If you feel a deep, sore pain right at the bottom of your back every time you sit or stand up, it can be worrying and exhausting. You might even start to doubt yourself or feel you’re being “oversensitive”.
That kind of pain is often coccydynia or tailbone pain. It’s common, it can be very uncomfortable, and it can absolutely affect your quality of life.
At RAD Clinics, we regularly see people who have lived with tailbone pain for months, sometimes years, because they didn’t realise anything could be done. The reassuring news is that coccydynia is usually manageable, and in many cases, we can significantly reduce your pain and help you sit, drive and sleep more comfortably again.
What is Coccydynia?
Coccydynia simply means pain in and around the coccyx, which is a small triangular “tailbone” at the very bottom of your spine.
You might notice:
- A dull ache when you sit
- A sharp twinge when you stand up
- A bruised feeling if you press on the area
The pain is usually:
- Worse when you sit, especially on a hard or low chair
- Triggered when you lean back or bend forward
- Easier when you stand, walk or lie on your side
On its own, coccydynia is not dangerous. But if it drags on, it can become chronic tailbone pain, which can affect your mood, sleep, work and social life. That is when getting a clear diagnosis and treatment plan starts to make a real difference.
What Causes Coccydynia?
Coccydynia happens when the coccyx or the tissues around it become irritated, inflamed or injured. Sometimes there is a clear event, such as a fall. Other times, it builds up gradually with no obvious single cause.
Common causes of coccydynia
A fall or direct injury
Slipping on stairs, falling on ice or landing heavily on your bottom can bruise, dislocate or occasionally fracture the coccyx. Pain may start straight away or over the next few days.
Prolonged sitting
Long periods on hard chairs, car seats or bike saddles can put constant pressure on the tailbone and surrounding ligaments. Drivers, cyclists and desk-based workers often notice this.
Pregnancy and childbirth
During childbirth, the coccyx can be pushed, and the ligaments stretched. Some women are left with tailbone pain in the weeks or months after delivery.
Degenerative changes (wear and tear)
As we age, small joints around the coccyx can develop osteoarthritis, becoming stiff and painful.
Infections or tumours (rare)
Infections in the bone or nearby tissues, or rare tumours in the region, can cause tailbone pain. These are uncommon but important to rule out if there are “red flag” symptoms such as fever, severe night pain or unexplained weight loss.
Postural problems
Slumping or leaning back heavily when sitting can overload the coccyx instead of spreading your weight through the pelvis.
Other potential causes
- Being overweight or underweight puts extra pressure on the coccyx, and loss of the normal fatty cushion around it can trigger pain.
- Repetitive activities such as cycling, rowing or horse riding, which can cause repeated micro-trauma to the area.
Sometimes, no clear cause is found. This is called idiopathic coccydynia. The pain is still real, and it can still be treated.
What are Coccydynia Symptoms?
Pain characteristics
People with coccydynia often describe:
- Pain right at the base of the spine, just above the buttocks
- A dull ache with occasional sharp, stabbing pains
- Pain made worse by sitting, especially on hard surfaces
- Pain when sitting down, standing up, or leaning backwards
Common symptoms
You may also notice:
- Tenderness if you press over the tailbone
- Difficulty sitting through meetings, driving or long journeys
- Pain during or after a bowel movement
- Pain that sometimes spreads into the lower back, buttocks or hips
Pain that sometimes spreads into the lower back, buttocks, or hips. This pain can sometimes resemble piriformis syndrome or sciatica, conditions that involve pain radiating from the spine to the legs. If you’re experiencing similar symptoms, it may be helpful to explore the differences between these conditions. For more information, check out our detailed article on Piriformis Syndrome vs Sciatica
Impact on daily life
Over time, tailbone pain can:
- Make you avoid sitting whenever possible
- Disturb your sleep because you cannot get comfortable
- Reduce your activity levels and exercise
- Affect your mood, energy and concentration
If this sounds familiar, it is worth speaking to your GP or arranging a specialist assessment at RAD Clinics rather than trying to cope alone.
How to Relieve Coccydynia?
Self-care measures for coccydynia relief
Simple changes can take some pressure off your tailbone:
Use a coccyx cushion or wedge pillow
- These have a cut-out at the back to keep weight off the coccyx when you sit.
Apply ice or heat
- Ice packs for the first few days after a fall or injury
- Gentle heat (warm pack or bath) later on to relax tight muscles
Avoid sitting for long periods
- Try to stand, stretch or walk for a couple of minutes every 20–30 minutes.
At-home exercises
Completely resting often makes pain worse. Gentle movement helps:
- Simple stretches for the lower back and hips
- Pelvic floor exercises to support the pelvic area
- Short walks, if comfortable, to keep everything moving
A physiotherapist can show you which exercises are safe and helpful for your situation.
Lifestyle modifications
- Aim for a healthy weight to reduce pressure on the coccyx
- Choose a firm, supportive chair instead of sinking into very soft sofas
- Consider a part-time standing desk if your job involves long periods of sitting
If you have tried these steps for several weeks and your tailbone pain is not improving, it is sensible to ask about further coccydynia treatment options.
Coccydynia Treatment Options
Conservative treatment options
Most people start with conservative (non-surgical) treatment, and many improve without needing surgery.
Pain relief medications
Your GP or pharmacist may suggest:
- Anti-inflammatory medicines such as ibuprofen
- Paracetamol, if suitable for you
Always follow the instructions and check if you have other health conditions or take regular medicines.
Physiotherapy
Physiotherapy can be very helpful in coccydynia:
- Hands-on techniques to ease tight muscles around the lower back and pelvis
- Posture advice to reduce pressure on the tailbone
- Exercise programmes to strengthen supporting muscles
Manual techniques
In some cases, specialist physiotherapists or pain doctors may use gentle manipulation around the coccyx joints, either externally or (in selected cases) internally. This is always discussed carefully in advance.
When conservative measures aren’t enough
If cushions, exercises, pain relief and physiotherapy have not been enough, your GP may refer you for more targeted treatment, such as injection therapy at RAD Clinics. This is often the next step before considering any surgical options.
Coccydynia Injection: A Solution for Persistent Pain
A coccydynia injection usually involves:
- A local anaesthetic to numb the area
- A corticosteroid (steroid) to reduce inflammation around the coccyx joints and soft tissues
At RAD Clinics, these injections are carried out under ultrasound guidance. Ultrasound lets the doctor see the coccyx and the surrounding tissues in real time and guide the needle to exactly the right spot.
Benefits of coccydynia injection
Studies suggest that steroid injections for coccydynia can:
- Provide short to medium-term pain relief for many patients
- Reduce inflammation and swelling around the tailbone
- Make it easier to sit, travel, work and sleep
- Create a “window” where physiotherapy and exercises are more comfortable and effective
Some people do well with a single injection; others may need a short series depending on how they respond.
When to consider coccydynia injections
You might consider a coccydynia injection if:
- Tailbone pain has lasted for several weeks or months
- Self-care, medicines and physiotherapy have not helped enough
- Pain is starting to affect your work, caring responsibilities, hobbies or sleep
At RAD Clinics, your doctor will take a detailed history, examine your back and pelvis, and may arrange imaging before deciding whether a coccydynia injection is appropriate for you.
Treatment of Coccydynia: When to Seek Help
It can be hard to know when to ask for help. You should speak to a doctor or consider a referral to RAD Clinics if:
- Tailbone pain has not improved after a few weeks of self-care
- The pain is severe, getting worse, or disturbing your sleep
- You struggle to sit through a normal day at work, drive, or sit at the table
- You developed pain after a significant fall or injury
- You notice fever, redness, warmth or feeling generally unwell
- You have unexplained weight loss, night pain, or new weakness/numbness in the legs or around the anus
A proper assessment can rule out serious causes, confirm whether you have coccydynia, and guide you towards the most suitable treatment, from self-management to ultrasound-guided injections at RAD Clinics.
Conclusion
Tailbone pain can be surprisingly draining. It affects how long you can sit, how you travel, how you work and how you relax with family and friends.
The key point is: coccydynia is real, common and often treatable. You do not have to simply “get on with it”.
From cushions and simple exercises, through to physiotherapy and coccydynia injections under ultrasound guidance at RAD Clinics, there are several ways to ease the pain and get you back to sitting and moving more comfortably.
If your symptoms are not improving or you are worried about what is causing your tailbone pain, consider speaking to your GP or booking an appointment with RAD Clinics. We will talk things through in simple terms, explain your options, and help you find a treatment plan that works for you.
Common Questions About Coccydynia
What happens if coccydynia is left untreated?
Some people improve gradually. Others are left with ongoing pain that interferes with sitting, work, driving and sleep, and can affect mental wellbeing. Getting assessed early can reduce the risk of long-term problems.
What can be mistaken for coccydynia?
Other causes of pain in a similar area include lower back (lumbar) problems, sacroiliac joint pain, pelvic floor dysfunction, and certain anal or rectal conditions. A careful clinical assessment helps to sort these out.
What doctor do you see for coccydynia?
You can start with your GP. They may refer you to:
- A musculoskeletal or pain clinic
- A physiotherapist
- An orthopaedic or spinal specialist
RAD Clinics works closely with referrers to provide ultrasound-guided diagnostic and injection treatments for tailbone pain.
Is coccydynia a form of arthritis?
Coccydynia itself is a symptom, i.e tailbone pain, not a diagnosis of arthritis. In some people, the pain is caused by arthritis or degeneration in the joints of the coccyx; in others, it is due to trauma, childbirth, posture, or other factors.
References
- NHS. Tailbone (coccyx) pain – symptoms, causes, self-care and when to see a GP.
- Mabrouk A, et al. Coccyx Pain (Coccydynia). StatPearls. Updated 2023–2024.
- Finsen V, et al. Corticosteroid injection for coccydynia: a review of 241 patients. Bone Joint J. 2020.
- Ahmed T. Efficacy of local steroid injection in treating coccydynia. Advanced Spine Journal. 2020.
