Coccydynia, the medical term for tailbone pain, is a common symptom experienced during pregnancy. This discomfort, localized at the small, triangular bone at the base of the spine, can make sitting, standing, and moving painful. Understanding the distinct hormonal and mechanical changes that cause this pain is the first step toward finding effective relief. This article explains the underlying causes of tailbone discomfort and provides strategies for management.
Hormonal and Physical Shifts Causing Coccyx Pain
Coccyx discomfort during pregnancy involves a combination of hormonal changes and mechanical strain. The body releases a hormone called Relaxin, which is designed to soften and increase the elasticity of ligaments throughout the pelvis in preparation for childbirth. This necessary process also affects the ligaments supporting the sacrococcygeal joint, the area where the tailbone attaches to the sacrum, introducing a degree of instability.
This joint instability is then exacerbated by significant mechanical factors. As the uterus expands, the center of gravity shifts forward, causing the expectant person to compensate by increasing the curve in the lower back, known as lumbar lordosis. This shift tilts the pelvis and places direct, unnatural pressure on the coccyx, which is not designed to be a weight-bearing structure when sitting.
The increasing weight of the growing baby, placental tissue, and amniotic fluid also exerts downward pressure on the pelvic floor muscles, which attach directly to the coccyx. This constant strain can cause these muscles to become tense and tight, pulling on the tailbone and contributing to the aching sensation. Changes in gait, sometimes described as a “pregnancy waddle,” and prolonged sitting further strain the already vulnerable joint, making the pain more pronounced.
Daily Management and At-Home Relief Techniques
Simple adjustments to daily routines can significantly reduce the pressure on the tailbone. When sitting, avoid slumping backward, which puts direct weight on the coccyx. Instead, lean slightly forward to distribute weight onto the “sit bones” (ischial tuberosities). Limit prolonged periods of sitting, making a point to stand and move around every 30 to 45 minutes.
Specialized cushions are highly effective for offloading pressure when sitting. While traditional donut cushions are available, wedge-shaped coccyx cushions with a posterior cutout are generally recommended, as they suspend the tailbone and encourage a more upright posture. Sleeping posture can also be modified by lying on the side with a pillow placed between the knees, which helps keep the hips and pelvis in a neutral, less strained alignment.
Applying a cold compress to the painful area can help reduce inflammation, while a warm compress may help relax tense surrounding muscles. Gentle, prenatal-safe stretches such as pelvic tilts, the Cat-Cow pose, or the Figure-Four stretch can help mobilize the pelvis and release tension in the pelvic floor. For pain relief, Acetaminophen (Tylenol) is often considered a safe option during pregnancy, but any over-the-counter medication should first be discussed with a healthcare provider.
When to Consult a Healthcare Provider
While most coccyx pain during pregnancy can be managed with at-home strategies, certain symptoms warrant immediate medical attention. A healthcare provider should be consulted if the pain suddenly becomes severe or debilitating, if it is accompanied by a fever, or if there is any new numbness or tingling sensation in the legs or buttocks. These symptoms may signal an underlying issue that requires a professional diagnosis.
A physician will perform a physical examination to rule out other causes of pain, such as referred pain from the lower back. They may recommend an X-ray to check for a fracture or dislocation. For persistent pain, a referral to a pelvic floor physical therapist is often the next step, as they can provide specialized treatment like manual soft tissue release and personalized postural training. In rare and severe cases that do not respond to conservative care, a localized steroid injection may be considered, but such treatments are usually reserved until after delivery.