Tailbone Pain: Why Does My Tailbone Hurt When Sitting or Standing Up?

Oct 13

Tailbone Pain: Causes, Relief & Treatment | Osteopath Auckland

Does sitting down cause a sharp pain right at the bottom of your spine?

Perhaps you're constantly shifting around in your chair, avoiding hard seats or dreading a long drive because your tailbone becomes increasingly uncomfortable.

Maybe standing up after sitting sends a sudden stabbing pain through your coccyx, or you've noticed tenderness after a fall that just doesn't seem to be settling.

You might even find yourself leaning to one side when sitting because putting pressure directly on your tailbone hurts.

Tailbone pain can be surprisingly frustrating, especially when something as simple as sitting becomes uncomfortable.

The reassuring news is that many cases of tailbone pain improve with appropriate management, and there are practical ways to reduce discomfort while the area recovers.

What Is Tailbone Pain?

Your tailbone, also called the coccyx, is the small bony structure at the very bottom of your spine.

It sits just below your sacrum and provides attachment points for several ligaments and pelvic floor muscles.

Tailbone pain is medically known as coccydynia.

It can develop following an injury, prolonged pressure or irritation of the tissues around the coccyx.

Sometimes the cause isn't immediately obvious.

Unlike general lower back pain, which is usually felt higher around the lumbar spine, tailbone pain tends to be more localised to the very bottom of your spine.

A common clue is pain when sitting directly on the tailbone, particularly on hard surfaces.

What Does Tailbone Pain Feel Like?

Tailbone pain doesn't feel the same for everyone.

Some patients experience a dull ache, while others describe a sharp or stabbing sensation during certain movements.

You might recognise one of these descriptions.

"It feels like I'm sitting on a bruise."

Perhaps your tailbone feels tender whenever you sit on a firm chair.

"I get a sharp pain when I stand up."

You may be relatively comfortable once seated, but the movement from sitting to standing causes sudden discomfort.

"I can't sit for very long."

You might notice aching that gradually increases during meetings, driving or watching television.

"My tailbone hurts when I lean backwards."

Leaning back in a chair can place more pressure around the coccyx and aggravate symptoms.

"The pain started after I fell onto my bottom."

You may have slipped on stairs, fallen during sport or landed awkwardly on a hard surface.

"I haven't injured myself, so why does my tailbone hurt?"

Tailbone pain can sometimes develop gradually, particularly with prolonged sitting or repeated pressure.

"The pain feels deep at the bottom of my spine."

Some people experience a deep ache around the coccyx that is difficult to relieve by changing position.

Although these symptoms can be consistent with coccydynia, other conditions can cause pain in the same area, so an assessment may be helpful.

Why Does My Tailbone Hurt?

There are several possible causes of tailbone pain.

1. Falling Onto Your Tailbone

One of the most common causes of coccyx pain is a fall directly onto your bottom.

Perhaps you slipped on wet tiles, fell down stairs or landed awkwardly while playing sport.

The impact can bruise the tissues around your tailbone and, in some cases, cause a fracture or other injury.

You might notice pain immediately, followed by tenderness when sitting or standing up.

2. Prolonged Sitting

Sitting for long periods, particularly on hard surfaces, can increase pressure around the coccyx.

You may notice discomfort after working at a desk, driving or sitting through a long meeting.

For some people, symptoms gradually develop without one obvious injury.

3. Cycling and Repetitive Pressure

Cycling, rowing and other activities involving repeated pressure around the sitting bones and pelvis can sometimes contribute to discomfort.

You might notice pain after longer rides or exercise sessions.

However, pain from these activities doesn't always originate directly from the coccyx.

4. Coccyx Joint or Soft Tissue Irritation

The coccyx has small joints and surrounding ligaments and muscles that can become sensitive.

Pain may be associated with local tissue irritation or altered coccyx movement, particularly following an injury.

5. Pelvic Floor Muscle Tension

The pelvic floor muscles have connections around the coccyx.

In some people, pelvic floor muscle tension or dysfunction may contribute to pain in the tailbone region.

This can be one reason why tailbone pain sometimes persists even after an initial injury has healed.

6. Referred Pain From Nearby Structures

Not all pain felt near your tailbone comes directly from the coccyx.

The sacrum, lower back, pelvic floor and other nearby tissues can sometimes contribute to discomfort in this region.

An assessment can help determine whether your symptoms are likely to be coccyx-related or coming from another area.

Why Does My Tailbone Hurt During Everyday Activities?

Tailbone pain can make ordinary activities surprisingly uncomfortable.

Tailbone Pain When Sitting

This is one of the most common complaints.

Perhaps you're comfortable standing or walking, but sitting on a chair causes an immediate ache or sharp pain.

Hard chairs, benches and prolonged sitting may be particularly uncomfortable.

You might find yourself constantly shifting position or leaning forwards to reduce pressure.

Tailbone Pain When Standing Up From a Chair

Does your tailbone hurt most when you go from sitting to standing?

This movement changes the pressure and forces around your coccyx.

If the area is sensitive, standing up can cause a sharp or catching sensation.

Tailbone Pain When Driving

Driving involves prolonged sitting, often with limited opportunities to change position.

You might notice your tailbone aching during longer journeys or feeling particularly sore when getting out of the car.

Tailbone Pain When Working at a Desk

If your job involves sitting for much of the day, tailbone pain can make concentrating on work difficult.

You may find yourself standing frequently, shifting around in your chair or avoiding certain sitting positions.

Tailbone Pain When Exercising

Cycling, rowing, sit-ups and some gym exercises may aggravate tailbone pain because of direct pressure or movement around the pelvis.

You might notice discomfort during exercise or aching afterwards.

Tailbone Pain When Leaning Backwards

Leaning back in a chair can increase pressure around your coccyx.

Some people find sitting more upright or slightly forwards more comfortable.

Tailbone Pain When Sleeping

Although tailbone pain is often worse when sitting, some people also experience discomfort when lying on their back or changing position in bed.

If tailbone pain is affecting your ability to sit, drive, work or exercise, getting an assessment may help identify the cause and appropriate management options.

Book a Tailbone Pain Appointment with Sarah

What Can I Do to Relieve Tailbone Pain?

The most appropriate treatment depends on the cause of your symptoms, but several strategies may help reduce discomfort.

1. Reduce Direct Pressure on Your Tailbone

Try avoiding prolonged sitting on hard surfaces.

A coccyx cushion with a cut-out at the back may help reduce pressure on the painful area.

2. Change Sitting Positions Regularly

If you work at a desk, try standing up and moving around regularly.

You don't need to maintain one perfect sitting posture all day.

3. Lean Slightly Forwards When Sitting

Some people find that leaning slightly forwards helps reduce direct pressure on the coccyx.

Choose a position that feels comfortable rather than forcing yourself to sit rigidly upright.

4. Try Heat or Cold for Temporary Relief

A cold pack wrapped in a towel may help following a recent injury.

For ongoing muscle discomfort, some people find gentle warmth helpful.

5. Modify Activities That Aggravate Your Symptoms

If cycling, rowing or certain gym exercises increase your pain, consider temporarily reducing or changing these activities.

You may be able to continue with other forms of exercise that don't aggravate your symptoms.

6. Keep Moving Comfortably

Walking and gentle movement are often more comfortable than prolonged sitting.

Unless you've been advised otherwise following an injury, staying active within your comfort levels can help maintain general mobility.

7. Seek Advice if Your Pain Persists

If your tailbone pain isn't improving, keeps returning or is affecting your everyday activities, an assessment can help determine whether further treatment or investigation is needed.

You don't have to wait until sitting becomes unbearable before asking for help.

Book an Osteopathy Appointment with Sarah

How Long Does Tailbone Pain Take to Heal?

Recovery depends on the cause and severity of your symptoms.

A mild coccyx bruise may improve over several weeks.

A more significant injury or fracture can take longer, sometimes around eight to twelve weeks or more.

Some people experience persistent coccydynia lasting several months.

If your symptoms aren't improving as expected, further assessment may be needed to identify contributing factors or exclude other causes.

Persistent tailbone pain doesn't automatically mean there's permanent damage.

However, ongoing pain deserves appropriate assessment rather than simply waiting indefinitely for it to settle.

How Can Osteopathic Treatment Help Tailbone Pain?

If tailbone pain is making sitting, driving or everyday movement uncomfortable, osteopathic assessment and treatment may help you understand your symptoms and manage associated musculoskeletal discomfort.

I'm Sarah Boughtwood, a structural osteopath based in Milford on Auckland's North Shore, with over 10 years of clinical experience.

I treat adults and children aged five years and older, helping patients manage musculoskeletal aches, pains and injuries.

My approach is to understand not just where your tailbone hurts, but how that pain is affecting your everyday life.

Perhaps you're struggling to sit at work, drive comfortably, exercise or stand up from a chair without pain.

During your appointment, I'll take the time to listen to your symptoms, understand how your pain developed and assess your lower back, pelvis and surrounding muscles and joints as appropriate.

Depending on your assessment, treatment may include:

Gentle soft tissue techniques to help manage associated muscle discomfort
Appropriate joint mobilisation of nearby areas where suitable
Advice on reducing pressure around your coccyx
Practical sitting and workplace modifications
Individualised mobility and strengthening exercises
Guidance on gradually returning to exercise and everyday activities
Referral for imaging or further medical assessment when indicated

Treatment is adapted to your symptoms, comfort levels and medical history.

Osteopathic treatment may help manage associated musculoskeletal symptoms, but evidence for manual therapy specifically treating coccydynia is limited. Persistent or complex cases may benefit from pelvic health physiotherapy or other medical management.

My aim is to help you understand your tailbone pain, improve your comfort and return to everyday activities with greater confidence.

Book a Tailbone Pain Assessment with Sarah

When Should I Be Concerned About Tailbone Pain?

Many cases of tailbone pain are musculoskeletal, but some symptoms require medical assessment.

Seek prompt medical attention if you experience:

Severe pain following a significant fall or accident
New weakness or numbness in your legs
Numbness around your groin or saddle area
New difficulty controlling your bladder or bowel
Fever, redness, swelling or discharge around the tailbone
Unexplained, persistent pain that is worsening

New bladder or bowel dysfunction, saddle numbness or significant neurological symptoms require emergency medical assessment.

Pain around the tailbone can sometimes be caused by skin infections or pilonidal disease rather than the coccyx itself.

Children with persistent tailbone pain, particularly following an injury or with unexplained symptoms, should also be medically assessed.

Do I Need an X-ray for Tailbone Pain?

Not everyone with tailbone pain needs imaging.

For many cases, your symptoms, medical history and physical examination can help guide treatment.

However, imaging or further investigation may be appropriate following significant trauma, if symptoms are unusual or if pain persists despite appropriate management.

As an osteopath, I can assess whether referral for imaging or further medical evaluation may be appropriate.

Can I See an Osteopath for Tailbone Pain Under ACC?

Yes. If your tailbone pain is related to an injury that qualifies for ACC cover, you may be eligible for subsidised osteopathic treatment.

For example, coccyx pain following a fall, sporting accident or direct impact may qualify.

Not all tailbone pain is covered by ACC, particularly when symptoms develop gradually without a qualifying injury.

I'm an ACC-registered osteopath, and you don't need a GP referral to book an appointment.

Don't Let Tailbone Pain Make Sitting a Daily Struggle

Tailbone pain can affect so many everyday activities.

Perhaps you're uncomfortable sitting at work, struggling through long car journeys or avoiding exercise because your coccyx hurts.

It can be frustrating when something as simple as sitting down or standing up becomes painful.

But tailbone pain doesn't automatically mean something is seriously damaged or that you'll always have discomfort when sitting.

With an appropriate assessment and management plan, many cases of coccydynia can improve.

If you're experiencing persistent coccyx pain, discomfort when sitting or pain following a fall, I'd love to help you explore your treatment options.

I'm Sarah, a structural osteopath based in Milford, Auckland, providing individualised care for adults and children aged five years and older.

Let's work towards helping you sit, move and get through your day more comfortably.