It is a common reflex to want to manipulate a joint that feels “stuck” or painful, and the tailbone, or coccyx, is no exception. The distinct, often painful, sensation of needing your tailbone adjusted leads many people to search for a quick fix. However, the coccyx is a delicate structure at the base of the spine, not a typical joint like a finger or knee. The risks of trying to “pop” it yourself far outweigh any perceived benefit. Understanding the underlying cause of the discomfort, known medically as coccydynia, is the first step toward finding safe relief.
Anatomy and Causes of Coccyx Discomfort
The coccyx is a small, triangular bone located at the very end of the spinal column, typically composed of three to five fused or semi-fused vertebral segments. Unlike the mobile joints in the rest of the spine, the coccyx has limited movement, articulating with the sacrum just above it via the sacrococcygeal joint. This bone serves as an attachment point for various muscles, tendons, and ligaments.
The sensation of needing the coccyx to “pop” or crack is usually not a sign of a simple bony misalignment that can be self-corrected. Instead, this feeling often results from significant tension in the powerful muscles and ligaments attached to the bone. Causes of coccydynia, or tailbone pain, range from external trauma, such as a fall onto the buttocks, to internal trauma, like the pressure experienced during childbirth.
Non-traumatic causes include prolonged sitting on hard or narrow surfaces, which places excessive pressure on the coccyx. This pressure can irritate the surrounding tissues, leading to inflammation and pain. The pain can also be caused by muscle tension or hypermobility (excessive movement) or hypomobility (too little movement) at the sacrococcygeal joint.
Risks of Self-Manipulation
Attempting to aggressively “pop” the tailbone through twisting, forceful stretching, or pressing can worsen the underlying condition and cause new injuries. The coccyx is not designed for the same kind of manipulation as other joints, and applying uncontrolled force can increase inflammation in the already sensitive area. This can exacerbate the pain, potentially turning an acute issue into a more persistent, chronic problem.
Self-manipulation also carries the risk of straining or tearing the attached ligaments and muscles, which can lead to bruising and instability in the joint. Repeated, forceful attempts at self-adjustment can contribute to Over Manipulation Syndrome, where ligaments become overstretched, causing joint instability in the spine. Mishandling this area also risks irritating nearby nerves, such as the pudendal nerve, which can lead to increased localized pain or neurological symptoms.
The coccyx is already susceptible to dislocation or fracture from trauma, and aggressive self-adjustment could potentially displace the bone further. Without a professional assessment, it is impossible to know the exact cause of the pain, meaning a person could be attempting to manipulate a small fracture or a severely inflamed joint. Seeking proper, gentle care is always the safer alternative to self-treating this delicate area.
Safe Techniques for Easing Tailbone Tension
Instead of attempting self-manipulation, which is risky, a number of safe, gentle techniques can help relieve the tension and pressure on the coccyx. Postural modification is an effective strategy, which involves leaning forward while sitting to shift weight off the tailbone and onto the sit bones. Avoiding slouching and maintaining a neutral spine alignment while seated also helps reduce direct pressure on the coccyx.
To manage pain and pressure, consider the following:
- Specialized seating, including donut-shaped pillows or wedge-shaped cushions, designed to reduce coccyx pressure.
- Brief, regular breaks from sitting every 20 minutes.
- Applying ice or a cold pack to the painful area for 10 to 15 minutes a few times a day to reduce inflammation.
- Using Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, temporarily to manage pain and swelling.
Gentle stretches can target the tight muscles attached to the coccyx, such as the piriformis and pelvic floor muscles. A modified Child’s Pose or the Cat-Cow yoga poses can help loosen the lower back and pelvis. Pelvic floor relaxation techniques, sometimes called reverse Kegels, can also relieve muscle tension that often contributes to coccyx discomfort.
When Professional Assessment is Necessary
While many cases of coccydynia improve with rest and self-care within a few weeks, persistent or severe pain requires a professional evaluation. Consult a healthcare provider if tailbone pain lasts longer than a few weeks, is severe, or significantly interferes with daily activities like sitting or sleeping. Sudden onset of pain following a specific fall or trauma also warrants an immediate assessment to rule out a fracture or dislocation.
Prompt medical attention is necessary for red-flag symptoms, including neurological symptoms like numbness or weakness in the legs, or signs of infection such as a high temperature or drainage near the coccyx. A physician can perform a physical examination, potentially including a rectal exam, and may use imaging like X-rays or MRI to determine the precise cause, which could range from hypermobility to a tumor.
Specialists who treat chronic coccydynia include Physical Therapists, Orthopedists, and pain management physicians. Professional treatments include targeted physical therapy, which may involve manual manipulation of the coccyx (often performed intrarectally) or specialized pelvic floor exercises. Other options include corticosteroid injections to reduce inflammation in the joint. In cases where all other treatments fail, surgery to remove the coccyx, known as a coccygectomy, may be considered.