What is tailbone pain?
Tailbone pain is any discomfort in the region of the very lowest level of the spine, including pain between the buttocks and pain throughout the genital area. The tailbone is a bony spike at the bottom of the sacrum, which is a shield-shaped group of fused bones that connects the spinal column to the pelvis. Medically speaking, the tailbone is called the coccyx, and tailbone pain is called coccydynia or coccygodynia.
Tailbone pain usually is not a symptom of a serious disease, disorder or condition. Rarely, it can be a symptom of a tumor. Tailbone pain can result from trauma (an injury to the coccyx), vaginal childbirth, arthritis, and sitting for long periods of time—especially on a hard surface.
Depending on the cause, tailbone pain can occur suddenly, develop gradually, or come and go over a long period of time. Tailbone pain might only happen in certain circumstances, such as when you rise from a chair, or it can feel like a constant dull ache.
Tailbone pain often clears up on its own, but you should seek prompt medical care if you experience tailbone pain along with loss of feeling or movement in the legs or feet, difficulty urinating or having a bowel movement, painful sexual intercourse, or trouble achieving or maintaining an erection.
What other symptoms might occur with tailbone pain?
Tailbone pain might be accompanied by other symptoms, depending on the underlying cause.
You may experience acute tailbone pain specific to the coccyx (such as due to a fracture), or you might have symptoms that derive from other body systems. For example, degenerative spinal disease like arthritis may compress the nerve roots and cause loss of sensation in the body parts served by those particular nerves.
Nerve-related symptoms that may occur along with tailbone pain
Tailbone pain symptoms may be caused by conditions that compress or injure the spinal nerve roots that exit from the sacrum. Damage to these nerves can cause symptoms that include:
- Bladder incontinence
- Bowel incontinence or difficulty emptying the bowel
- Loss of feeling, control or movement in one or both legs or feet
- Loss of sensation in the perineum (the area of skin between the anus and the vagina or scrotum)
- Sexual dysfunction
Other symptoms that may occur along with tailbone pain
Tailbone pain may be accompanied by symptoms not related to nerve compression or damage. For example, pilonidal cysts of the hair follicles between the buttocks can cause tailbone pain.
Tailbone pain symptoms not due to nerve damage might include:
- Abscesses of the skin
- Muscle spasms
- Pain in the rectum
Symptoms that might indicate a life-threatening or serious condition
Tailbone pain, in and of itself, generally is not life-threatening. However, tailbone pain caused by trauma could be accompanied by other life-threatening injuries. Seek immediate medical care (call 911) if a person’s tailbone pain is caused by injury and is accompanied by:
- Head trauma
- Inability to breathe or difficulty breathing
- Inability to wiggle their toes
- Loss of consciousness or change in mental status (such as delirium)
- Numbness or paralysis of any body part
- Visible deformity of any limb, hip or other joint
If a person sustains mild trauma with tailbone pain and seems otherwise fine but later develops symptoms like a change in mental status (loss of consciousness, combativeness, delirium) or a severe headache, seek immediate medical care.
What causes tailbone pain?
Tailbone pain may arise from problems of the skin, muscles, connective tissues, nerves, or bones, including:
- Cysts of the skin or spinal nerves
- Degenerative spine disease (arthritis)
- Fracture of the coccyx or sacrum
- Fracture of the pelvis
- Muscle strains
- Spasm of the levator ani muscle
- Strained or torn ligaments
- Vaginal childbirth
Serious or life-threatening causes of tailbone pain
In some cases, tailbone pain may be a symptom of a serious or life-threatening trauma that should be immediately evaluated in an emergency setting. These types of trauma include:
- Car accident
- Fall accompanied by hitting the head
- Fall from a great height
- Industrial accident
Very rarely, tailbone pain can be caused by a malignant (cancerous) tumor, though this is extremely unlikely.
How is tailbone pain treated?
Tailbone pain usually clears up on its own with simple medical management, such as over-the-counter pain relievers and using a “donut pillow” for sitting while an injured coccyx heals. Tailbone pain treatment also may include physical therapy, pelvic floor therapy or, in severe cases, surgery.
What are the potential complications of tailbone pain?
Tailbone pain complications depend on the underlying disease, disorder or condition. In rare situations, untreated complications of tailbone pain can be life-threatening. A delay in treating tailbone pain can cause loss of function that cannot be recovered. Be sure to follow your treatment plan carefully and report ongoing symptoms to your healthcare professional. Over time, tailbone pain and the underlying cause of tailbone pain can cause serious complications, including:
- Bowel incontinence
- Impaired sexual function
- Loss of feeling and movement in the lower limbs