Tail bone pain

Pain at the bottom of your spine is common, and it is rarely serious. Most cases settle on their own over a few months with simple changes to how you sit. A short check-up can tell you what is behind it and whether you need anything more.

Reviewed by Dr. Kshitij Chaudhary, Last reviewed October 2026

What is the tailbone?

The tailbone, or coccyx, is a small triangle of bones at the very bottom of your spine. It sits just below the sacrum, between your buttocks. Cartilage covers the ends of these bones and ligaments hold them together. It curves inwards a little and normally moves very little.

What causes tailbone pain?

Doctors call it coccydynia. The usual causes are:

• A fall onto your bottom, or a direct hit to the area
• Sitting for long hours, especially on a hard or narrow surface like a bicycle seat
• Poor sitting posture
• Childbirth, particularly a vaginal delivery
• Arthritis in the joints around the tailbone

Sometimes there is no clear cause at all. That is common and does not mean something is wrong.

What does it feel like?

Most people feel pain, tenderness or swelling right over the tailbone. You may also see bruising after a fall.

The pain is often worse when you:

• Sit, especially on hard seats
• Get up from sitting
• Lean back
• Pass stool

Some people feel it in the lower back, buttocks, pelvis, rectum or lower belly.

Is tailbone pain serious?

Usually not. The bone can be bruised, dislocated or cracked, and all of these tend to heal with time and simple care. It can be uncomfortable and tiresome when you have to sit through the day. But it is rarely a sign of anything dangerous.

How is it diagnosed?

Your doctor will ask how it started and what makes it worse, then examine the area to find where it hurts.

Many people do not need a scan. An X-ray or other imaging is used when there was a significant injury, or when the pain does not settle as expected.

How is it treated?

Most tailbone pain needs only simple measures.

Change how you sit. Lean slightly forward so your weight does not rest on the tailbone. Use a cushion with a cutout at the back. Take breaks and avoid sitting for long stretches.

Use ice first, then heat. For the first 24 to 48 hours after an injury, use ice for 10 to 15 minutes at a time. Wrap it in a towel and never put it straight on skin. After a few days, heat often helps. Use a hot water bottle, a covered heating pad or a warm bath for 10 to 20 minutes. Never fall asleep on a heating pad.

Take pain relief. Anti-inflammatory tablets such as ibuprofen or naproxen can ease pain and swelling. Check with your doctor first if you have stomach, kidney or heart problems, or take blood thinners.

Keep stools soft. If straining makes the pain worse, a stool softener helps.

Consider an injection. If the pain carries on despite all this, a ganglion impar block may help. This is an injection of medicine around a small bundle of nerves near the tailbone that carries pain signals.

How long does it take to heal?

Generally, recovery takes a few months. Some people feel better sooner. Your doctor will tell you which activities are safe while you heal. Cycling and long drives are often best left alone for a while.

Will I need surgery?

Very unlikely. Most people recover with the steps above. Surgery is offered only when the pain is severe and every other option has been tried. The operation is called a coccygectomy, where the painful tailbone is removed.

When should I see a doctor?

See a doctor if:

• The pain has not improved after a few weeks of self-care
• You cannot sit even with a cushion, ice, heat and medicine

Questions to ask your doctor

• Did I bruise, dislocate or break my tailbone?
• Do I need an X-ray or any other scan?
• Which activities should I avoid, and for how long?
• Would a cushion or a ganglion impar block help me?
• If nothing works, is a coccygectomy an option for me?

This page is for general information and does not replace a medical consultation. Please see a doctor for advice about your own symptoms.

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About Dr. Kshitij Chaudhary

This page was written by Dr. Kshitij Chaudhary, a fellowship-trained spine surgeon at P.D. Hinduja Hospital, Mumbai, trained in complex spine surgery at Harvard Medical School (Beth Israel Deaconess) and the Twin Cities Spine Center, Minneapolis. 🏃🏾About Dr. Chaudhary