Overview
what it is and why it mattersImage pendingLabeled diagram of the vertebral column: cervical, thoracic, lumbar, sacral, and coccygeal segments with intervertebral discs.
Coccydynia is pain in your tailbone — the small bone at the very bottom of your spine. The most common causes are a direct fall onto your bottom, childbirth, or repeated low-grade impact (long hours on a hard bike seat, for example). In some patients no specific cause is ever found. The pain has a distinctive pattern: worst with sitting (especially on hard surfaces), sharper when you stand up from a chair, and sometimes worse during bowel movements.
Women get it about five times more often than men, and carrying extra weight raises the risk.
Symptoms
what you may noticeThe defining symptom is a deep ache right at your tailbone that gets worse the longer you sit — especially on a hard surface like a wooden bench or bleacher seat. Standing up from a chair often produces a sharp spike of pain at the moment of transition, then eases once you are fully upright and walking.
Some patients also feel increased pain during bowel movements or with prolonged driving. The area directly over the tailbone is usually tender to touch. In more persistent cases the pain can radiate into your lower buttocks or sacral region, making it difficult to find any comfortable seated position.
Diagnosis
exam first, imaging secondX-rays taken in both standing and sitting positions show whether the tailbone is fractured, dislocated, abnormally mobile (moving more than 25° between sitting and standing), or sitting at an unusual angle. These dynamic side-by-side X-rays tell your surgeon much more than a single static film. MRI is added when there's concern for a hidden fracture, infection, or mass.
Treatment Path
how care progresses at OSI1
Coccyx cushion (donut pillow)
A donut-shaped cushion (or a U-shaped cushion with the tailbone area cut out) takes pressure off the coccyx during long stretches of sitting — often the single most useful thing you can do early on.
3
Physical therapy
Pelvic-floor physical therapy and gentle hands-on tailbone mobilization can be very effective — particularly in women, where pelvic-floor muscle tension is often a contributor.
If Surgery Is Truly Needed
rare for most patientsSurgery helps only a small minority of spine patients — usually those with a specific structural problem plus a nerve issue that isn’t getting better with a structured non-operative trial. When that step is genuinely warranted, OSI coordinates it the same way we coordinate every other part of your care: imaging, records, and the handoff are handled for you, so no part of the process falls on your shoulders.
Providers Who Treat Coccydynia
spine team
Further Reading
authoritative sourcesExternal patient-education references and related OSI pages for additional background: