It has happened to all of us, you are walking down the stairs or on a slippery driveway, your feet fly out from under you and Bam! You land on your Bottom. Ouch! For many patients, this is the way coccyx or tailbone pain begins.
What Causes Coccyx Pain?
A fall can cause the muscles that attach to the tailbone to go into spasm, causing pain, or the fall may cause the tailbone to flex more than it is designed to and get “stuck” there. The most common symptoms are pain with sitting and particularly with leaning back while sitting as this puts the coccyx or tailbone in more contact with the chair.
Women and Birth Trauma
Another cause of tailbone pain in women is birth trauma. Pushing those babies out is hard on Mommys’ bodies! Many of the pelvic floor muscles and soft tissues attach on the coccyx. As everything gets stretched in order to get the baby’s head out something has to give. Sometimes it is the tailbone that gets pulled into a more flexed position. Sometimes it is muscle pain and spasm due to over stretching. Sometimes a difficult labor or the use of forceps which is necessary to get the baby out results in the tailbone getting moved more than it usually would.
Other Risk Factors
Tailbone pain occurs more often in women but can also occur in men. Other risk factors include a fall or other trauma to the tailbone, prolonged poor sitting posture, and being heavier. A body mass index of more than 27.4 in women or 29.4 in men increases the risk of developing tail bone pain.
Treatment for Pain
So, what should you do if you have tailbone pain? If it is because of a fall you should immediately apply an ice pack to your tailbone and leave it on 10-15 minutes at a time several times/day. Taking Tylenol, Ibuprofen or Aleve may also be helpful initially. And, trying to avoid sitting as much as possible and sitting in a very upright position will be helpful.
If these strategies don’t work to alleviate your symptoms after a week, you should see a health care provider. If you symptoms are related to the birth of a child, your obstetrician or nurse midwife is a good place to start. If they are related to a fall you could see your primary care provider first or (depending on your insurance) make an appointment directly with a pelvic floor physical therapist.
A pelvic floor physical therapist is trained to examine and treat disorders of the pelvis, hips, and perineal (the part of you that hits a bicycle seat) muscles and soft tissue. Treatments for coccyx pain typically involve recommending the use of a coccyx cushion for sitting, general relaxation techniques (the more uptight we are the more we are likely to tighten or contract these muscles.), massage or other manual techniques to pelvic floor muscles to try to get them to relax, or mobilizing or moving the coccyx back into place. Coccyx or tailbone pain can get better with appropriate treatment!
Learn more about Physical Therapy at the UVM Medical Center. Pelvic floor physical therapy is offered at the the UVM Medical Center Continence Center as well as at the Orthopedic Specialty Center. To make an appointment for at the Orthopedic Specialty Center, call 802-847-7910. To make an appointment at the Continence Center, call 802-847- 4151.
Ann Greenan Naumann, PT, is a Clinical Lead Physical Therapist at the Orthopedic Specialty Center. She has specialized training in physical therapy treatment of men and women with pelvic floor dysfunction as well as 30 years of experience treating patients with low back and lumbo-pelvic disorders