The main symptom of coccydynia (tailbone pain) is pain and tenderness at the base of your spine, near the top of your buttocks. The pain can be dull and achy or sharp and piercing. The pain is typically worse:

• While sitting down

• When standing up from a seated position

• During a bowel movement

• During intercourse

• During your period (for menstruating individuals)

Depending on how badly the coccyx is affected, the pain can range from uncomfortable to unbearable, making it hard to sleep and carry out everyday activities.

Diagnosing coccydynia is often a process of ruling out other conditions that can also cause tailbone pain, including sciatica and fracture. Your doctor will review your medical history (e.g., any falls or trauma; childbirth history) and examine your area(s) of pain. Detailed imaging, such as X-ray and CT scan, may also be used to aid in diagnosis.

Coccydynia is 5X more likely to occur in women and those assigned female at birth than men.1

Who is At Risk of Coccydynia?

Trauma or falls is the most common risk factor for coccydynia. Falling can bruise, fracture or dislocate your tailbone. Other risk factors include:

• Childbirth. In some cases, a vaginal delivery can stretch the muscles and ligaments around the tailbone too much, putting strain on the tailbone.

• Being overweight, which adds extra pressure on the tailbone

• Being female

• Structural issues with the coccyx

• Degenerative joint and/or spinal disease

• Prolonged sitting

What Is The Role of The Pelvic Floor in Coccydynia?

The pelvic floor is a group of dome-shaped muscles, ligaments, and tissues located at the bottom of the pelvic bones. Our pelvic floor is vital to many aspects of our health and function, including:

• Providing support to the pelvic organs (e.g., bladder, uterus, bowels)

• Offering stability to the low back and hip joints

• Maintaining bladder and bowel continence

• Optimizing sexual sensation and arousal

The pelvic floor muscles function best when they are able to dynamically relax and contract. But sometimes, pelvic floor dysfunction can occur. Pelvic floor dysfunction is when there is abnormal tension, weakness, and/or difficulty in coordinating the activation and relaxation of the pelvic floor muscles. Over time, a weak or overly tense pelvic floor compromises the natural circulation of blood flow that allows for constant nutrient and oxygen exchange within the tissues of the pelvis. As a result, the pelvic muscles can become painful and sore and the nerves that supply these muscles can become very irritated. The pain may radiate to different areas of the pelvis, including the coccyx (tailbone).

If you have been experiencing tailbone pain that hasn’t improved in a few weeks, talk to your doctor. Effective treatments are available, including pelvic health physiotherapy.

How Can Pelvic Health Physiotherapy Help?

Pelvic Health Physiotherapy can be very beneficial for patients experiencing coccydynia, and is usually one of the first treatments used to help relieve symptoms. In fact, 90% of individuals experiencing coccydynia improve with conservative (non-surgical) management, such as Pelvic Health Physiotherapy.2

Pelvic Health Physiotherapists work with patients to optimize the mobility, flexibility, strength, and coordination of the pelvic floor muscles, as well as identify and address any lifestyle factors that may be contributing to pelvic floor dysfunction. They will tailor a treatment plan to the state of your pelvic floor – there is no “one size fits all” approach. It’s best to get an assessment so that a trained Pelvic Health Physiotherapist can identify your needs and guide you on the correct program towards recovery.

Your individualized treatment program may include one or more of the following techniques:

• Manual therapy. This involves various hands-on techniques, such as stretching, soft tissue massage, and trigger point release.

• Exercise program. This includes stretching, strengthening, proper posture and breathing techniques, which are essential for overall pelvic health.

• Education. This includes guidance on pressure-relieving sitting devices and postural considerations that may help reduce the strain on your tailbone, thereby minimizing pain. Education on pain science can also aid in healing symptoms of coccydynia.

Typically, a number of sessions are required. Your Pelvic Health Physiotherapist will customize a plan to your unique needs and goals.

How Do We Approach Treatment For Coccydynia?

At Proactive Pelvic Health Centre, we are committed to providing a safe and comfortable place where clients can access multi-disciplinary pelvic care to help improve their quality of life.

Our approach to treating any type of pelvic floor dysfunction, including coccydynia, is evidence-based, empathetic and holistic. Before pelvic floor treatment begins, your Pelvic Health Physiotherapist will take your full medical history and thoroughly discuss your current symptoms. With informed consent, your Pelvic Health Physiotherapist will perform a complete physical assessment of the joints and tissues affecting this area. Based on the assessment, a personalized treatment plan will be developed to help you both identify and manage your symptoms.

We will use a variety of proven techniques – tailored to your needs and goals – to help improve the strength of your pelvic floor to better support your tailbone and spine, as well as review your sitting and postural habits so that changes can be recommended. With treatment and dedication, you can take control of your pain and regain the ability to enjoy the activities you love.