Prof. Dr. Erkan Kaptanoğlu


Tailbone Pain - Coccydynia

The tailbone (Coccyx) is composed of 3-5 small bones jointed to the lower end of the sacrum bone at the bottom of the spine. These bones fuse together at around the age of 30.

Coccydynia is pain in the tailbone, i.e. the coccyx bone. This pain is usually caused by problems with the joint (sacrococcygeal joint) between the coccyx bone and the sacrum bone. It may cause severe discomfort while sitting or leaning on one’s back.

Risk Factors

It is more common in women and overweight individuals. It is approximately 5 times more common in women than in men. Although the reason for this is not known, it is thought that women may be exposed to trauma more easily as the sacrum bones protrude slightly more towards the rear. Another reason may be the damage inflicted on the sacrum bones of women during childbirth. Obesity is also known to cause tailbone pain. This is thought to be due to the fact that obesity changes a person’s sitting position, thus the combination of both sitting in a bad position and excess weight resulting in more pressure to be exerted on the tailbone.

How Do We Protect Our Tailbone?

There is no clear way to prevent coccyx pain and to protect the tailbone, but risk factors can be reduced. Taking some precautions while doing sports activities such as horse riding, cycling, skiing, rowing and avoiding falls especially when walking on icy or rough roads can protect your tailbone.

Causes of Coccydynia

The most common causes of coccydynia are falling and difficult exercises such as extreme cycling and rowing. In these activities, the tailbone may be crushed, broken or dislocated. This causes a painful inflammatory reaction and muscle spasms. In addition, bone growth at the lower end of the sacrum bone, diseases in joints where the bone is joined to the spine, inflammations of the joints, infections, and cancers in this area can also be the cause of coccydynia.


The patient’s medical history is very important for diagnosis. History of falling and traumas are questioned. The fact that the pain is over the tailbone is usually indicative of an easy diagnosis and the pain may increase by putting pressure on the bone during the examination. Magnetic resonance imaging (MRI) and computed tomography (CT) of the patient may reveal the condition of the coccyx, dislocations in the sacrococcygeal joint, fractures in the bones or tumoral events after the examination.

Medical Treatment

Coccydynia may become chronic and may last for more than 2 months in a very small group of patients. This way, it can severely impair the quality of life. In these conditions, it is necessary to consult a doctor and seek treatment. Many people with tailbone pain can heal with medical treatment. The steps to be taken for medical treatment are listed below.

  1. Ice pack or hot compress application: both can relieve the pain quickly but for a short period.
  2. Bagel-shaped cushions may be therapeutic as they relieve the pressure on the tailbone while sitting.
  3. Sitting for too long should be avoided.
  4. Bed rest can accelerate healing as it prevents the straining of the tailbone.
  5. Nonsteroidal anti-inflammatory drugs can help relieve the pain by reducing the inflammation in the coccyx.
  6. Injection into the sacrum bone or sacrococcygeal joint can be performed. This injection can sometimes lead to total or long-term pain relief.
Surgical Treatment

Rarely needed. Considered only if all non-surgical treatments are tried for a long time to no avail. The coccyx bone is surgically removed. It is a very short and effective operation performed under general anesthesia.

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