FAQs on Tailbone Pain Treatment in Nashville

Tailbone pain is discomfort felt in or around the coccyx, which is the bony structure at the bottom portion of the spine. Tailbone pain can be caused by coccyx trauma during a hard fall onto the buttocks, or it can occur after prolonged sitting on a hard or narrow surface. Also called coccydynia, tailbone pain can be short-term, or become a chronic problem.

What symptoms are associated with tailbone pain?

Tailbone pain can feel achy and dull, or it can become sharp and piercing during sitting or rising from a seated position to stand. For women, tailbone pain is often worse during menstruation or bowel movements. The most common description of tailbone pain is “tenderness,” implying the coccyx region is tender to touch.

What causes tailbone pain?

Tailbone pain is usually caused by an injury, but it can occur spontaneously. Common causes of tailbone pain include:

  • Sciatica
  • Infection
  • Pilonidal cysts
  • Shingles
  • Fractured bone
  • Sacroiliitis

How is tailbone pain diagnosed?

To treat tailbone pain, the doctor will attempt to uncover the actual cause of the discomfort. The doctor will ask several questions, take a detailed past medical history, and conduct a physical examination. A rectal examination may be necessary, and women will have a pap/pelvic exam. For men, a prostate examination is usually required. The coccyx will be x-rayed to detect any bony growths or fractures, and additional tests may be necessary, such as a bone scan, a computed tomography (CT) scan, or a magnetic resonance imaging (MRI) scan.

What can I do to alleviate tailbone pain?

Tailbone pain may go away spontaneously, but it could transform into a chronic condition. To ease the pain associated with coccydynia, you can:

  • Use a doughnut-shaped wedge pillow
  • Lean forward while sitting
  • Sit upright with proper posture
  • Keep your back firm against the chair and feet flat on the floor
  • Apply ice or heat to the affected area
  • Take an over-the-counter pain reliever (Tylenol or Advil)

How is chronic coccydynia treated?

When tailbone pain does not improve, and it persists for longer than 3 months, it is considered chronic coccydynia. The treatment options include:

  • Medications – The doctor can give you prescription strength nonsteroidal anti-inflammatory drugs (NSAIDs), or a stronger analgesic can be ordered. In addition, certain anti-epileptic and antidepressant medications are used to relieve tailbone pain.
  • Physical therapy – The therapist will show you how to do pelvic floor relaxation techniques, such as deep breathing during urination or defecation. To strengthen the pelvic floor muscles, the therapist teaches exercises and unique techniques. Massage is used to manipulate the muscles attached to the tailbone.
  • Injection – A local anesthetic agent, with or without a corticosteroid, can be injected into the coccyx to relieve pain for a few weeks. In a recent study, patients with chronic tailbone pain reported a 50% reduction in pain with x-ray guided coccyx injection of triamcinolone acetate.
  • Ganglion impar block – The cluster of nerves located in front of the coccyx is called the ganglion impar. A block to this region involves injecting a local anesthetic near the nerves. The doctor may add a corticosteroid to the injection for added pain relief. In addition, permanent blocking requires the injection of a neurolytic agent (phenol or alcohol) near the nerves to destroy nerve root. A recent clinical study reported a success rate of 100%, with all participants reporting reduction of pain scores.
  • Radiofrequency ablation (RFA) – The doctor uses radiofrequency waves, which are delivered by injection probe to destroy nerve tissue of tailbone area. In recent clinical research trial, many patients report both short- and long-term relief with RFA for tailbone pain.

Resources

Ferrante FM, et al. (2004). Radiofrequency sacroiliac joint denervation for sacroiliac syndrome. Pain Medicine, 5(1), 26–32. doi: 10.1111/j.1526-4637.2004.04009.x.

Mitra, R, Cheung, L, & Perry P (2007). Efficacy of fluoroscopically guided steroid injections in the management of coccydynia. Pain Physician 10(6), 775-778.

Nathan ST, Fisher BE, & Roberts CS (2010). Coccydynia: a review of pathoanatomy, aetiology, treatment and outcome. J Bone Joint Surg Br, 92(12), 1622-1627.

Toshniwal GR, Dureja GP, & Prashanth SM (2007). Transsacrococcygeal approach to ganglion impar block for management of chronic perineal pain: a prospective observational study. Pain Physician, 10(5), 661-666.