Coccyx Pain: Common Causes and Treatments

May 11, 2025, 8:47 am | Read time: 4 minutes

Pain at the very bottom of the back—right above the buttocks—can be extremely uncomfortable and significantly impact daily life. Doctors refer to this condition as coccydynia, the medical term for tailbone pain. If left untreated, it can be excruciating and adversely affect the quality of life for those affected.

The coccyx is a small but significant part of the spine. Issues in this area can have acute or chronic causes, ranging from injuries and posture problems to organic diseases. FITBOOK explains what the coccyx is all about and how to treat the pain.

What Do Coccyx Pains Feel Like?

Coccyx pain occurs especially when sitting, standing up, or bending the body and can radiate to surrounding areas. It ranges from dull, constant pain to sharp stabs, significantly affecting daily life. Distinguishing between local and referred pain can be challenging, making an accurate diagnosis crucial. The medical term is coccydynia, derived from the Latin Greek “coccyx” (tailbone) and “odynia” (pain).

Why the Coccyx Is So Sensitive to Stress

The coccyx forms the lowest section of the spine and typically consists of several fused vertebrae. Although it is a rudimentary part of the body from an evolutionary perspective, it plays an important role in supporting and connecting ligaments, tendons, and pelvic floor muscles. Due to its exposed position and thin protective layer, it is particularly sensitive to pressure and mechanical stress. When this balance is disrupted, pain can occur: sitting, cycling, or standing up becomes unpleasant.¹

Typical Triggers of Coccyx Pain

Direct Fall

A direct fall on the buttocks, such as from slipping, can cause immediate, severe pain in the coccyx area. In such cases, a bruise or, in the worst case, a fracture is often present, necessitating prompt medical examination.

Poor Posture

However, coccyx pain often develops gradually rather than suddenly. A common cause is poor posture, which leads to overloading certain muscles and ligaments, resulting in tension. According to Kubosch, prolonged sitting is often the simple cause.

Menstruation

Another common trigger is menstruation. Many women experience pain radiating to the coccyx during their period. When the uterus and surrounding muscles contract to shed the lining, it can cause discomfort. Additionally, increased blood flow in the pelvic region raises pressure on surrounding nerves and tissues, including the coccyx, as Kubosch explains.

Pregnancy

Many women are also affected during pregnancy. In preparation for childbirth, ligaments and joints in the pelvis loosen, which can affect the stability of the coccyx.²

Other Possible Causes

In addition to falls or poor sitting posture, inflammatory diseases such as periostitis or chronic inflammatory conditions like ankylosing spondylitis are possible triggers. Pressure from fistulas, cysts, or benign to malignant tumors in the buttocks area can also cause discomfort. Problems with ligament structure or severely tense muscles in the pelvic area are other factors. If no organic cause is found, experts refer to idiopathic coccydynia.

How to Relieve the Pain

If you have fallen on your coccyx, you should initially cool the affected area and avoid lying on your back—a measure recommended by David Kubosch.

If tension is the cause, heat helps relax the muscles—such as through a warm bath, a hot water bottle, or a heat patch. Targeted stretching and strengthening exercises for the lower back muscles can also help alleviate pain.

For people who sit a lot, such as in an office, an ergonomic sitting posture is crucial. A well-padded chair or special seat cushions like wedge or donut cushions can reduce pressure on the coccyx. It is also advisable to change positions regularly while sitting.

Preventing Coccyx Pain

Everyday tips are also helpful: sitting upright, frequent position changes, and sleeping on your side can noticeably relieve the coccyx. Supportive measures include seat rings or coccyx cushions. For acute pain, cold and heat applications help. Targeted back training and pelvic floor exercises—especially during pregnancy—provide long-term prevention. Loose-fitting clothing and, if necessary, anti-inflammatory medications or stool softeners complete the self-help measures.

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Therapies for Persistent Pain

If conservative measures do not bring improvement, further treatments such as manual therapy, osteopathy, or targeted physiotherapy may be considered. These can relieve tension and correct poor posture. If psychological stress is a possible cause, psychotherapy can help alleviate pain. Only in extreme cases is part of the coccyx surgically removed.³

When Medical Clarification Is Necessary

Are the coccyx pains very severe? Or are you unsure of their origin? This is a reason to have the symptoms medically clarified. If the pain persists for more than six weeks, you should see a doctor, advises David Kubosch.

The first point of contact is usually the general practitioner’s office. If necessary, a referral to a specialist practice—typically in orthopedics, trauma surgery, gynecology, or neurology—follows.

With material from dpa

This article is a machine translation of the original German version of FITBOOK and has been reviewed for accuracy and quality by a native speaker. For feedback, please contact us at info@fitbook.de.