILBONE PAIN
- Could have begun with or without a direct injury (a fall or vaginal childbirth are the most common sources of trauma).
- Once 4-6 weeks have passed from the injury, all of the tissues should have naturally healed. However, pain can still last after all the tissues have healed!
- Chronic tailbone pain does not mean that there was incomplete tissue healing. Instead, it means that the tissues are still sensitive.
- Chronic coccydynia can cause pain with sitting, bowel movements, and moving from sitting to standing.
Do I need an x-ray?
- Because there is no acute injury, there is no automatic need for an x-ray. However, if your tailbone pain is associated with changes in your bowel and bladder function, changes in sensation or strength in your legs, or you have a history of cancer in yourself, seek medical care.
How can I reduce chronic tailbone pain?
- It is our best advice to avoid pressure on the tailbone when pain is acute (within the first month). However, most people who have had tailbone pain for a long time will tell us that they have already been doing this when they come in for physical therapy!
- If you have already been doing a good job of avoiding tailbone pressure, graded exposure to pressure on the tailbone is actually usually the best way forward.
- Many people are afraid to sit again after a tailbone injury. It’s normal to be nervous! However, if you avoid sitting on normal surfaces for the long term, the tailbone may actually stay sensitive to pressure and feel painful for longer! This is often the case for people who have chronic tailbone pain.
- Some people benefit from a pain relief injection at the tailbone guided by advanced imaging.
What can pelvic physical therapy do for my chronic tailbone pain?
- Your pelvic PT will evaluate your situation and offer individual advice about gradually increasing your tolerance for sitting and other painful movements. If you can do normal activities, including exercising, with minimal to no pain increases, it is safe to do so!
- This process happens at your pace, and your physical therapy will be able to help you navigate any bumps along the way! With the guidance of your pelvic PT and some patience, you’ll get back to what you love and ditch the coccyx cushion for good!
Struggling with Chronic Tailbone Pain? We’re Here to Help.
If your tailbone pain has lasted for weeks or months, you don’t have to keep living with it. Chronic tailbone pain (coccydynia) often involves more than the tailbone itself. A pelvic floor physical therapist can evaluate how your pelvic floor muscles, hips, spine, and movement patterns may be contributing to your symptoms and develop a personalized treatment plan to help reduce pain and improve sitting, exercise, and everyday activities.
At Agile Physical Therapy, our pelvic floor specialists provide individualized, one-on-one care to help people with chronic tailbone pain return to the activities they enjoy. Treatment may include manual therapy, movement retraining, pelvic floor muscle assessment, exercise, and education tailored to your specific needs. We offer one-on-one, 60-minute pelvic floor physical therapy appointments at our San Mateo, Palo Alto, and Los Gatos clinics. If you don’t live near one of our locations, we also offer virtual pelvic floor physical therapy for residents of California and Massachusetts. Virtual visits can be an excellent option for education, exercise progression, movement coaching, and many pelvic health concerns.