Coccydynia, or tailbone pain, is a localized and often debilitating condition affecting the coccyx, the small triangular bone located at the very base of the spinal column. This discomfort is frequently exacerbated by direct pressure, such as when sitting, and can significantly limit daily activities. As a non-invasive, drug-free approach, chiropractic care is a common method people seek to manage and find relief from this specific type of pain. The treatment focuses on the mechanical integrity of the pelvic region to address the underlying physical causes of the discomfort.
Causes of Tailbone Pain (Coccydynia)
Tailbone pain can arise from a variety of causes. A sudden, backward fall onto the buttocks is a frequent source of acute coccydynia, potentially leading to bruising, fracture, or displacement of the coccyx bone itself.
Repetitive strain from activities that place chronic pressure on the tailbone, like prolonged sitting on hard or narrow surfaces, can also cause inflammation and pain over time. In women, childbirth can sometimes lead to an internal injury or displacement of the coccyx due to the stresses placed on the pelvic structures. Poor posture can also contribute to chronic pressure, causing irritation of the sacrococcygeal joint where the coccyx meets the sacrum.
The Chiropractic Approach to Pelvic Alignment
Chiropractic care for tailbone pain is fundamentally based on restoring proper mechanical function to the lower spine and pelvis. The coccyx is connected to the sacrum at the sacrococcygeal joint, and misalignment or fixation in this area can cause persistent pain and joint irritation. Chiropractors assess the mobility of this joint to determine if it is moving too much (hypermobile) or too little (hypomobile), as both can lead to chronic discomfort.
Adjustments aim to mobilize the coccyx and sacrum, reducing irritation and promoting a return to normal joint motion. By addressing the position of the coccyx, the chiropractor also works to reduce the mechanical tension placed on the soft tissues attached to it. The coccyx serves as an attachment point for several muscles and ligaments, including the gluteus maximus and the muscles of the pelvic floor.
Restoring alignment helps release the chronic tension and spasm in these connected muscles, which often contribute to the pain cycle. This mechanical approach addresses the underlying physical dysfunction.
Adjustment and Soft Tissue Techniques
External Adjustments
Chiropractors utilize various hands-on techniques to address the mechanical issues contributing to coccydynia. External adjustments involve applying gentle, controlled pressure or mobilization to the coccyx through the skin and surrounding tissues. This external manipulation is often performed manually or with the assistance of specialized instruments, which can deliver a low-force impulse to the affected area.
Internal Adjustments
A chiropractor may suggest an internal adjustment if external methods have not provided sufficient relief. This procedure involves inserting a gloved finger into the rectum to directly palpate and gently reposition the coccyx. Internal manipulation allows for direct contact with the sacrococcygeal joint and the muscles that attach to the front of the coccyx, such as the coccygeus and levator ani muscles. This technique requires explicit, informed consent from the patient and is performed only by practitioners with specific training in the procedure.
Soft Tissue Techniques
Soft tissue work targets the muscles that attach to or surround the tailbone. Techniques like trigger point therapy, myofascial release, and external massage relieve muscle tension and spasms in the gluteal and pelvic floor regions. Releasing these tight muscles decreases the pulling force exerted on the coccyx, further supporting the alignment achieved through the adjustment.
When Chiropractic Care Is Not Appropriate
There are specific situations where chiropractic care for coccydynia may be contraindicated or require co-management with a medical doctor. An initial assessment rules out “red flags” that indicate a more serious underlying pathology.
Acute or suspected fractures of the coccyx require medical imaging and stabilization before manual manipulation is considered. Pain originating from non-mechanical causes, such as tumors, cysts, or active infections in the spine or pelvis, requires medical management. Signs of systemic illness, such as unexplained fever or severe, progressive neurological deficits like Cauda Equina syndrome, necessitate immediate medical attention and are absolute contraindications to adjustment.
Conditions like severe osteoporosis, which can make bones fragile, also require a modified or non-manipulative approach to prevent injury. If the chiropractor suspects a cause outside the scope of mechanical joint dysfunction, they will refer the patient for further diagnostic testing, such as X-rays or MRI, to ensure the safest and most appropriate course of action.