Coccydynia: Tailbone Pain, Treatment and When to See a Physio

Tailbone pain can make sitting, driving, working and even getting up from a chair surprisingly difficult. The medical name is coccydynia: pain and tenderness around the coccyx, the small bone at the very bottom of the spine. It often settles with sensible self-care, but persistent or severe symptoms deserve a proper assessment.

What does coccydynia feel like?

The main symptom is pain or tenderness at the base of the spine, just above the buttocks. It may be a dull ache with occasional sharper pain. It is commonly worse:

• while sitting, particularly on a firm surface;
• when moving from sitting to standing;
• when bending forwards;
• during a bowel movement; or
• after a long drive, cycle ride or period at a desk.

Some people also find that sleep, work, exercise or sex becomes uncomfortable. Tailbone pain is not the same as ordinary lower back pain, although the two can overlap. If your pain is higher in the back, our guide to relieving lower back pain may be more relevant.

What causes tailbone pain?

Common triggers include a fall onto the bottom, pregnancy or childbirth, prolonged sitting, repeated pressure from activities such as cycling, and changes in how the coccyx joint moves. Body weight at either end of the range can alter pressure around the coccyx, and sometimes there is no obvious cause.

A physiotherapy assessment considers how the symptoms started, exactly where the pain is felt, what aggravates it, and whether the hips, lower back, pelvic floor or surrounding muscles are contributing. Imaging is not automatically required for every case; a clinician can advise if the history or examination suggests that further investigation is appropriate.

How to ease coccyx pain at home

1. Reduce pressure without becoming completely inactive

A coccyx cushion with a cut-out at the back can make sitting more comfortable. Support your lower back, keep your feet resting on the floor and change position regularly. Avoid long, unbroken periods of sitting, but continue comfortable walking and everyday movement rather than staying in bed.

2. Try heat or wrapped ice

The NHS suggests a wrapped ice pack for 20 to 30 minutes; some people prefer a heat pack. Protect the skin and stop if it becomes painful or numb. If you have reduced sensation, poor circulation or another condition affecting skin safety, ask a health professional before using heat or ice.

3. Make bowel movements easier

Straining can increase coccyx pain. Fluids, fibre and regular movement may help. If constipation is a problem, ask a pharmacist or GP whether a stool-softening laxative is suitable for you.

4. Use pain relief safely

Anti-inflammatory medicines such as ibuprofen can help some people, but they are not suitable for everyone. Check the label and ask a pharmacist or GP if you are pregnant, have asthma, stomach ulcers, kidney or heart problems, take blood-thinning medicine, or are unsure what is safe for you.

How can physiotherapy help coccydynia?

Physiotherapy is not a one-size-fits-all list of exercises. Depending on the assessment, treatment may include advice about sitting and activity, graded movement, exercises for the hips and trunk, and work on muscles around the pelvis and coccyx. Pelvic-floor input may be appropriate, particularly when symptoms relate to pregnancy, childbirth, bowel movements or pelvic tension.

The aim is to reduce irritation, restore confidence in movement and build tolerance for sitting and daily activity. A virtual appointment can still be useful for history-taking, movement assessment and a tailored self-management plan; read more about rehabilitation from home with virtual physiotherapy.

How long does tailbone pain take to recover?

Many cases improve over a few weeks, but recovery can take longer—sometimes several months—especially after a significant injury or when symptoms have already become persistent. Progress is rarely perfectly linear: a longer journey, a hard chair or a sudden increase in activity can cause a temporary flare-up without necessarily meaning that damage has worsened.

A useful recovery plan gradually increases sitting and activity tolerance while keeping symptoms manageable. If there is no clear improvement after a few weeks, or pain continues to restrict normal life, seek clinical advice rather than repeatedly pushing through it.

When should you see a GP or seek urgent help?

Arrange a GP assessment if tailbone pain has not improved after a few weeks of self-care, is severe or worsening, or is affecting daily activities. Also contact a GP if you have a high temperature, pain elsewhere such as the abdomen or higher back, unexplained weight loss, night pain, or bleeding from the bottom.

Seek urgent medical help after a major injury, or if you develop new numbness around the genitals or back passage, increasing leg weakness, difficulty passing urine, or loss of bladder or bowel control. These are not typical features of straightforward coccydynia and need prompt assessment.

What happens if simple treatment does not work?

Persistent pain does not automatically mean surgery. A GP or specialist may reconsider the diagnosis and discuss further options. The NHS lists physiotherapy and, where appropriate, corticosteroid with local anaesthetic injections among treatments that may be considered before surgery. An operation to remove part or all of the coccyx is reserved for selected cases when other approaches have not helped.

Trusted guidance

This article is based on current NHS guidance on tailbone (coccyx) pain, last reviewed 20 November 2025. It is general information and does not replace an individual diagnosis or urgent medical care.