That Pain at the Very Bottom of Your Spine

The tailbone is a leftover from our prehistoric ancestors who obviously had tails. Unfortunately, this little group of three to five bones at the very bottom of our spine can be a painful customer, especially for women.

Here’s some more information on coccydynia, tailbone pain.

What is the coccyx?

The coccyx is a triangular section of bone that makes up the very bottom of our spine. It is located below the sacrum. Like our wisdom teeth, our coccyx is classified as vestigial, meaning it was once a part of our bodies but it is simply a leftover, a vestige. To compensate for our third set of molars, our wisdom teeth, descending and crowding our now-shorter jaws and teeth arrangements, we simply have the wisdom teeth removed usually during the teenage years.

No such luck with the coccyx. The coccyx consists of three to five different bones connected by fused, or semi-fused, joints and/or disc-like ligaments. Because it is not fully fused, the coccyx can move forward and backward to a limited degree. Although surgery is an option for treatment, it involves a difficult recovery.

Who has coccydynia?

Women are five times more likely to develop tailbone pain than men. Why is this the case? Anatomy:

  • Women have a broader pelvic structure, which exposes the coccyx more than in men.
  • Women tend to place more weight on the coccyx when they sit, leading to injury.
  • Women often injure the coccyx during childbirth, as the baby moves over the tailbone.

This pain is:

  • Localized— It usually is confined to the tailbone and doesn’t radiate outward.
  • Involved with sitting— The positioning of the hips when sitting exposes the coccyx. This especially true when sitting on a hard surface.
  • Worse when transitioning to standing up— The movement of rising from a seated position or vice versa is usually more painful.
  • Associated with sex and bowel movements— The proximity of the coccyx to the genitals and the anus can lead to heightened pain during sex or defecation.


The vast majority of patients (over 90%) with coccydynia find non-surgical treatments effective. These involve using non-steroidal anti-inflammatory medications, applying a cold pack several times daily, using a heating pad for the first few days after injury, modifying activities such as changing to a standing desk at work, and the use of various supportive pillow options.

If the pain continues, treatments can involve corticosteroid injections or surgery to remove the coccyx. Surgery is not difficult, but the recovery is quite painful and enduring.

If you have back pain on any part of your spine, please call the team at DFW Center for Spinal Disorders, (817) 916-4685. We have eight locations that can help with your pain.

Posted in: Spine Surgery

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