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Coccygodynia: A Case Report of Post-Traumatic Pelvic Floor Pain Due to Myofascial Trigger Points

March 2nd, 2012 by James Lehman · Updated September 30th, 2026

Coccygodynia has been termed a “pain in the rear.” The painful coccyx first coined as “coccygodynia” some 150 years ago is still a misunderstood symptom that affects women more frequent- ly than men and most often after a traumatic incident. Sixty percent of patients with common coccygodynia present with mechanical coccygeal lesions that most frequently follow a fall onto the buttocks. Forty percent of the patients with coccygodynia present with normal alignment and proper function of the coccyx with “idiopathic” causes. Recently, a significant study implied that coccygodynia is primarily due to physical pathology rather than a manifestation of an underlying neurosis. Read the article

What Is Coccygodynia?

Coccygodynia (also called coccydynia) means pain in or around the coccyx, the small triangular bone at the very bottom of the spine that is commonly called the tailbone. The pain is usually felt when sitting, especially when leaning back, and when standing up from a seated position.

Common Causes

  • A fall onto the buttocks or another direct injury
  • Childbirth
  • Prolonged sitting on hard or narrow surfaces
  • Tension and trigger points in the pelvic floor and gluteal muscles, the focus of the case report summarized above
  • In some people no clear cause is found

Conservative Care Options

Most people improve with conservative care, which may include:

  • A wedge-shaped or U-shaped cushion that takes pressure off the tailbone when sitting
  • Avoiding long periods of sitting and leaning slightly forward when seated
  • Heat or ice, and short-term pain relief as advised by a doctor or pharmacist
  • Manual therapy and treatment of myofascial trigger points in the surrounding muscles
  • Pelvic floor physical therapy

When pain persists despite these measures, a medical doctor may discuss injections. Surgery to remove the coccyx is reserved for a small number of carefully selected cases.

When to See a Doctor

Tailbone pain that began without an injury and keeps getting worse, pain with fever, or pain with bowel or bladder changes should be evaluated promptly. Pain on one side of the lower back and buttock may instead come from the sacroiliac joint, and our guide to back pain red flags lists symptoms that need urgent care.

Section added September 2026 by the Ask Dr. Lehman editorial team.

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