What is causing my tailbone pain?

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Question:

I have had tailbone pain for 20 years. I am 36 years old. It comes and goes, but it flares up after sitting for long period of times. It feels the best when I am exercising regularly or stretching daily. When I’m in pain it feels like it’s on fire and sometimes part of my leg will hurt as well. What could be causing this pain?

Answer:

Thank you for your question. Without doing an examination, we’re not able to comment on your specific condition. There are several potential causes for tailbone pain.

Tailbone pain can be caused by trauma which causes bruising or fracture to the coccyx (tailbone). In these cases, the tailbone will be very tender to touch and the pain will typically resolve over time, especially if irritating positions and activities are avoided or minimized.

The sacroiliac joint, which are the joints a couple of inches away from where the spine meets the pelvis on either side, can cause pain that goes down the leg and may be worse with sitting for long periods of time. In certain circumstances, this could also contribute to tailbone pain.

Tailbone pain can also be caused by dysfunction of the internal pelvic muscles, known as the pelvic floor. There are several muscles within the pelvic floor which act as a hammock to support the base of your core. Both muscles and ligaments within your pelvic floor have attachments at the tailbone and along the sacrum and can be potential causes of tailbone pain. These muscles can become dysfunctional and painful due to trauma (such as childbirth) or due to prolonged suboptimal postures or other repetitive activities.

Another cause of tailbone pain is pain that is referred from joints or other structures in the low back, pelvis, or hip joint. Referred pain is pain that is felt at a body region that is different from the region of the body where the pain is being generated. If there is no issue with any of the muscles or other structures in your leg, yet you are still experiencing pain there, it may be an example of referred pain. Without performing an examination of your leg and tailbone region, we cannot tell if this pain is referred from another body region or if it is due to irritation at your tailbone and leg.

A physical therapist can assess your low back, hips, and pelvic floor to determine the causes as well as appropriate treatments to address your tailbone pain. Physical therapy treatment for tailbone pain will often include coaching on postural strategies to minimize discomfort with sitting, as well as instruction in stretching of tight muscles and strengthening of weak muscles within your pelvic floor, hips, and abdomen. Physical therapy treatment for tailbone pain may also include hands-on therapeutic techniques to improve movement in stiff joints or other tissues in order to further help reduce your pain.

In rare cases, tailbone pain may come from a non-musculoskeletal origin. In this case, a physical therapist will refer you to the appropriate healthcare providers to ensure that you get the care you need.

Please note, this reply is for informational purposes only. It’s not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, physical therapist, or other qualified health provider with a medical condition.

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