Coccydynia (Tailbone Pain)

• Women are five times more likely than men to develop coccydynia.
• Adults and adolescents get it more often than children.
• Obese persons are three times more susceptible than those at the ideal weight according to the BMI (Body Mass Index)scale.

Tailbone pain ranges from a dull ache to a fierce stab. It can last for weeks, months or sometimes longer.

There are three types of events that cause tailbone pain: 

• External Trauma: A bruised, broken or dislocated coccyx caused by a fall. 
• Internal Trauma: Trauma caused by a difficult childbirth or from sitting on a narrow or hard surface for too long. 
• Others: Infection, abscess and tumors.
• Interestingly, for one-third of those with coccydynia, the cause is unknown.

• Falling

If you take a really bad fall you can bruise, break (fracture) or dislocate (knock out of place) your tailbone (coccyx).

• Repetitive Strain Injury (RSI)

Sports like bicycling and rowing require you to lean back and forth and stretch your spine. Too much of that repeated motion can strain the tissues around your coccyx.

• Pregnancy/Childbirth

During the third trimester of pregnancy.        ——>body secretes hormones——> soften the area between the sacrum and the coccyx.

enables the coccyx to move during childbirth.

Stretch the muscles and ligaments.  

around the coccyx too far

causing additional pain.

Such a strain on those soft tissues keeps them from supporting your coccyx at the correct angle.

• Obesity
• Extra weight applies additional pressure to the coccyx——> cause the coccyx to lean backward.
• Your tailbone will hurt if it is out of position.
• Underweight
• If you don’t have enough fat in your buttocks ——> prevent coccyx ——>rubbing against. ——> the muscles, ligaments and tendons, that can cause. ——>The rubbing inflames the soft tissues.
• Sitting

If you’re sitting on a hard or narrow surface.

• Cancer
• Only in rare cases is tailbone pain a sign of cancer. It is extremely unlikely.

The symptoms of coccydynia include:

• Achy or piercing pain in the tailbone.
• More severe pain when changing from sitting to standing up.
• More severe pain when sitting for long periods of time.
• Pain during bowel movements.
• Pain during inter course .
• Painful buttocks
• Back pain

Non-operative treatments may range from the recommendation of

• non-steroidal anti-inflammatory drugs (NSAIDs)
• activity modification
• ergonomic adjustments, and
• physical therapy

physiotherapy will include :-

• progressive stretching and
• strengthening programme
• that will be specifically developed by the physiotherapist to suit your needs and goals.
• Other treatments will include  massage and soft tissue techniques to reduce any muscle 

1. Ergonomic adjustments

The initial goal of treatment should be focused on :-

• providing postural education
• correct sitting posture
• Sitting more erectly on a firm chair a proper sitting posture and ensures weight is taken off the coccyx.
• Recommend the use of Modified wedge-shaped cushions (coccygeal cushions)

1. Manual therapy

Mobilizations: This can help realign the posture of the coccyx. Manipulation: It can be done intra-rectal.

Massage: Massaging the coccygeus muscles has also been proven to relieve pain.

1. Internal techniques

• massage of the levator ani muscle or the coccygeus muscle
• joint mobilization while the coccyx is hyperextended
• to stretch the levator ani, or repeated mobilizations while the coccyx is rotated.

1. External techniques

• manipulations of either the coccyx or sacroiliac joint,
• mobilizations of the sacrococcygeal or intercoccygeal joints
• posterior mobilizations to the thoracic spine
• stretching of the piriformis or iliopsoas.

1. Shock wave therapy

Extracorporeal shockwave therapy show as great result in coccydynia pain management