Pelvic crest pain when sitting
Tailbone pain (coccygodynia)
Last edited by Dr. rer. nat. Geraldine Nagel • Medical editor
Checked by Dr. med. Frauke Gehring • General practitioner
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Tailbone pain is relatively rare, but it can be very severe and stressful in everyday life. Learn more about the causes of the pain and how to treat it.
Coccyx pain (technical term: coccygodynia) refers to pain in the lowest area of the spine: the coccyx. The tailbone and / or the soft tissues of this region react with sharp, stabbing, or pulling pain when pressure is applied.
The symptoms do not have to be limited to the coccyx region, but can also radiate into the anal and lumbar areas as well as the hips.
Often, pain in the tailbone increases when sitting or when getting up from a sitting position. In some cases, they even make sitting impossible.
In some cases, tailbone pain also causes pain during bowel movements or pain during sexual intercourse.
The term coccygodynia is derived from the scientific name of the affected group of bones: the coccyx. These include the bones of the spinal column, also known as the tailbone or cuckoo's leg. The word part -dynie again means something like pain.
Tailbone pain: causes
Tailbone pain (coccygodynia) can have various causes. Exactly why the pain occurs cannot be determined with certainty in every case. Overall, women are more likely to experience tailbone pain than men.
Possible triggers for tailbone pain are tiny tissue injuries (so-called microtraumas) that occur over a long period of time. Such microtraumas may develop under certain circumstances with mechanical loads such as long periods of sitting (e.g. when sitting down), especially on harder surfaces (such as with hard chairs, hard bicycle saddles, rowing benches).
But also long periods of sitting on softer surfaces (for example on the sofa) can lead to pain in the tailbone in some people.
Tailbone pain often occurs during pregnancy when the bony pelvic ring loosens as a result of hormonal changes.
Reading tip:Pregnancy complaints - morning sickness, back pain, heartburn & Co.
Other possible causes of tailbone pain include:
- Coccyx contusion
- Tailbone sprain
- overmobile or dislocated / dislocated tailbone
- Tailbone fracture
- Misalignments of the coccyx
- Injuries in the pelvic area
- Lumbar pain (e.g. lumbago)
- Root irritation syndrome (lumbar sciatica)
- disc prolapse
- Inflammation of the bursitis (bursitis)
- Coccyx fistulas
- Piriformis Syndrome
- gynecological diseases
- Nerve pain (neuralgia) in the area of several nerves in the coccyx plexus (the Nervi anococcygei) - i.e. pain that is limited to the area of the nerves that supply the skin between the coccyx and anus
- post-traumatic osteoarthritis (wear and tear on the joints that can occur some time after an injury)
- Tumors in the area of the coccyx
- surgical interventions
- severe overweight (obesity)
Under certain circumstances, tailbone pain can also have psychosomatic causes. Then psychological stress triggers tailbone pain, for example when the muscle tone increases as a result of persistent stress and contributes to painful tension. Constant pain, in turn, can make the nerves in the affected area more sensitive.
Tailbone pain: diagnosis
In the case of tailbone pain (coccygodynia), the doctor will usually first ask a few questions about the exact symptoms. This is usually followed by a physical examination. Pressure on the tip of the tailbone or the transition between the tailbone and sacrum usually triggers a painful reaction.
In most cases, an X-ray examination does not reveal any abnormalities in the coccyx in people with tailbone pain.
However, imaging tests such as a pelvic ultrasound scan, computed tomography (CT), or magnetic resonance imaging (MRI) scan can help rule out other possible causes of tailbone pain. If there is a suspicion of an inflammation or a tumor, a contrast agent is also used for the examination to show the coccyx area in more detail.
Tailbone pain: treatment
In order to relieve tailbone pain (coccygodynia), several measures are often used in combination for treatment.
To make the tailbone pain more bearable, pain relievers may be appropriate temporarily - for example, active ingredients from the group of non-steroidal anti-inflammatory drugs (such as ibuprofen).
Local anesthetics / glucocorticoids
The doctor may consider injecting local anesthetics into the affected area to relieve pain in the tailbone and adjacent soft tissues.
Depending on the situation, active ingredients from the group of glucocorticoids can also help to inhibit inflammatory processes in the coccyx region.
Physiotherapy / manual therapy
In the case of tailbone pain, physiotherapeutic measures (such as exercises to stretch and strengthen the muscles, massages and posture tips) or mobilization or manipulation of the tailbone (e.g. by a manual therapist) are often helpful.
Heat / cold
Heat or cold often have a soothing effect on tailbone pain. However, those affected have to try out what works best against tailbone pain in individual cases.
Reading tip:Warmth or cold - what helps with which pain?
A soft seat cushion, a soft U-shaped seat cushion or a soft seat wedge with a recess often make it easier to sit in the case of acute pain in the tailbone. You can get special pillows of this type in medical supply stores, for example.
Seat rings, on the other hand, do not help everyone with tailbone pain, as they can put too much pressure on the tailbone.
Avoid sitting for long periods
Sitting for long periods of time can lead to tailbone pain. Therefore, getting up and walking around more often can help. It can also relieve pain by leaning forward slightly when sitting.
Reduce pain during bowel movements
Tailbone pain is sometimes associated with painful bowel movements. This is especially true if someone has constipation. Here it can make sense to pay more attention to a diet that makes the stool softer.
In consultation with the doctor, laxatives can also be used if necessary. These make the stool softer and encourage emptying of the bowels.
Reading tip:Constipation - what to do
If everything indicates that the tailbone pain has psychosomatic causes, psychotherapy can be used as a further measure.
Coccyx pain: course
The course of tailbone pain (coccygodynia) varies from case to case. They usually last a few days to several weeks and then heal on their own.
Depending on the cause (e.g. a broken tailbone), pain in the tailbone may also take a chronic course and last for months to years. In such cases, treatment becomes more difficult.
Tailbone Pain: Prevent
Coccyx pain cannot actually be prevented. To reduce the risk, tailbone injuries (e.g. after a fall) should be treated as soon as possible.
Regular early diagnosis examinations can also help to identify any organic diseases in the pelvic floor area early enough.
Coccydynia (tailbone pain). Online information from National Health Services: www.nhs.uk (as of July 11, 2019)
Tailbone pain: How can I relieve it? Online information from the Mayo Clinic: www.mayoclinic.org (as of April 20, 2019)
Tailbone pain (coccygodynia). Online information for medical staff from Deximed: deximed.de (status: 8.1.2019)
Niethard, F. U., Pfeil, J .: Orthopädie. Thieme, Stuttgart 2017
Lirett, L.S., et al .: Coccydynia: An Overview of the Anatomy, Etiology, and Treatment of Coccyx Pain. The Ochsner Journal, No. 14, pp. 84-87 (2014)
Wirth, C. J., et al .: Practice of Orthopedics and Trauma Surgery. Thieme, Stuttgart 2014
Mattle, H., et al .: Neurology. Thieme, Stuttgart 2013
Koop, I .: Gastroenterology compact. Thieme, Stuttgart 2013
Wülker, N .: Pocket textbook on orthopedics and trauma surgery. Thieme, Stuttgart 2010
Bischoff, H.-P .: Practice of Conservative Orthopedics. Thieme, Stuttgart 2007
Guidelines of the German Society for Coloproctology: Coccygodynia (PDF). AWMF guidelines register No. 081/005 (as of December 2002)
ICD-10 Diagnostic Key:
You can find the appropriate ICD-10 code for "tailbone pain (coccygodynia)" here:
Onmeda reading tips:
- German Pain League Here you can find information on the subject of pain, addresses of self-help groups and contacts to relevant doctors. The Pain League is the umbrella organization for more than 100 self-help groups.
Last content check:12.02.2021
Last change: 12.02.2021
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