Treatment

There are a number of treatments that can help reduce the pain of coccydynia. Simple measures you can try at home are usually recommended first.

Coccydynia often improves over a few weeks or months. If it continues despite simple treatments, your GP may refer you to a specialist to discuss other options.

Self care measures

The following advice may help reduce pain and allow you to get on with your everyday activities.

use a specially designed coccyx cushion – these can be bought online and from some shops; they help reduce the pressure on your tailbone while you're sitting down
avoid prolonged sitting whenever possible – try to stand up and walk around regularly; leaning forward while seated may also help
wear loose-fitting clothes – avoid clothing such as tight jeans or trousers that may put pressure on your tailbone
apply warm and cold packs to your tailbone – warm packs include hot water bottles and microwaveable heating pads; cold packs are available as freezable gel-filled pads from pharmacies, or you can use a bag of frozen vegetables wrapped in a towel
try laxatives (medicines to treat constipation) if the pain is worse when you are having a poo – many laxatives are available to buy from pharmacies and supermarkets without a prescription
take over-the-counter painkillers

Painkillers

Anti-inflammatory painkillers (NSAIDs)

If your pain and discomfort is not too severe, it may be relieved with over-the-counter painkillers.

A type of painkiller known as a non-steroidal anti-inflammatory drug (NSAID) is often recommended. Ibuprofen is a type of NSAID available without a prescription.

NSAIDs can help ease pain and reduce inflammation (swelling) around your coccyx.

However, some people cannot take NSAIDs because they're allergic to them or have an increased risk of developing stomach ulcers. If this is the case, try taking paracetamol instead. Ibuprofen gel that you rub into your skin may also be an option.

Ask a pharmacist or GP for advice if you're unsure what to take.

Other painkillers

If the pain is more severe, a stronger painkiller such as tramadol may be required. Tramadol can cause side effects, such as constipation, headaches and dizziness.

It's usually prescribed for a short time as it can be addictive. If it's prescribed for longer, the dose will have to be reduced gradually before being stopped to avoid withdrawal symptoms.

Physiotherapy

If your pain has not started to improve after a few weeks, your GP may be able to refer you to a physiotherapist.

A physiotherapist can:

give you advice about posture and movement to help reduce your pain
teach you some simple exercises to help relax the muscles around your tailbone
try techniques such as massage and stretches

Injections

If your coccydynia does not respond to painkillers, your doctor may recommend injecting medicine into your lower back.

Several different types of injections can be tried.

Steroid injections

Injections of corticosteroids into the area around the tailbone can reduce inflammation and pain. Sometimes, they're combined with local anaesthetic to make them even more effective.

The injections can help relieve the symptoms of coccydynia, although the effects may only last for a few weeks.

They cannot cure your condition and too many injections can damage your tailbone and lower back, so you may only be able to have this type of treatment once or twice a year.

Nerve blocks

Injecting local anaesthetic into the nerves that supply the coccyx can help reduce the pain signals coming from them.

As with steroid injections, the effect may only last a few weeks or months.

But unlike steroid injections, it's usually safe to have repeated injections of local anaesthetic.

Surgery

Surgery for coccydynia is usually only recommended when all other treatments have failed.

It may involve removing some of your tailbone (partial coccygectomy) or occasionally all of it (total coccygectomy).

A coccygectomy is carried out under general anaesthetic (where you're asleep).

After surgery, most people find their symptoms improve considerably, although it can take several months. Some people will continue to experience pain.

It takes a long time to recover from coccygectomy, anywhere from a few months to a year.

Page last reviewed: Mon Jul 2022 Next review due: Wed Feb 2020