Tailbone Pain: Causes, Recovery, and When to Seek Help

Experiencing pain near the coccyx when rising?

In late June, I traveled for five days in Hualien and Taitung by tour bus.
The first two days were fine, but starting on the third day, I experienced pain when trying to stand up after sitting down.
Initially, I thought it was due to sitting too long or the bus seat.
However, by the fourth and fifth days, I felt pain every time I sat down.
The pain in my coccyx was so severe that I could barely get up; I had to use something to push myself up.
Once I stood up, the pain was not as intense, and bending or leaning back did not cause any discomfort.
After returning from the trip, the pain persisted, but it was not as severe as before.
I tried to avoid sitting as much as possible.

Later, one day, I experienced numbness in the back of my hand extending to my fingers for an entire night, which made me worry that my spine might be misaligned and pressing on a nerve.
Towards the end of July, I decided to see an orthopedic doctor.
The doctor suggested that the pain was likely due to carrying heavy items during the trip, which caused soft tissue damage from prolonged strain.
X-rays showed no significant issues, and I was advised to avoid sitting and bending for a while.
The doctor mentioned that it would take about a month to heal on its own.
By August, I indeed felt that the pain was decreasing, and I thought I was recovering.
However, a few days ago, around September 7, I started to feel some pain again while sitting.
It was not as severe as before, but it felt very similar, with the pain seemingly shifting slightly lower, near the coccyx.
The pain has been increasing day by day, and by yesterday (the 11th), when I tried to get up to go to the bathroom, the pain felt almost as intense as it did in July.

I would like to ask the doctor if this situation indicates a recurrence.
Shouldn't the healing of soft tissue damage gradually improve and eventually resolve? Why does it seem to fluctuate instead? I have not experienced any falls or impacts, and I just had X-rays taken.
If there are no issues with my spine and it is not related to the previous soft tissue damage, what could be the problem? Which specialist should I consult? Given my current situation, I am unsure which department to visit next.
Thank you for your help.

Lin, 20~29 year old female. Ask Date: 2020/09/12

Dr. Chen Bochen reply Orthopedics

Hello, Ms.
Lin.
The coccyx has many ligaments and pelvic floor muscles connected to it.
Inflammation in this area is not easy to resolve and can recur frequently.
I recommend the following: 1.
Avoid prolonged sitting.
2.
Pay attention to your sitting posture; make sure to sit fully in the chair with back support and avoid slouching.
3.
Apply heat therapy, such as taking warm showers or soaking in a hot bath.
4.
If you experience tenderness when pressing on the area at the base of the coccyx, using an anti-inflammatory ointment may be helpful.
Wishing you a speedy recovery.

Reply Date: 2020/09/12

More Info

Tailbone pain, or coccydynia, can be a frustrating and debilitating condition that significantly impacts daily activities, especially sitting. Based on your description, it seems that your pain began after a prolonged period of sitting during your trip, which may have led to soft tissue damage around the tailbone area. This type of pain can often be exacerbated by poor posture, prolonged sitting, or carrying heavy loads, as you mentioned.

Understanding Tailbone Pain
The tailbone, or coccyx, is a small triangular bone at the base of the spine, and pain in this area can arise from various causes, including:
1. Trauma or Injury: Even if you did not experience a direct fall or impact, prolonged pressure on the tailbone from sitting for extended periods can lead to inflammation and pain.

2. Soft Tissue Damage: As your doctor suggested, carrying heavy items or sitting for long durations can strain the muscles and ligaments around the coccyx, leading to soft tissue injuries.

3. Postural Issues: Poor posture while sitting can place additional stress on the coccyx, contributing to pain.
4. Inflammation: Conditions such as coccydynia can result from inflammation of the surrounding tissues, which may not always be visible on X-rays.

Recovery and Management
Recovery from tailbone pain can be gradual, and it is not uncommon for symptoms to fluctuate. Here are some strategies to help manage and alleviate your pain:
- Avoid Prolonged Sitting: Try to limit the time spent sitting, especially on hard surfaces. If you must sit, consider using a cushion designed to relieve pressure on the tailbone.

- Posture Correction: Pay attention to your posture while sitting. Keeping your back straight and using ergonomic chairs can help reduce strain on the coccyx.

- Pain Relief Medications: Over-the-counter anti-inflammatory medications (NSAIDs) can help reduce pain and inflammation. However, if these are not effective, consult your doctor about other options.

- Physical Therapy: A physical therapist can provide exercises to strengthen the muscles around the pelvis and improve posture, which may help alleviate pain.

- Heat Therapy: Applying heat to the affected area can help relax the muscles and reduce pain. A warm bath or heating pad may provide relief.

- Coccyx Cushions: Special cushions are available that are designed to relieve pressure on the tailbone while sitting.

When to Seek Further Help
If your symptoms persist or worsen, it may be beneficial to consult a specialist. Given your history and the nature of your pain, consider seeing:
- Orthopedic Specialist: They can evaluate your spine and coccyx for any underlying issues that may not have been detected in previous examinations.

- Pain Management Specialist: If your pain is chronic and significantly affecting your quality of life, a pain management specialist can offer advanced treatment options, including injections or other interventions.

- Physical Medicine and Rehabilitation (PM&R) Specialist: They can provide a comprehensive approach to managing your pain through rehabilitation and physical therapy.

Conclusion
Tailbone pain can be complex and may require a multifaceted approach to treatment. It is essential to listen to your body and avoid activities that exacerbate your pain. While soft tissue injuries can take time to heal, with appropriate management, many individuals find relief and can return to their normal activities. If your pain continues to interfere with your daily life, do not hesitate to seek further medical advice.

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