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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! 


  • 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.

Chronic Tailbone Pain

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. 

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!

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