Coccyx or Tailbone Pain
Condition Overview
The coccyx, or tailbone, is the bony structure at the bottom of your sacrum. The coccyx, along with the ischial tuberosities (sit bones) bear weight when we are sitting down. The pelvic floor muscles flex the coccyx forward towards the pubic bone, and the glute muscles support and tense the coccyx as well.
Coccyx pain is very common. Women are 5x more likely to develop pain here versus men. Pain to the coccyx is often caused by direct trauma to the area during a fall, vaginal childbirth, degenerative joint changes or prolonged sitting, especially on a hard or narrow surface.
Symptoms Can Include:
Achy or sharp pain at the tailbone
More severe pain when sitting for prolonged periods
Increased pain going from sitting to standing
Pain during bowel movements
Pain during sexual intercourse
This pain can also radiate out to the glute muscles and cause low back pain as well.
How Can Physical Therapy Help?
In physical therapy, we will discuss your symptoms, pain reproduction, functional limitations, and goals of therapy. We will discuss behavioral modifications such as decreasing sitting times, use of a donut or wedge to reduce stress to coccyx, movement patterns and body mechanics, improving bowel habits, wearing loose fitting clothing, and use of ice/heat for temporary pain relief.
During our evaluation, we will assess the low back and hips, including the glutes to assess muscle tension, range of motion, flexibility, and pain with palpation.
We may also include an internal pelvic floor muscle assessment with your consent as these muscles flex the coccyx about 15 degrees. Therefore, these muscles (whether the cause of pain or just a side effect) have to be assessed to see muscle tone, strength, endurance, coordination, and to teach appropriate strategies to reduce stress and strain to the coccyx on a daily basis.
From our findings we will set-up a treatment plan depending on your pelvic floor characteristics! There may be lifestyle modifications that we need to address (reduce sitting times, improved posture, constipation).
We will most likely perform manual treatment that can include but is not limited to dry needling, myofascial release, cupping, and connective tissue mobilization around your glutes and pelvic floor musculature.
Depending on how your muscles are responding, it may be beneficial to get a pelvic wand in order to work on these muscles independently at home and continue with pain relief.
With each session we will progress as able and learn new activities to include in your daily routine to manage and prevent worsening symptoms!