Coccydynia is a type of lower back pain felt around the last bone at the base of the spine (known as the coccyx or tailbone).

The pain of coccydynia can range from mild to severe and is usually worse when:

  • sitting down – particularly if you are leaning backwards
  • moving from sitting to a standing position

Some people can only tolerate sitting in the same position for a few minutes before having to move to relieve the pain.

The pain in and around your coccyx can sometimes make it very difficult to carry out everyday activities, such as driving, bending over or sitting down.

It may seem odd, but sitting on a soft surface may be more painful than sitting on something hard. This is because sitting on a soft surface places most of your weight on your coccyx rather than on the hard bones below your pelvis.

Other symptoms

As well as pain in your coccyx, other symptoms of coccydynia may include:

  • backache
  • shooting pains down your legs
  • pain before or when you pass stools
  • pain during sex
  • painful buttocks and hips
  • in women: increased pain during your period

If you have coccydynia, the pain in your coccyx can also make it difficult to sleep comfortably at night. You may need to keep changing positions while lying in bed.

What causes coccydynia?

Coccydynia can occur when something damages the coccyx or surrounding area, such as:

  • the muscles and ligaments supporting the coccyx stretching out of place during childbirth
  • trauma to the coccyx, resulting from an accident
  • pulling the coccyx out of its normal position, either through poor posture or repeated activity, such as cycling or rowing

In around a third of cases of coccydynia, no obvious cause can be found, although age-related "wear and tear" may play a part.

Read more about the causes of coccydynia.

When to seek medical advice

See your GP if you have persistent lower back pain that lasts more than a few days.

While coccydynia is not usually a serious condition it is important your GP examines you in case there is a more serious and less common cause of your symptoms, such as a fracture.

In most cases, they can diagnose coccydynia based on your symptoms and a physical examination of your lower back and spine.

In some cases your GP may refer you for further tests, such as: 

  • two X-rays (one sitting and one standing) – comparing the two images will help determine whether your coccyx is moving more than normal when you sit or stand
  • an MRI scan – to check for other conditions, such as a bone infection or bone cancer, which may be causing unexplained symptoms

X-rays can also be used to check if any of the bones that make up the coccyx have been fractured.

Treating coccydynia

Painkillers, such as ibuprofen, are the first step in trying to treat coccydynia and in most cases the pain will resolve within a few weeks.

If this fails, stronger treatment, such as steroid injections (corticosteroids) will be recommended.

In a minority of cases the pain can persist for more than three months, which is known as chronic coccydynia. Chronic coccydynia is unlikely to clear up by itself and will probably require a combination of treatments.

There are a number of things you can do yourself to help with the pain, including using specially designed cushions to support the coccyx.

Spinal manipulation techniques such as physiotherapy, osteopathy and chiropractic can also provide short-term relief from pain.

In a small number of cases surgery may be required to remove the coccyx (coccygectomy).

Read more about the treatment of coccydynia.

Who is affected

Coccydynia is uncommon. It is estimated around one in 100 cases of lower back pain are the result of coccydynia. Women are five times more likely to develop coccydynia than men due to the association with childbirth.

Older adults are more prone to coccydynia, but the condition can affect people of all ages, including children.

Back pain

Back pain is the largest cause of absence from work in the UK. Philip Sell, consultant orthopaedic and spinal surgeon, discusses the causes of and treatments for back pain.

Media last reviewed: 27/05/2015

Next review due: 27/05/2017

The coccyx

The coccyx is referred to as the "tail bone". It's located just above the cleft in the buttocks, and curves forward so that it points towards the front of the body.

The coccyx is made up of three small bones, loosely fused together. They become more flexible in pregnant women to help them give birth more easily.

Various muscles, tendons and ligaments are attached to the coccyx and it bears weight when somebody is sitting down.


Look after your back

Tips to keep your back healthy and avoid back pain, including exercises and advice on good posture

Page last reviewed: 22/07/2014

Next review due: 22/07/2016