Coccydynia

Find out about the main treatments for coccydynia (tailbone pain), including things you can try at home, painkillers, physiotherapy and painkilling injections.

There are a number of treatments that can help reduce the pain of coccydynia. Simple measures you can try at home are usually recommended first.

Coccydynia often improves over a few weeks or months. If it continues despite simple treatments, your GP may refer you to a specialist to discuss other options.

This page covers:

Self-care measures

Painkillers

Physiotherapy

Injections

Surgery

Self-care measures

The following advice may help reduce pain and allow you to get on with your everyday activities.

  • Use a specially-designed coccyx cushion – these can be bought online and from some shops; they help reduce the pressure on your tailbone while you're sitting down.
  • Avoid prolonged sitting whenever possible – try to stand up and walk around regularly; leaning forward while seated may also help.
  • Wear loose-fitting clothes – avoid clothing such as tight jeans or trousers that may put pressure on your tailbone.
  • Apply warm and cold packs to your tailbone – warm packs include hot water bottles and microwaveable heating pads; cold packs are available as freezable gel-filled pads from pharmacies, or you can use a bag of frozen peas wrapped in a towel.
  • Try laxatives (medicines to treat constipation) if the pain is worse when you open your bowels – many laxatives are available to buy from pharmacies and supermarkets without a prescription.
  • Take over-the-counter painkillers (see below).

Painkillers

Anti-inflammatory painkillers (NSAIDs)

If your pain and discomfort isn't too severe, it may be relieved with over-the-counter painkillers.

A type of painkiller known as a non-steroidal anti-inflammatory drug (NSAID) is often recommended. Ibuprofen is a type of NSAID available over-the-counter without a prescription.

NSAIDs can help ease pain and reduce inflammation (swelling) around your coccyx.

However, some people can't take NSAIDs because they're allergic to them or have an increased risk of developing stomach ulcers. If this is the case, try taking paracetamol instead. Ibuprofen gel that you rub into your skin may also be an option.

Ask a pharmacist or GP for advice if you're unsure what to take.

Other painkillers

If the pain is more severe, a stronger painkiller such as tramadol may be required. Tramadol can cause side effects, such as constipation, headaches and dizziness.

It's usually prescribed for a short time as it can be addictive. If it's prescribed for longer, the dose will have to be reduced gradually before being stopped to avoid withdrawal symptoms.

Physiotherapy

If your pain hasn't started to improve after a few weeks, your GP may be able to refer you to a physiotherapist.

A physiotherapist can:

  • give you advice about posture and movement to help reduce your pain
  • teach you some simple exercises to help relax the muscles around your tailbone
  • try techniques such as massage and stretches

Read more about physiotherapy.

Injections

If your coccydynia doesn't respond to painkillers, your doctor may recommend injecting medication into your lower back.

Several different types of injections can be tried.

Steroid injections

Injections of corticosteroids into the area around the tailbone can reduce inflammation and pain. Sometimes, they're combined with local anaesthetic (numbing medication) to make them even more effective.

The injections can help relieve the symptoms of coccydynia, although the effects may only last for a few weeks.

They can't cure your condition and too many injections can damage your tailbone and lower back, so you may only be able to have this type of treatment once or twice a year.

Nerve blocks

Injecting local anaesthetic into the nerves that supply the coccyx can help reduce the pain signals coming from them.

As with steroid injections, the effect may only last a few weeks or months.

But unlike steroid injections, it's usually safe to have repeated injections of local anaesthetic.

Surgery

Surgery for coccydynia is usually only recommended when all other treatments have failed.

It may involve removing some of your tailbone (partial coccygectomy) or occasionally all of it (total coccygectomy).

A coccygectomy is carried out under general anaesthetic (where you're asleep).

After surgery, most people find their symptoms improve considerably, although it can take several months. Some people will continue to experience pain.

It takes a long time to recover from coccygectomy, anywhere from a few months to a year.

Anaesthetic
Anaesthetic is a drug used to either numb a part of the body (local), or to put a patient to sleep (general) during surgery.
Anti-inflammatory
Anti-inflammatory medicines reduce swelling and inflammation.
Corticosteroid
Corticosteroid is a naturally occurring hormone produced by the adrenal gland, or a synthetic hormone having similar properties. It is used to reduce inflammation, so reducing swelling and pain.
Incision
An incision is a cut made in the body with a surgical instrument during an operation.
Inflammation
Inflammation is the body's response to infection, irritation or injury, which causes redness, swelling, pain and sometimes a feeling of heat in the affected area.
Pain
Pain is an unpleasant physical or emotional feeling that your body produces as a warning sign that it has been damaged.
Spine
The spine supports the skeleton, and surrounds and protects the delicate spinal cord and nerves. It is made up of 33 bones called the vertebrae.
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