Coccyx pain - causes and therapy

Coccyx pain - causes and therapy

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Coccyx pain plagues us in the lowest part of the spine and sometimes also affects the lower back. Pain on the tailbone is not common and usually has an acute cause: For example, sitting on hard chairs or bicycle saddles for a long time causes small injuries in the tissue that are not visible to the naked eye. It is not the spine itself that is inflamed, but the wounds hurt. Pain in the tailbone should not be confused with anal pain.

Fractures, bruises and dislocations

Breaks, bruises and dislocations or nerve damage are also possible triggers. It is controversial whether coccyx pain can also have psychosomatic causes.

Irritation to the tendon and muscle attachments of the coccyx can cause pain as well as a fusion of the sacrum with the first coccyx vertebra.

The pain usually lasts from a few days to a few weeks; sometimes they form as spontaneously as they disappear, but sometimes they last for years.

Not only hard, but also too soft underlay can lead to such pain: couch potatoes who spend their time in front of the TV are therefore at risk.

There are also various triggers, but these are mostly rare: a sprained, bruised, dislocated or broken coccyx, an injury to the pelvis, herniated disc, neuralgia of the nerves between the coccyx and anus, tumors on the coccyx, operations on the abdomen and births.

Coccyx dislocation

Many sufferers suspect that their coccyx is dislocated. However, such dislocation is rare. Patients experience severe pain, especially when sitting. But such a contortion can be treated well.

The doctor puts his index finger in the rectum and grabs the dislocated bone. He fixes it and presses it from the outside against the coccyx with the thumb. The dislocation is released by gently pulling the index finger away from the sacrum and pushing the sacrum towards the feet.

If he is successful, the pain will immediately subside. Conversely: if the pain persists, it has not been possible to bend the tailbone into its natural position.

Pain can also exist if the cause of the pain was not a luxation of the coccyx. The sacroiliac joint next to the sacrum can also hurt, and this pain can easily be mistaken for a dislocated coccyx.

Coccyx fracture

If the coccyx breaks, those affected immediately notice this, because they experience extreme pain and bruises form. X-rays create certainty. The coccyx fracture can be fixed in one operation.

First of all, however, the doctor hopes for self-healing. A simple fracture on the tailbone usually heals well. Seat cushions and high-dose pain relievers help those affected by the immense pain.

One affected person reports: “I sailed down the stairs almost exactly two years ago and landed on the most valuable thing. A spinal disc burst and I broke my coccyx. "

Such a break cannot always be made. She writes: “The fracture in the coccyx cannot be straightened, it will always hurt, sometimes more, sometimes less. I just put up with it, because it would not be really easy to simply remove the piece of bone by surgery. I often sit on one leg and thus relieve the pressure on my buttocks, and in addition to that, the decrease in my buttocks hurts totally. ”

Another patient reports: “A few years ago I fell down a marble staircase at the swimming pool and broke my coccyx. It has to heal so much, nothing is done and I often had a lot of pain in the first few years. I still feel it when I sit for a long time, and I will always keep something of it. It is not treatable. "


The pain on the tailbone pulls, stings or burns - depending on the trigger. The tailbone is in the pain center, but the anal area, the loins and the hips can also be affected.

Usually the pain is severe when the person is sitting or getting up from sitting. If the pain is severe, the patients even have problems sitting down at all. Rarely, but all the more uncomfortable, are pain during bowel movements or pain during sex.

Sex is not impossible, but the male position in the missionary position, one of the most common positions during sexual intercourse, hurts, and so sexual enjoyment suffers, and the pain at the end of the spine can also strain an intimate relationship.

The diagnosis

The doctor first asks where exactly the pain occurs, in which situations and for how long it persists. Then he picks up the question: has the victim injured himself recently in the affected area, is he doing an activity that involves too much sitting?

Is it a coccyx pain? To determine this, the doctor presses lightly on the tip of the coccyx and the transition from the coccyx and sacrum. It would hurt in these places.

If the cause is not clear, an ultrasound examination, computed tomography or magnetic resonance imaging can be used. If cancer is suspected, contrast media represent the site in detail.


If there is no tumor or fracture, the main thing is to avoid behavior that promotes pain and treat symptoms.

Doctors use pain relievers and local anesthetics that are injected into the coccyx area. Physiotherapy and acupuncture (which shifts pain) are also helpful, as well as warmth and relaxation. Acute pain can be alleviated with a therapeutic pillow. This has an open seat ring at the back and can be purchased in the medical supply store.

Pain on the tailbone is often due to long-ago falls, which those affected no longer remember - injuries in ice hockey are typical. If these falls don't really heal, but connective tissue forms around the wound, trigger points remain.

Those affected usually do not notice anything at all. However, if the trigger points are irritated, for example by falling again, the old wound jerks through extreme pain.

Such painful areas can be treated with sensorimotor body therapy. If the doctor initially presses the appropriate area to examine how far the trigger points extend, it is very painful for those affected, but inevitable.

A nerve block focuses on the nerves that trigger the pain. If it is chronic pain, plus cold or warmth therapies.

If an anatomical deformity of the coccyx is the cause, it only helps to surgically remove the coccyx. Such an operation is only appropriate if all conservative therapies fail, and it only takes months to improve.

Those affected report

Coccyx pain is not the same as coccyx pain. If you suffer from a blocked coccyx, the methods to relieve the symptoms help little. An affected person reports:

"There was no usable therapeutic approach (despite surgeon, orthopedist, osteopath and various physiotherapists), driving for years with a 'punched pillow' car, having a matching pillow on the office chair, etc. On the bad days there was / was even on the sofa are uncomfortable to painful. "

He only felt better when an osteopath found that the patient was suffering from a blocked coccyx: “Now I was in a chiropractic and osteopathy practice a few days ago (…). Actually, I just wanted to have my Atlas vertebra checked there (which was also necessary), but also told about the coccyx problem. So it was scanned there (painful, but only briefly ...) and a blocked coccyx was found. This blockage was later released (again painful ...) and I actually have the brilliant feeling of improvement for the first time in 10 years. "

A fistula on the tailbone requires long therapy. A woman reports:

"In the past 3-4 years I have felt a strange feeling of pressure on my coccyx, but I didn't think anything of it. (...) In the summer of this year, however, there was a feeling of pressure in the coccyx area, which developed into an abscess after a few days. (...) The (surgeon) split the abscess, diagnosed the coccyx fistula and advised me to operate. "

The operation went smoothly: “The surgery then took place in mid-September under general anesthesia. The fistula ducts were stained and tissue was cut out over a large area. It was definitely the most enjoyable part of this whole story because you simply oversleep it. The operation took about 30 minutes, because according to the doctor the fistula was bigger than expected. I woke up without any complications and painless and was able to go home 3 hours after the operation. ”

After the operation, those affected go through a painful time: "Unfortunately, the wound bleed a bit in the afternoon, but a new, moist bandage was simply put on in the emergency room of the hospital. The first 2-3 days were great, because thanks to good painkillers I had almost no pain and could even sleep on my back (which is a blessing for me, since I am absolutely not on my side and certainly not on my stomach can sleep). Unfortunately, the next few days really started to hurt (...) I had very severe pain for the first two weeks. ”(Dr. Utz Anhalt)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dr. phil. Utz Anhalt, Barbara Schindewolf-Lensch


  • Robert Maigne: Spinal Pain and Its Treatments through Manipulation, Hippokrates Verlag, 1970
  • Friedrich Anderhuber, Franz Pera, Johannes Streicher: Waldeyer - Human Anatomy: Textbook and Atlas in one volume, Walt der Gruyter, 2012
  • Hans Peter Bischoff: Practice of Conservative Orthopedics, Georg Thieme Verlag, 2007
  • Ulrich T. Egle et al .: Special Pain Therapy: Guidelines for Continuing Education and Practice, Schattauer Verlag, 1999
  • Henrik Simon, Chiropractic textbook, Georg Thieme Verlag, 2014
  • Hans Tilscher, Hugo Kantor, Wolfgang Gangl, Gerhard Bogner: "Coccygodynia - a diagnostic and therapeutic problem in orthopedics", in: Journal of Orthopedics and Traumatology, Volume 124 Issue 5, 1986, Thieme Connect

Video: Tailbone Injury Side Bent Treated in One Visit Part 1 of 2 (September 2022).


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