Coccydynia, or tailbone pain, is persistent, localized discomfort felt at the base of the spine. This condition is experienced near the coccyx, a small, triangular bone that serves as an attachment point for various muscles and ligaments. The pain can interfere significantly with daily activities like sitting, driving, and sleeping. Chiropractic care offers a non-invasive approach focusing on the mechanical and muscular issues contributing to this discomfort.
Causes and Symptoms of Coccydynia
Tailbone pain frequently originates from direct trauma, such as a fall that bruises, fractures, or dislocates the coccyx. Repetitive strain from activities like cycling or prolonged sitting can also cause chronic inflammation. A significant cause, particularly in women, involves the trauma and stretching of ligaments that can occur during childbirth. Poor posture or degenerative changes in the sacrococcygeal joint also contribute to the development of pain over time.
Symptoms center around localized tenderness that worsens when pressure is applied, such as while sitting. Individuals often report a dull ache, which can spike into a sharp twinge when moving from a seated position to standing. The discomfort may also be felt during bowel movements or sexual intercourse, and it can occasionally radiate into the lower back or hips. When the pain lasts for more than a few weeks, it is classified as a chronic condition.
Evaluating the Source of Tailbone Discomfort
A chiropractor’s initial assessment focuses on a detailed patient history to understand the pain’s onset, whether it was acute trauma or a gradual issue. The practitioner will specifically inquire about the mechanism of injury and which activities, like prolonged sitting or rising, tend to worsen the symptoms. This consultation helps distinguish between pain caused by local coccygeal issues and discomfort referred from the lower back or sacroiliac joints.
The physical examination involves careful external palpation to locate the exact point of maximum tenderness and to assess the mobility of the coccyx itself. Specialized orthopedic tests, such as the seated recline test, may be used to provoke pain by shifting the body’s weight onto the tailbone. The assessment also includes checking surrounding soft tissues, such as the gluteal muscles and pelvic floor attachments, for tension and trigger points that may be pulling the coccyx out of alignment. If a fracture or severe underlying issue is suspected, the chiropractor may order imaging, such as X-rays, to rule out conditions requiring immediate medical referral.
Chiropractic Methods for Coccydynia Relief
Chiropractic treatment for coccydynia is centered on restoring proper alignment and movement to the sacrococcygeal joint and reducing associated muscle tension. Techniques often involve gentle, controlled external manipulation of the coccyx to correct misalignment or hypomobility by applying specific pressure to encourage a neutral position. Certain cases benefit from instrument-assisted adjustments, which deliver a low-force impulse directly to the joint.
Soft tissue work is an important component, as muscles like the gluteus maximus and pelvic floor attach directly to the coccyx and can pull it into a painful position. The chiropractor uses techniques such as myofascial release and trigger point therapy on these external muscles to reduce hypertonicity and inflammation. In specific circumstances, and with the patient’s informed consent, a chiropractor trained in the technique may perform an internal adjustment to directly mobilize the joint and release tension in the deeper pelvic floor muscles. The combination of joint mobilization and soft tissue therapy works to improve the overall function of the tailbone and pelvis.
Safety, Adjunct Therapies, and Prognosis
Chiropractic manipulation for the coccyx is generally considered a safe, non-surgical option when performed by a licensed professional. Treatment plans are individualized, and the techniques used are specifically tailored to the mechanical issue, such as gently repositioning a hypermobile coccyx or mobilizing a stiff one. Patients are often advised to incorporate adjunct therapies at home to support the in-office treatment and accelerate recovery.
A common recommendation is the use of a specialized cushion, often U-shaped or wedge-shaped, which relieves pressure on the coccyx while sitting. Postural education is also provided to teach patients how to shift their weight forward onto their sit bones rather than leaning back onto the tailbone. Specific home stretches and exercises aimed at strengthening core stability and addressing external muscles like the hamstrings are frequently prescribed to maintain the corrected alignment.
While individual results vary, many people experience improvement within a few weeks of starting conservative care. If a patient’s condition does not respond to chiropractic care, or if assessment reveals a pathology, the chiropractor will facilitate a referral to a primary care physician or specialist for further medical management.