Clinically reviewed by What is tailbone pain
Coccydynia is pain at the coccyx, the small tail of bone at the very bottom of the spine, made of three to five tiny segments. In Urdu it is dum ki haddi ka dard.
It is a small bone with a lot of attachments. Pelvic floor muscles, gluteal muscles and several ligaments all pull on it. That is why it can hurt out of all proportion to its size, and why sitting, which puts your body weight straight through it, is what hurts most.
It is more common in women, because of the shape of the pelvis and because of childbirth.
Symptoms you might have
- Pain right at the very bottom of the spine, between the buttocks, in a spot you can touch
- Worse sitting, especially on a hard chair or leaning back
- A sharp pain on standing up from sitting
- Pain on opening the bowels, and worse when constipated
- Uncomfortable lying flat on the back, so people turn onto their side
- Pain that does not travel down the leg, which separates it from sciatica
Why it happens
- A backward fall onto the tailbone, onto a step, a kerb or the edge of a hard chair. This is the commonest cause
- Childbirth, particularly a long labour or a large baby
- Long hours sitting on hard surfaces, including the floor and wooden benches
- Motorbike riding over broken roads, where every jolt lands in the same place
- Rapid weight loss, which removes the padding you were sitting on
- Constipation and long periods straining on the toilet
- Sometimes no clear cause at all, which is still a real problem
When you should see a physiotherapist
Come in once it has lasted more than a couple of weeks, or sooner if you cannot sit for work. The practical half of treatment, how you sit and what you sit on, makes a difference within days.
Go to a hospital the same day with numbness around the groin or back passage, loss of bladder or bowel control, or weakness in both legs.
See a doctor first after a heavy fall, to check whether the bone is broken or displaced. Also see a doctor if there is a lump, swelling, redness or any discharge near the tailbone, which can be an infected sinus and needs treating as an infection rather than as pain.
See a doctor too for unexplained weight loss, fever, or night pain that does not change with position.
Al-Shama Physiotherapy Clinic
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اپائنٹمنٹ کے بارے میں پوچھیںAppointment ke liye poochein
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How it is treated
Most coccydynia settles without anything invasive, and the first results come from taking weight off the bone rather than treating the bone.
- Seating and sitting technique, changed at the first visit: a wedge cushion with a cut out at the back so the coccyx hangs free, and sitting leaning slightly forward
- Manual therapy to the gluteal muscles, the ligaments around the coccyx and the lower back, which is where most of the pull comes from
- Exercise therapy: pelvic floor relaxation rather than squeezing, with hip, glute and trunk strengthening
- TENS, which suits this well because the pain is often constant while sitting and the pads are easy to place around the area
- Dry needling for the gluteal and pelvic muscles in spasm
- Bowel advice, because straining and constipation keep the pain going in a large number of cases
Surgery to remove the coccyx is rare and is a last resort after a year or more of failed treatment. Injections are sometimes used and that is a doctor's decision. We do not prescribe medicine.
Exercises, and what to avoid
What helps
- Slow breathing with the pelvic floor and buttocks deliberately relaxed, two or three minutes at a time
- Knee hugs and gentle lower back rocking, which eases the pull on the coccyx
- Glute bridges and hip strengthening once sitting is tolerable
- Standing up and walking for two minutes every half hour, which is treatment rather than a break
What to avoid
- Hard pelvic floor squeezing programmes. The pelvic floor here is usually too tight, not too weak, and squeezing makes it worse
- Sitting it out to finish a task. The pain climbs and takes longer to settle afterwards
- Deep squats, sit ups and cycling on a narrow saddle in the early weeks
- Rubber ring cushions that leave the tailbone unsupported in the middle but press the area all round
What you can do at home
Get a wedge cushion with a cut out at the back, so the tailbone sits over the gap and your weight goes through the sitting bones instead. This is the single most useful thing you can buy.
Sit leaning very slightly forward, not reclined. Leaning back rolls your weight straight onto the coccyx.
After a fall, use ice for the first two to three days, ten to fifteen minutes at a time with a cloth between the ice and the skin. After that, heat suits it better.
Treat constipation seriously. Water, fibre, a footstool so your knees are higher than your hips on the toilet, and no long straining. Straining pulls directly on the sore bone.
How long it takes
Coccydynia after a fall usually improves over four to eight weeks, and most people are comfortable sitting again within about three months.
Pain after childbirth often settles within a few weeks to three months, helped by the cushion, the sitting changes and pelvic floor work.
Pain that has been there longer than six months takes patience. It still improves, usually over three to four months of consistent treatment, but the gains come in steps rather than steadily.
What slows it most is continuing to sit for long unbroken hours, straining with constipation, and sitting leaning back on soft sagging furniture.
Urdu / Roman Urdu
Choose your reading script / اپنی پسند کا رسم الخط منتخب کریں
اردوUrdu script
دم کی ہڈی کا درد اکثر پیچھے گرنے، زچگی کے بعد، یا گھنٹوں سخت جگہ بیٹھنے سے ہوتا ہے۔
سب سے زیادہ فائدہ بیٹھنے کا طریقہ بدلنے سے ہوتا ہے۔ ایسا کشن لیں جس کے پیچھے کٹاؤ ہو تاکہ دم کی ہڈی خالی رہے۔ ذرا آگے جھک کر بیٹھیں۔
گرنے کے بعد پہلے 2 سے 3 دن ٹھنڈا سیک، پھر گرم سیک۔ ہر 20 سے 30 منٹ بعد اٹھ کر چلیں۔
قبض کا علاج ضروری ہے۔ زور لگانا سیدھا اس ہڈی پر کھینچتا ہے۔ پانی، فائبر اور پیروں کے نیچے اسٹول۔
فوراً ہسپتال جائیں اگر: شرمگاہ یا پاخانے کے گرد سن ہونا ہو، پیشاب پاخانے پر کنٹرول ختم ہو جائے، یا دونوں ٹانگیں کمزور ہوں۔ دم کی ہڈی پر گلٹی، سوجن یا پانی آ رہا ہو تو ڈاکٹر کو دکھائیں۔
Roman Urdu
Dum ki haddi ka dard aksar peeche girne, zachgi ke baad, ya ghanton sakht jagah baithne se hota hai.
Sab se zyada faida baithne ka tareeqa badalne se hota hai. Aisa cushion lein jis ke peeche katav ho taake dum ki haddi khali rahe. Zara aage jhuk kar baithen.
Girne ke baad pehle 2 se 3 din thanda sek, phir garam sek. Har 20 se 30 minute baad uth kar chalen.
Qabz ka ilaj zaroori hai. Zor lagana seedha is haddi par kheenchta hai. Pani, fibre aur pairon ke neeche stool.
Foran hospital jayen agar: sharamgah ya pakhane ke gird sun hona ho, peshab pakhane par control khatam ho jaye, ya dono taangein kamzor hon. Dum ki haddi par gilti, sujan ya paani aa raha ho to doctor ko dikhayen.
Treatment at the clinic, and online
INFORMATION → INDIVIDUAL CARE
A plan built around you.
Talk with Dr. Zahra Fatima, DPT. Understand your next steps, with guidance for your own symptoms and daily routine.
Talk it through
Discuss your symptoms, what you find difficult and what you want to get back to.
Understand your next steps
Use the consultation to discuss which care and exercises fit your situation.
Take your plan with you
Your online consultation includes a written plan you can refer to afterwards.
Questions people ask
What is the best cushion for tailbone pain?
How should I sit with coccydynia?
How long does tailbone pain last after a fall?
Can childbirth cause tailbone pain?
Should I do Kegel exercises for tailbone pain?
Related conditions
- Lower back pain treatment
- Slip disc treatment
- Upper back pain treatment
- Middle back pain treatment
- Scoliosis physiotherapy