Tailbone Pain

Tailbone Pain

Tailbone pain is a tricky one. Many people experience it and don’t always understand why and what they can do about it. In this post, we will cover a few common reasons why the coccyx gets sore to hopefully help you understand more about this issue and why you might still be struggling with discomfort in this area. 

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Important Anatomy

One thing that is really important to understand about the anatomy around the tailbone is that parts of your nervous system—specifically your dura—run from top to tail. The dural tube directly connects the head (cranium) and neck to the coccyx. 

Concussions, or orthodontic work like braces that work to pull your teeth and jaw alignment into a more optimal position, for example, can create tension and poor alignment in your cranium, which can easily be transferred all the way down to your pelvis via the dural tube. This can then lead to pain and problems in the pelvis.

The same connection works in reverse. If you fall hard on your tailbone, the tension around the tailbone can cause headaches and issues in the neck and cranium via the dural tube connections.

The easiest way to think of it is if one end gets twisted, the other end notices and twists to counterbalance. This is really important to understand because it’s about nerve connections and bone alignment. It’s also a demonstration of how everything in our body is connected, and sometimes the area that is hurting is not always the area that’s creating the problems.

Let’s get back to tailbone pain.


We’ve all fallen on our bottom at some point in our lives. Sometimes you fall off to one side, and sometimes, you land squarely in the middle of your bottom and hit your tailbone. The impact of a fall can vary enormously, potentially fracturing the tailbone. Sometimes a heavy fall can lead to the tailbone getting the tip bent under (hook shape), and sometimes you can feel quite bruised and need to sit on a special cushion for a few days.

When there is a significant trauma or impact to the coccyx—sometimes even when you haven’t fractured the bone—the coccyx can get jammed up on one side. This creates tension in the dural tube, which wraps around the spinal cord. It creates a twist in the bottom bone (sacrum + coccyx), which, in turn, forms a twist in the pelvis. 

Often this also leads to changes in the pelvic floor muscles which can mean that some of those internal muscles get tight. Everyone has pelvic floor muscles. This poor alignment of the coccyx when it gets fixated off to the side and the tension that then surrounds it can create all kinds of pain and painful spots on the tailbone and other areas like the lower back and pelvis.

The tailbone needs to be able to move depending on what movements you’re doing. If the tailbone becomes fixated, it restricts that movement, and this can be another source of pain or nerve tension.

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Another kind of trauma that can happen and hurt the tailbone is childbirth. The position of the baby and the woman during labour can be really important—particularly if the woman has preexisting coccyx issues or a hook-shaped coccyx. When a woman gives birth, the pelvis has to open and allow the baby to pass through in the event of a vaginal delivery. Instrumental or complex deliveries can lead to coccyx injuries. 

Tight Pelvic Floor

We mentioned briefly already that tight pelvic floor muscles can impact the coccyx. This is because some of the pelvic floor muscles attach directly to the coccyx. If those muscles are chronically tight or in spasm, then they’re pulling on the tailbone, and it can get sore and even get pulled out of alignment.

Anyone can have a tight pelvic floor. There are many reasons why someone might have tight areas in their pelvic floor, and some of them include:

  • Trauma, including surgical, birthing, and sexual trauma

  • Prostate issues

  • Chronic UTIs and thrush

  • Endometriosis

  • Muscle imbalances

  • Anxiety and stress

  • Poor standing posture

  • Hip problems

Anything that alters the coccyx alignment will impact the nerve tension in the area and can make it uncomfortable to sit in certain positions that put pressure on the coccyx or general aching in the area. 

Tailbone Pain Relief

Tailbone pain, or coccydynia, can be effectively managed with various self-care measures. If you’re wondering how to relieve tailbone pain or what helps tailbone pain, first, avoid sitting on hard surfaces for prolonged periods and use a cushion or pillow for added support. Applying ice packs to the affected area can help reduce inflammation and provide relief. 

Gentle stretches and exercises that promote pelvic and core strength can also be beneficial. Additionally, practising good posture and using ergonomic seating can reduce pressure on the tailbone. If the pain persists, seeking professional help, such as pelvic floor physiotherapy, can address underlying issues and provide targeted relief for tailbone discomfort. 

Tailbone Pain Physiotherapy 

Skilled physios like those at Sydney Advanced Physio will be able to assess your body to see what we can do to help you with coccyx pain. If you think your pelvic floor might be contributing to the issue, we recommend you book in to see one of our therapists specialising in pelvic floor treatment. 

Pelvic floor physiotherapy can be highly beneficial in addressing tailbone pain. This specialised therapy aims to alleviate tension and imbalances that may contribute to tailbone discomfort by assessing and treating the pelvic floor muscles.  

Our physiotherapists employ targeted exercises and manual techniques to improve pelvic floor function, which, in turn, can reduce strain on the coccyx and surrounding structures. By addressing the root causes of tailbone pain, pelvic floor physiotherapy offers effective relief and promotes overall pelvic health.

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