Sometimes, people think it is funny to pull a chair out from under someone as they sit down. If this prank has ever happened to you, you know too well what tailbone pain feels like.

These compression injuries cause pressure on the coccyx or tailbone. At best, the injury is a bruise. Other times it’s a more serious fracture. Since you cannot put your tailbone in a sling, it often hurts to walk, sit, or lift for four to eight weeks after an injury.

What is the tailbone?

The coccyx, or tailbone, is a set of four vertebrae found at the very end of the spine. An inch long, the coccyx looks like a stubby, short tail. This, of course, is how it got its common name. The coccyx distributes weight evenly when we sit. It also supports the muscles, ligaments, and tendons of the pelvic area.

What causes tailbone pain?

The most common causes of coccyx pain are falls and arthritis. Impact injuries, childbirth, exercise, cycling, horseback riding, excessive sitting, bone spurs, nerve damage, or infection can also lead to tailbone pain.

Women are more prone to tailbone injuries than men. The female body structure has a wider pelvic area to accommodate childbirth. This exposes the coccyx and makes it more susceptible to injury.

When the coccyx is injured, a person may feel a dull or stabbing pain at once. The area may remain tender to the touch and cause discomfort for weeks after injury. The level of discomfort can range from an irritating throbbing sensation to intense sharp pain that limits movement. A severe coccyx injury may also cause pain during bowel movements or intercourse.

Even sitting can cause pain. A person may need to change positions often, lean forward, or use a donut pillow and avoid sitting on hard surfaces to avoid putting pressure on the tailbone.

How is a tailbone injury diagnosed?

To diagnose tailbone pain, known as coccydynia, your health care provider will talk to you about your injury, daily activities, and pain level. After gathering the facts, your provider may do a physical exam of the spine and sometimes conduct a rectal exam. Following the physical exam, the provider may order a series of X-rays or an MRI to determine the presence of a fracture or a dislocation. Some providers will order a series of X-rays to see the position of the coccyx while a person is standing and sitting, to make a sure diagnosis.

Is there a difference in treatment for a coccyx bruise or tailbone fracture?

The severity of the injury will determine the level of treatment. Most coccyx injuries are treated at home with rest and pain management. The health care provider may tell the patient to:

  • Alternate ice and rest every 20 minutes for the first few hours after the injury to help reduce the swelling.
  • Take over-the-counter pain relievers, like aspirin, ibuprofen, or acetaminophen, as needed.
  • Use a donut cushion to make sitting more tolerable.
  • Eat high-fiber foods or use a stool softener to ensure bowel movements do not strain and stress the coccyx.
  • Wear loose clothing.
  • Take hot baths to relieve muscle tightness after the swelling subsides.
  • Practice gentle stretching exercises.
  • Avoid lifting and unnecessary bending.

More severe tailbone injuries may need medical intervention, such as:

  • Stronger medications to manage pain.
  • A prescribed laxative to soften bowel movements.
  • Nerve blocks or numbing medications.
  • Steroid injections.
  • Massage therapy.
  • TENS (Transcutaneous electrical nerve stimulation).
  • Partial or total coccyx removal (coccygectomy).

If your coccyx is dislocated, realignment by an orthopedic provider may be the only way to reduce pain.

How long does it take to recover from a tailbone injury?

Tailbone bruises usually heal in two to four weeks. But a fracture may take eight weeks or more to feel better.

Gentle movements, such as walking, can increase circulation and decrease the pressure on the tailbone. Follow the guidance of your medical provider, moving too much too soon can delay recovery. You may also need to change your sleeping patterns and sleep on your side to ease the pain during the night.

How do you prevent tailbone injuries?

There are a few precautions and preventative steps a person can take in their daily lives to avoid tailbone injuries.

  • Increase core strength and balance through physical exercise or physical therapy.
  • Remove tripping hazards in the home, in the yard, or at the office.
  • Avoid walking on wet or slippery surfaces.
  • Wear shoes with non-slip tread.
  • Avoid cycling or sitting for extended periods of time.
  • Take care when walking across a wet parking lot. The painted lines are often very slippery.
  • Never, ever pull a chair out from underneath someone. It’s not funny and can cause severe injury.

Whether you or a loved one experience a tailbone injury, it can disrupt your life.

If you fall or feel pain in the tailbone, contact one of Bone & Joint and make an appointment with an orthopedic provider. These specialized health care providers can diagnose your pain and prescribe the best treatment plan to help you feel better faster.