Tailbone Pain Causes

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Tailbone pain

Tailbone pain has many causes.  We have simplified the causes of tailbone pain to the following sections:

Physical Injury

In our chiropractic practice, we have observed that physical injury is the most common cause of our patient's tailbone pain.  An injury usually occurs after some type of physical force is applied to the coccyx (tailbone) area.

The physical tailbone injuries can be divided into a  blunt force and a gradual force that is applied to the tailbone area.

    Blunt Force

    Most people can recall the blunt type of tailbone injury that caused the tailbone pain.  Usually, it is a  fall episode on tailbone.  Sudden fall on the buttocks during skiing or skating are examples of blunt trauma. Sometimes after the fall on the buttocks, there are multiple symptoms such as tailbone pain, difficulty walking, difficulty sitting or getting up from a chair, numbness in the legs, very painful sitting experience, and/or headache.

    Tailbone pain/injury caused by a physical trauma may respond very well to chiropractic care or manual therapy. The sooner the tailbone injury is evaluated and treated, the faster recovery can be achieved.

    In contrast, a delay in care can lead to chronic tailbone pain, increased pain or other complicated symptoms. Time is of-the-essence after a coccyx injury.

    Gradual Forcesitting2

    Gradual physical trauma that can cause a tailbone  injury is more complicated  to identify, correlate, detect and recognize by the tailbone sufferer and/or the treating doctor.   Prolonged sitting on a broken-down chair for many days is an example of gradual physical trauma to the coccyx.

    The gradual nature of this injury can lead to more complicated injuries that goes beyond the tailbone pain.  It can affect the pelvic muscles and ligaments supporting the coccyx. Usually patients report a gradual onset of pain.  This type of pain should not be ignored since some  pathological processes can produce similar symptoms.

    Some pathological processes might be hazardous to one’s health  and require medical interventions.  A combination of blood tests and imaging studies can be considered to rule out some hazardous pathological processes. Please refer to your Medical Doctor for ruling out the pathology.

    Tailbone pain can develop gradually as the result of cumulative forces applied to the coccyx.   It might start with a sensation of discomfort during the first experience of gradual traumatic forces (broken-down seat or chair).

    When gradual physical forces are applied to the tailbone area, people usually do not experience any symptoms or pain immediately.  This type of injury can account for some of the idiopathic tailbone pain. (Idiopathic tailbone pain source is unknown or obscure.)

    Often a person is not aware of the gradual traumatic forces until pain or a significant level discomfort is presented, possibly hours or days later.

    The minimal gradual traumatic forces are often difficult to detect  by  an individual patient as the cause of tailbone pain or injury. Lack of timely detection and removal or modification of gradual traumatic forces will cause the pain or injury over time.

    The cumulative trauma and partial adaptation to the pain can lead to subsequently more complaints. Furthermore, symptoms and pain may develop beyond the tailbone region.

    The following is a list of gradual forces that tailbone sufferers have experienced and reported.   Please note that most of these activities appear to be harmless as many people are able to do it with seemingly no problem:

    Prolonged exercising/stretching on hardwood floor
    Prolonged sitting
    Prolonged sitting on non-ergonomic chair
    Prolonged sitting during pregnancy
    Prolonged sitting on a lawn chair
    Prolonged sitting on sands at the beach
    Sitting on a bicycle seat with the gel padding
    Sitting on a bicycle seat/saddle with no ergonomics
    Sitting on a broken down car seat or office chair
    Sitting on ride-on mower
    Sitting on hard surfaces such as stadium bleachers

Pathological Process of a Disease

When suspecting a pathology, we refer the patient to other medical specialists to evaluate and rule out the pathology.   MRI of  coccyx is one of the tests that can rule out some of the pathologies of coccyx and pelvic area such as cancer. 

Psychological Factors

Although there is a possibility of psychosomatic reflexes or psychological causes of tailbone pain, we have not observed such clinical cases in our practice.

Referred Pain

Sometimes the pain is referred to the coccyx from other anatomical structures due to trauma or pathology. 


When the source of the tailbone pain is unknown or obscure, it can be classified as an idiopathic tailbone pain.   Some of the idiopathic tailbone pain can be the result of  the gradual traumatic forces.

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