The tailbone is a common name for the last four vertebrae of the spine that are fused together. Like the appendix, it is vestigial, meaning you really don't need it in order to function normally. The tailbone is also called the caudal vertebrae or the coccyx, and tailbone pain is also called coccydynia or coccygodynia. The tailbone is also somewhat difficult to feel from the surface because it is located at the very base of the spine beneath the buttocks. Pain in this region can be caused by an injury to the tailbone itself, to the muscles and ligaments that surround it, or both.

Common characteristics of tailbone pain

If you're experiencing tailbone pain, you may describe it as:

Deep, aching pain in the center of the low back: It will likely be just above the rectum/anus.
Variable: The discomfort can vary widely in intensity, ranging from minimal to severe, immobilizing pain.

Common accompanying symptoms

Tailbone pain can be difficult to treat and often becomes chronic. Therefore, tailbone may be accompanied by depression, isolation, and anxiety.

Who is most often affected by tailbone pain symptoms?

Women are more likely to incur damage to the ligaments surrounding the coccyx during childbirth. Even if you haven't given birth, the female pelvis leaves the tailbone more prone to injury.

Are tailbone pain symptoms serious?

The severity of tailbone pain is ultimately dependent on the cause.

Not serious: A bruise to the tailbone or a strain of the surrounding muscles and ligaments is not serious and will likely heal with conservative treatment.
Moderately serious: Other causes, such as a fracture, will not get better solely with rest. You should see a physician as soon as possible if you experienced a significant injury.
Serious: In rare cases, tailbone pain can be caused by tumors or deep infection.

Tailbone pain causes

Many conditions can have tailbone pain as a symptom. The most common are those that damage or inflame the coccyx or its surrounding tissues.

Most common causes

Trauma is the most common cause of tailbone pain.

Falls: Especially if you drop to the ground and land on your lower back or while in a seated position
Other trauma: Such as a hard hit during an automobile accident or while playing sports

Less common causes

The following are less common causes of tailbone pain.

Childbirth
Obesity
Repetitive strain injury: This may occur from activities such as competitive rowing or cycling.
Poor posture while sitting: This can throw the spine out of alignment and place too much pressure on and around the tailbone.
Wear-and-tear: A loss of the natural cushioning material within the spine's discs often occurs due to aging.

Rare and unusual causes

The following causes are considered unusual in terms of tailbone pain.

An abscess or infection: This may affect the soft tissues surrounding the tailbone.
Tumor: This may irritate the tailbone itself or nearby structures and cause pain.

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5 tailbone pain conditions

The list below shows results from the use of our quiz by Buoy users who experienced tailbone pain. This list does not constitute medical advice and may not accurately represent what you have.

Piriformis syndrome

The two piriformis muscles, left and right, each run from the base of the pelvis to the top of the thighbone. The two sciatic nerves, left and right, are each attached to the spine and run down between the pelvic bone and the piriformis muscle to the back of each leg.

If the piriformis muscle is damaged through sudden trauma, or through overuse as in sports, the resulting inflammation or spasm of the muscle can trap the sciatic nerve between the pelvic bone and the muscle.

Piriformis syndrome is most often found in women over 30.

Symptoms include pain over one or both sides of the low back, and shooting pain (sciatica) down one or both legs.

Diagnosis is made through physical examination and sometimes imaging such as CT scan or MRI.

Treatment involves rest; over-the-counter, nonsteroidal anti-inflammatory drugs; physical therapy; therapeutic injections; and, rarely, surgery.

The best prevention is a good regimen of stretching before exercise, to help prevent damage to the piriformis.

Rarity: Common

Top Symptoms: pelvis pain, butt pain, pain when passing stools, leg numbness, hip pain

Symptoms that never occur with piriformis syndrome: involuntary defecation, leaking urine

Urgency: Primary care doctor

Tailbone bruise

A bruise is the damage of the blood vessels that return blood to the heart (the capillaries and veins), which causes pooling of the blood. This explains the blue/purple color of most bruises. Bruises of the tailbone are common, given the location on the body.

You can treat this at home with rest (exercise as tolerated) and ice (10-20 minutes at a time).

Rarity: Rare

Top Symptoms: constant butt pain, tailbone pain, tailbone pain from an injury, tailbone injury, butt bruise

Symptoms that always occur with tailbone bruise: tailbone pain from an injury, tailbone injury, constant butt pain

Urgency: Self-treatment

Spinal stenosis

The spine, or backbone, protects the spinal cord and allows people to stand and bend. Spinal stenosis causes narrowing in the spine. The narrowing puts pressure on nerves and the spinal cord and can cause pain.

Next steps including visiting a primary care physician. For this condition, a physician might suggest further investigation including imaging of the spine. Treatments may include medications, physical therapy, or braces. For severe cases, surgery is sometimes recommended.

Rarity: Common

Top Symptoms: lower back pain, back pain that shoots down the leg, back pain that shoots to the butt, difficulty walking, thigh pain

Urgency: Primary care doctor

Mechanical low back pain without sciatica

About 80 percent of people will experience mechanical back pain. Mechanical means that the pain comes from the spine or its supporting structures. Sometimes, people experience sciatica with their low back pain. Sciatica is a general term to describe pain that travels from the back into the leg. Most of the time, it is unclear to doctors what exactly causes the episode of low back pain. However, it is most often due to a muscle strain, or an injured tendon or ligament. A slipped or herniated disc is also a possible cause. Fortunately, in any of these cases, initial treatment is the same. Pain usually goes away within 4-6 weeks, often sooner.

Hemorrhoids

Hemorrhoids, or "piles," are swollen veins in the anus or rectum. They may be located inside the rectum (internal) or outside the body at the anus (external.)

The condition is caused by straining during bowel movements and/or from increased pressure during pregnancy and childbirth.

Hemorrhoids are a common occurrence, especially in older people. Pregnant women are susceptible, as is anyone who has chronic constipation or is obese.

Symptoms include discomfort, pain, pressure, and itching. There may be small amounts of bleeding during bowel movements, though some hemorrhoids cause no symptoms at all.

Severe pain can indicate a thrombosed hemorrhoid, meaning a clot has formed within it. This is not serious but the pain can be debilitating and requires treatment right away. Also, rectal bleeding can also be a sign of more serious diseases such as diverticulitis or cancer and should always be diagnosed by a medical provider.

Diagnosis is made through physical examination and sometimes through colonoscopy.

Treatment begins with good hygiene, cold compresses, and over-the-counter pain relievers. Surgery may be done for some cases.

Fibromyalgia

Fibromyalgia is a set of chronic symptoms that include ongoing fatigue, diffuse tenderness to touch, musculoskeletal pain, and usually some degree of depression.

The cause is not known. When fibromyalgia appears, it is usually after a stressful physical or emotional event such as an automobile accident or a divorce. It may include a genetic component where the person experiences normal sensation as pain.

Almost 90% of fibromyalgia sufferers are women. Anyone with rheumatic disease, such as rheumatoid arthritis or lupus, may be more prone to fibromyalgia.

Poor sleep is often a symptom, along with foggy thinking, headaches, painful menstrual periods, and increased sensitivity to heat, cold, bright lights, and loud noises.

There is no standard test for fibromyalgia. The diagnosis is usually made when the above symptoms go on for three months or more with no apparent cause.

Fibromyalgia does not go away on its own but does not get worse, either.

Treatment involves easing symptoms and improving the patient's quality of life through pain medications, exercise, improved diet, and help with managing stressful situations.

Rarity: Common

Top Symptoms: fatigue, arthralgias or myalgias, anxiety, depressed mood, headache

Symptoms that always occur with fibromyalgia: arthralgias or myalgias

Urgency: Primary care doctor

Colonic neoplasm

Colonic neoplasm means "new tissue" growing in the colon, or large intestine. This neoplasm may be either benign (not cancerous) or malignant (cancer.)

The exact cause of any cancer remains unknown. Risk factors seem to be:

Being over fifty years of age.
Family history of the disease.
A high-fat, low-fiber diet, typical in the modern world
Chronic inflammatory diseases of the colon such as Crohn's disease.
Smoking and alcohol use.
Diabetes, obesity, and inactivity.

The earliest symptoms are usually polyps, small growths within the colon which can be detected on colonoscopy and removed before they can become cancerous. Later symptoms may be unexplained fatigue; change in bowel habits; persistent abdominal discomfort such as gas or cramps; blood in stool; or rectal bleeding.

Diagnosis is made through colonoscopy and sometimes blood testing.

Treatment is done through surgery, which may be minor or extensive; and through chemotherapy with radiation therapy, usually done before and after surgery. Supportive care to keep the patient comfortable is also an important part of treatment.

Coccydynia

The tailbone, called the coccyx, is the lowest part of the spine. Coccydynia is pain around the area of the tailbone, which is triggered by activities that cause pressure on the tailbone such as sitting on a hard chair. Symptoms get better with standing or walking. Doctors are not completely sure what causes this pain.

You can safely treat this condition on your own. This condition has no directed treatment, so you are advised to take over-the-counter pain medication and take pressure off the tailbone by sitting on a soft cushion whenever possible.

Rarity: Uncommon

Top Symptoms: back pain, lower back pain, painful sex, back pain that shoots to the butt, constant butt pain

Symptoms that always occur with coccydynia: constant butt pain

Symptoms that never occur with coccydynia: warm and red tailbone swelling

Urgency: Self-treatment

Tailbone pain treatments and relief

When it is an emergency

Seek immediate tailbone pain treatment in the emergency room if you experience numbness in your legs, especially if you find that you cannot move them normally or you also lose control of your bowel movements (incontinence).

When to see a doctor

You should see a physician to address the following.

Ongoing tailbone pain symptoms: Imaging can be done and a definite diagnosis can be made.
Corticosteroid injections for pain management
Referral to a chiropractor
Referral to a physical therapist: The therapist can prescribe exercises to properly stretch the muscles and ligaments surrounding the tailbone, as well as offer treatments with heat, ultrasound, and therapeutic massage.

At-home treatments

You can try the following tailbone remedies at home.

Use special cushions: There are some available that take the pressure off of the tailbone while you're sitting.
Avoid prolonged sitting: Stand up and walk around frequently.
Alternate warm and cold packs
Pain medication: Try over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) or naproxen (Aleve). Acetaminophen (Tylenol) may also help, as well as topical pain-relievers also available over-the-counter.

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FAQs about tailbone pain

Here are some frequently asked questions about tailbone pain.

Do hemorrhoids lead to tailbone pain?

No, hemorrhoids do not lead to tailbone pain. Hemorrhoids are engorged veins in your lower rectum or anus [9]. Hemorrhoids can be located inside the rectum but are typically not painful. Alternatively, hemorrhoids can extend beyond the anus, and these hemorrhoids can cause pain with defecation.

Why does my tailbone hurt when I sit?

Tailbone pain, or coccydynia, is most often caused by falling on or incurring trauma to the tailbone [2-4]. It can also be caused by childbirth. More rarely, it may be caused by a tumor or infection in the tailbone. Tailbone pain is often worse when sitting due to the increased pressure. This is particularly true of women due to their broader pelvis.

Can menstruation cause tailbone pain?

No, menstruation does not cause tailbone pain. Tailbone pain is most often caused by trauma to the tailbone. Less commonly, it can be caused by a tumor or infection of the tailbone. Some women experience tailbone pain during and following childbirth.

Is my tailbone bruised or broken?

The tailbone, or coccyx, is located at the very bottom of the spine and is made up of three to five vertebrae [1]. If you recently received trauma to the area and are now experiencing localized tailbone pain that worsens with sitting, it is possible that this fused bone has broken. If so, you should visit your physician for treatment.

Questions your doctor may ask about tailbone pain

Do your symptoms worsen when sitting?
Have you had any changes in your weight?
Are you sexually active?
Do your symptoms improve with activity (moving around and such)?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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The stories shared below are not written by Buoy employees. Buoy does not endorse any of the information in these stories. Whenever you have questions or concerns about a medical condition, you should always contact your doctor or a healthcare provider.

Jeffrey M. Rothschild, MD, MPH.

Associate Professor of Medicine, Brigham and Women’s Hospital

Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...

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