Medicines for Tailbone pain

What it is

Coccydynia is pain in the coccyx — the small, triangular bone at the very bottom of the spine, commonly called the tailbone. The pain is felt low down between the buttocks, right at the base of the spine, and is characteristically worse when sitting (particularly on hard surfaces, leaning back, or sitting for long periods), and when moving from sitting to standing; it can also be uncomfortable during certain activities and, sometimes, when opening the bowels. It ranges from a dull ache to sharp pain. Common causes include injury to the coccyx — such as a fall onto the bottom, a knock, or childbirth — and prolonged or poor sitting posture; sometimes it develops without an obvious cause, and, less commonly, it can relate to other conditions. It is more common in women. While coccydynia can be quite painful and, in some people, persistent and frustrating, it is usually not a sign of anything serious, and most cases improve over time with simple measures. Occasionally, persistent tailbone pain, or pain with other features, is assessed further to exclude other causes.

How it is treated

Coccydynia usually improves with a conservative approach, though it can sometimes take a while and be persistent. The mainstays are relieving the pressure and pain on the coccyx and allowing it to settle. Helpful measures include: using a specially shaped cushion (such as a wedge-shaped or coccyx cushion with a cut-out at the back) to take pressure off the tailbone when sitting, and improving sitting posture and avoiding prolonged sitting on hard surfaces; simple pain relief and anti-inflammatory measures; and treating constipation if it makes the pain worse. Physiotherapy can help — including advice on posture, and specific techniques and exercises; some people benefit from manual therapy. Applying heat or ice can ease discomfort. Most cases settle over weeks to months. For persistent, troublesome coccydynia not responding to these measures, further options are considered under specialist guidance — such as a steroid injection around the coccyx, and, rarely, other procedures or (very occasionally) surgery, though these are reserved for resistant cases after assessment. Persistent pain is also assessed to exclude other causes. The reassuring message is that tailbone pain is usually not serious and most cases improve with cushioning, posture, pain relief and time, with further treatments available for persistent cases.