Tailbone Pain (Coccyx Pain, Coccydynia) Location and Symptoms
Tailbone pain is a sharp or dull pain on the end of the spine — in the lower back between the upper buttocks (Picture 1). The pain can be severe; some women describe it as a “bruised tailbone”.
Causes of the Tailbone Pain in Early Pregnancy (First Trimester)
During pregnancy, the hormones relaxin and estrogen cause relaxation of the ligaments in the pelvic floor, which allows the coccyx to shift more than usually; this can cause pain.
Pregnancy may worsen the tailbone pain caused by pre-existing conditions, such as:
- Herniated disc in the lower back — pain may be located in the sacral area or in the left or right buttock and may spread down a leg and possibly causing tingling in the feet.
- Lower back injury, a fall on the tailbone
- Symphysis pubis dysfunction (SPD) — tailbone pain associated with pubic pain or pain in other spots in the pelvis; it may radiate down a leg but not below the knees.
- Cancer in the pelvic area
Picture 1. Tailbone pain location
LEFT: The woman is sitting upright
RIGHT: The woman is leaning forward, which can ease the pain
Tailbone Pain in Late Pregnancy (Second and Third Trimester)
In late pregnancy, the baby’s head can press upon the coccyx, which may cause pain.
Triggers of Tailbone Pain
- Pressure upon the tailbone
- Sneezing, coughing
- Lying on the back, sitting on the hard surface, moving from sitting to standing, prolonged standing
- Walking, running, cycling, riding, driving, lifting heavy objects, doing squats or jumping,
- Bowel movement
Sitting Positions, Coccyx Cushions
You can try to sit on a doughnut (donut) pillow or inflatable ring, a wedge pillow (U-pillow or V-pillow; nothing presses on the coccyx). Some women find relief when they lean forward on the table (Picture 1) (2). You can try an exercise ball when sitting in the office.
Standing and Walking
- Avoid prolonged standing and walking.
- Avoid bending over to pick objects.
- Try shoes with cushy soles.
- Do not wear shoes with high heels.
- Try a maternity support belt.
Tailbone Pain Relief and Treatment
The following may help relieve tailbone pain (3):
- Frequently change positions — from sitting to walking and vice versa.
- Empty the bowel regularly — a full rectum may press upon the coccyx and worsen the pain.
- Apply heat or ice pads or try warm (not hot) baths.
- Swimming may help relieve the pain.
- Try certain yoga positions, such as “cat to cow” pose.
- A doctor may suggest a mild painkiller, such as paracetamol (acetaminophen). Aspirin and ibuprofen, and steroid injections are not recommended in pregnancy.
- A physiotherapist or pregnancy chiropractor may suggest special exercises or the massage of the tailbone area.
Can Tailbone Pain Be Cured?
There is no cure for the tailbone pain during pregnancy, but the pain usually goes away shortly after delivery. If the tailbone pain is severe and repeats during every pregnancy, you may discuss with a surgeon about surgical coccyx removal (coccygectomy) (1).[ref]