• By Liza Torborg

Weekend Wellness: In most cases, tailbone pain goes away within a few months

August 16, 2014

older woman with lower back painDEAR MAYO CLINIC: Is there anything that can be done for a tailbone that is painful? My mother is 70 and won’t go to the doctor even though she is miserable. She said there is nothing they can do for her. Shouldn’t a doctor be consulted in this case?

ANSWER: Tailbone pain can be very uncomfortable. Fortunately, in most cases, the pain goes away on its own within a few months. During that time, there are steps your mother can take to help lessen the pain. If her tailbone pain lasts for more than two months, or if it gets worse despite home remedies, then your mother should see a doctor.

Your tailbone, or coccyx, is the bony structure at the bottom of your spine that helps to support your pelvic floor. Tailbone pain, a condition called coccydynia, is usually dull achy pain in or around the tailbone. But the pain may become sharper or more intense after sitting or standing for a long time, during sex, or with urination or a bowel movement.

There are many possible causes of tailbone pain. It is often the result of an injury due to a fall or trauma during childbirth. Tailbone pain can sometimes arise after sitting on a hard surface for a long time or sitting on an ill-fitting or jouncing seat. In some cases, the pain may be the result of sitting posture changes brought on by obesity or aging. Only rarely is the cause more sinister, such as an infection, a benign tumor or cancer.

Medical treatment typically is not needed for tailbone pain. But encourage your mother to try the following measures to lessen the pain while she’s seated: sit completely upright, do not slump or slouch, keep her back firmly against the chair, her knees level with her hips, feet on the floor and shoulders relaxed. Although it is best to avoid sitting on hard surfaces, a heavily cushioned, over-stuffed surface may also be undesirable because it can allow you to sink into an unnatural, painful sitting posture. Select a supportive chair with a moderate amount of cushioning.

If pain is not relieved by those changes, adjusting her weight by leaning forward slightly when seated may help. Sitting on a doughnut-shaped cushion or a wedge (V-shaped) cushion may help by distributing weight away from the painful area. Using heat or ice on the painful area, as well as taking over-the-counter pain relievers, also may offer some relief.

Your mother can use these techniques until the pain subsides. In many cases, the pain will lessen and then disappear over the course of several weeks or several months. In only a minority of people does tailbone pain last beyond that length of time.

If tailbone pain does persist for more than two months, or if it gets worse despite these measures, then your mother should see her physician for an evaluation to rule out other potential causes. For chronic tailbone pain, a consultation with a specialist in pain medicine or physical medicine and rehabilitation may be useful.

Depending on the situation, treatment for chronic tailbone pain may include instruction in pelvic floor relaxation techniques, physical therapy, or manipulation of the coccyx, which is usually performed through the rectum. An anesthetic and corticosteroid injection may be helpful in some severe or persistent cases. This is usually performed by an anesthesiologist or other expert in pain management. Given the potential for substantial complications, surgery is only considered as a last resort in severe cases. David Bell, M.D., Primary Care Internal Medicine, Mayo Clinic, Rochester, Minn.