Tailbone Pain

Tailbone pain is a tricky one. Lots of people experience it and they don’t always understand why and what they can do about it. In this post we’re going to cover a few reasons why coccyx’s get sore that are quite common to hopefully help you understand a little bit more about this issue and why you might still be struggling with discomfort in this area.


Important Anatomy

One thing that is really important to understand about the anatomy around the tailbone is that parts of your nervous system – specifically your dura – run from top to tail. The dural tube connects the head (cranium) and neck very directly to the coccyx. Concussions, or orthodontic work like braces that work to pull your teeth and jaw alignment into a more optimal position, for example, can create tension and poor alignment in your cranium which can easily be transferred all the way down to your pelvis via the dural tube. This can then lead to pain and problems in the pelvis.

The same connection works in reverse. If you fell really hard on your tailbone the tension around the tail bone can then cause headaches and issues in the neck and cranium via the dural tube connections.

The easiest way to think of it is if one end gets twisted the other end notices and twists to counterbalance. This is really important to understand because it’s about nerve connections and bone alignment. It’s also a demonstration of how everything in our body is connected and sometimes the area that is hurting is not always the area that’s creating the problems.

Let’s get back to tailbone pain…



We’ve all fallen on our bottom at some point in our lives. Sometimes you fall off to one side, and sometimes you land squarely in the middle of your bottom and hit your tailbone. The impact of a fall can vary enormously and sometimes the tail bone can be fractured. Sometimes a heavy fall can lead to the tail bone getting the tip bent under (hook shape), and sometimes you can feel quite bruised and need to sit on a special cushion for a few days.

When there is a significant trauma or impact to the coccyx – sometimes even when you haven’t fractured the bone – the coccyx can get jammed up on one side. This creates tension in the dural tube which wraps around the spinal cord. It creates a twist in the bottom bone (sacrum + coccyx) which in turn creates a twist in the pelvis.  Often this also leads to changes in the pelvic floor muscles which can mean that some of those internal muscles get tight. Everyone has pelvic floor muscles. This poor alignment of the coccyx when it gets fixated off to the side and the tension that then surrounds it can create all kinds of pain and painful spots on the tailbone and other areas like the lower back and pelvis.

The tailbone needs to be able to move depending on what movements you’re doing. If the tailbone becomes fixated it restricts that movement and this can be another source of pain or nerve tension.

Another kind of trauma that can happen and hurt the tail bone is child birth. The position of the baby and the woman during labour can be really important – particularly if the woman has preexisting coccyx issues or a hook-shaped coccyx. When a woman gives birth the pelvis has to open and allow the baby to pass through in the event of a vaginal delivery. Instrumental or complex deliveries can lead to coccyx injuries.


Tight Pelvic Floor

We mentioned briefly already that tight pelvic floor muscles can impact the coccyx. This is because some of the pelvic floor muscles attach directly to the coccyx. If those muscles are chronically tight or in spasm then they’re pulling on the tailbone and it can get sore and even get pulled out of alignment.

Anyone can have a tight pelvic floor. There are many reasons why someone might have tight areas in their pelvic floor and some of them include:

  • Trauma including surgical, birthing, and sexual trauma
  • Prostate issues
  • Chronic UTIs and thrush
  • Endometriosis
  • Muscle imbalances
  • Anxiety and stress
  • Poor standing posture
  • Hip problems


Anything that alters the coccyx alignment will impact the nerve tension in the area and can make it uncomfortable to sit in certain positions that put pressure on the coccyx or general aching in the area.

Skilled physios like those at Sydney Advanced Physio will be able to assess your body to see what we can do to help you with coccyx pain. If you think your pelvic floor might be contributing to the issue we recommend you book in to see one of our therapists that specialise in pelvic floor treatment.

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