Tailbone Pain (Coccydynia): Symptoms, Causes & PT Treatment
Updated October 20261 minute read
Coccydynia is pain at the tailbone (coccyx), typically worse when sitting, leaning back while seated, or rising from a chair. It often follows a fall onto the tailbone, childbirth, or prolonged sitting, though sometimes there's no clear cause. It's not usually serious and responds well to cushioning, posture changes, and physical therapy — including pelvic floor work, since those muscles attach near the tailbone. Persistent pain after a fall should be evaluated to rule out a fracture.
What is coccydynia?
Coccydynia is pain in and around the coccyx (tailbone) at the very base of the spine. The nearby pelvic floor muscles often play a role.
Symptoms
Common features are localized tailbone pain, worse with sitting (especially on hard or soft sinking surfaces), leaning back when seated, and standing up from sitting; sometimes pain with bowel movements.
What causes it / risk factors
A fall onto the tailbone, childbirth, prolonged sitting, and pelvic floor muscle tension contribute; sometimes there's no clear trigger.
How it's diagnosed
Diagnosis is clinical from the location and sitting-related pattern; imaging is used after significant trauma or for persistent cases.
Physical therapy treatment
What a PT does. Your therapist addresses sitting posture and cushioning, relaxes and balances the pelvic floor and surrounding muscles, and restores comfortable movement. Exercises & progression (overview). Cushioning and posture changes, pelvic floor relaxation/coordination, and surrounding muscle work. Recovery timeline. Many cases improve over several weeks to a few months.
Treatment options compared
Cushioning, posture, and PT are first-line. Injections are used for stubborn cases; surgery is rare.
Red flags
Seek care for tailbone pain after a significant fall (possible fracture), with fever, or with bowel or neurological changes.
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Frequently asked questions
Sitting loads the coccyx and nearby muscles, which are irritated.
Sources (6)
- Lirette LS, et al. Coccydynia: an overview of the anatomy, etiology, and treatment of coccyx pain. Ochsner J. 2014. — PubMed
- MedlinePlus: Tailbone trauma. — NIH/MedlinePlus
- Blanco-Diaz M, et al. Physiotherapy approaches for coccydynia: evaluating effectiveness and clinical outcomes. BMC Musculoskelet Disord. 2025. — BMC Musculoskelet Disord
- Charrière S, et al. Conservative treatment for chronic coccydynia: a 36-month prospective observational study of 115 patients. Eur Spine J. 2021. — Eur Spine J
- Sidiq M, et al. Effectiveness of physical therapy interventions for coccydynia: a systematic review with a narrative synthesis. Arch Physiother. 2025. — Arch Physiother
- MedlinePlus: Back Pain. — MedlinePlus
This article is for education only and isn't medical advice. Always talk to a licensed clinician about your specific situation.