Pain in the Tailbone

Pain at the very base of the spine at the coccyx, or "tailbone", is a common problem encountered in chiropractic practice. The pain may be present while walking or lying down, but it is most commonly felt when sitting. It may not be possible to sit straight, and shifting from side to side, slouching or a cushion are necessary to keep pressure away from the bone.

The most common cause of the pain at the base of the spine is lack of normal movement in the sacroiliac joints of the pelvis. This can result from a fall on the tailbone, sometimes many years before the onset of symptoms. Often the falls occurred in childhood. Other causes include prolonged driving or sitting, occupational strain, pregnancy, or postural habits.

When the sacroiliac joints function normally, the pelvic bones move in such a way that the tailbone is tucked under while sitting, allowing the weight to be properly supported across the buttocks. If this mechanism is blocked, the end of the coccyx is subjected to a great deal of abnormal pressure and pain the sitting position. Patients with the problem may have been advised to avoid sitting or to use a doughnut-shaped cushion. In some cases, the coccyx has been surgically removed, although even this often does not relieve the pain.

The first step in treating pain in the coccyx should be a spinal evaluation to determine whether it is a biomechanical problem which can be corrected. A course of chiropractic treatments may resolve the problem without the need for surgery or the prospect of living with the pain indefinitely.