A broken tailbone heals on its own in most cases, but the recovery takes 8 to 12 weeks and requires deliberate pain management and lifestyle adjustments during that time. There’s no cast for this bone. Treatment centers on reducing pressure on the coccyx, controlling pain, and gradually returning to normal activity as healing progresses.
What a Broken Tailbone Feels Like
The main symptom is pain and tenderness at the very base of your spine, near the top of your buttocks. It typically feels like a dull, persistent ache punctuated by occasional sharp stabs. The pain gets noticeably worse when you sit down, stand up from a seated position, bend forward, or have a bowel movement. Long car rides, cycling, or any activity that puts direct pressure on the area can be excruciating in the first few weeks.
Most tailbone fractures happen from a hard fall directly onto the bottom, though childbirth and repetitive strain (like prolonged sitting on hard surfaces) can also cause them. A bruised tailbone produces similar symptoms but typically heals in about 4 weeks. A fracture takes roughly 8 to 12 weeks. Your doctor can usually confirm a fracture with an X-ray, though in some cases imaging doesn’t show a clear break and diagnosis is based on the injury mechanism and severity of symptoms.
Immediate Care in the First 48 Hours
Ice the area for about 20 minutes every hour you’re awake during the first 48 hours. Use a cloth or towel between the ice pack and your skin. After those initial two days, continue icing two to three times a day, especially after any activity that triggers discomfort.
Rest as much as possible and stop any physical activity that causes pain. When sleeping, lie on your stomach to keep pressure off the tailbone. If that’s not comfortable, try sleeping on your side with a pillow between your knees. Over-the-counter anti-inflammatory pain relievers can help manage swelling and discomfort during the acute phase.
How to Sit Without Making It Worse
Sitting is the single biggest challenge during recovery. A specially designed cushion makes a real difference, but the type matters. In a study of 55 patients who tried both donut-style cushions and wedge cushions (which have a triangular cutout at the back to keep the tailbone from contacting the surface), patients with a preference were almost five times more likely to choose the wedge cushion over the donut. That said, 42% of patients in that study didn’t find either type helpful, so you may need to experiment.
Beyond cushions, a few sitting habits reduce pain significantly. Sit upright rather than leaning back, which tilts your weight toward the tailbone. When you must sit for longer stretches, alternate shifting your weight between your left and right buttock. Avoid hard surfaces entirely. And most importantly, avoid sitting for long periods at all. Stand up, walk around, and break up seated time as frequently as you can.
Managing Bowel Movements
Because pain flares during bowel movements, straining on the toilet can be one of the most dreaded parts of recovery. Eat plenty of fiber, drink extra water, and consider a stool softener to keep things moving easily. Some people find that leaning slightly forward while sitting on the toilet shifts weight away from the coccyx and reduces pain.
Returning to Activity
As pain begins to ease, typically a few weeks into recovery, you can start light physical activity like short walks. Increase gradually. If an activity causes pain at the tailbone, that’s your signal to scale back. Continue using your cushion for sitting and keep icing after activity if there’s any discomfort. The healing timeline is slow and frustrating, but pushing through pain can aggravate the fracture and extend your recovery.
Physical Therapy for Persistent Pain
If pain lingers beyond the expected healing window, pelvic floor physical therapy can help. The muscles of your pelvic floor attach near the coccyx, and after weeks of guarding against pain, those muscles often become tight or dysfunctional. A pelvic floor therapist works on releasing tension in the soft tissues surrounding the tailbone, strengthening and lengthening the pelvic floor muscles, and retraining movement patterns that may be contributing to ongoing pain. This includes correcting habits like slouching or leaning back while seated.
Therapists also address secondary issues that develop during recovery, like changes in bowel or bladder function, and provide education on positioning during daily activities and sexual activity to avoid flare-ups.
Injections for Pain That Won’t Resolve
For tailbone pain that persists despite conservative treatment, corticosteroid injections or nerve blocks are an option. Injections can be delivered into the joint at the base of the coccyx or used to block a nerve cluster located just in front of the tailbone. The procedure typically takes less than five minutes and often produces 50 to 75% pain relief. Some patients experience complete, lasting relief, though results vary.
When Surgery Becomes an Option
Surgery to remove part or all of the tailbone (called a coccygectomy) is not considered until at least six months after the injury, and only after other treatments have failed. It’s a last resort, but the outcomes are generally favorable. A review of over 700 patients who underwent the procedure found that 84% reported good to excellent results. The most common complication is wound infection, occurring in about 10% of cases. The overall complication rate is around 13%, with issues like delayed wound healing or minor bleeding accounting for the rest. Serious complications are rare.
What Recovery Actually Looks Like
The first two weeks are usually the worst. Sitting is painful, sleeping positions are limited, and everyday tasks like driving or working at a desk may not be feasible. By weeks three through six, most people notice gradual improvement and can tolerate light activity and modified sitting. Full healing of the bone typically occurs between 8 and 12 weeks, though some residual tenderness can persist for several months, especially with prolonged sitting.
Throughout recovery, the key priorities stay the same: minimize direct pressure on the tailbone, use a cushion whenever you sit, stay active within your pain limits, and give the bone time. Most broken tailbones heal completely without any intervention beyond these measures.