Doctor, Why Does My Tailbone Hurt When I Sit? – Coccydynia | Spine Comics Episode 3

Six-panel Know Your Spine comic explaining coccydynia, common causes of tailbone pain, evaluation, conservative treatment and warning signs.

Doctor, Why Does My Tailbone Hurt When I Sit? – Coccydynia | Spine Comics Episode 3

Tailbone pain—also called coccydynia—often becomes noticeable while sitting, especially on hard surfaces or for long periods. It may also hurt when rising from a chair or when pressure is applied directly over the coccyx.

What is the coccyx?

The coccyx is the small terminal part of the spine, situated below the sacrum. Pain arising from this region is called coccydynia.

Spine Comics illustration showing the sacrum and coccyx and explaining that localized tailbone pain is called coccydynia.
What is the coccyx? Episode 3 explains the anatomy behind tailbone pain.

Why does tailbone pain happen?

Common causes include:

  • A fall directly onto the buttocks
  • Childbirth
  • Prolonged sitting or repeated pressure on the coccyx
  • Sitting on hard surfaces

Sometimes, no definite cause is found. A focused history and examination are therefore more useful than assuming every patient needs a scan.

Spine Comics illustration showing common causes of coccydynia: a fall, childbirth, prolonged pressure and cases with no clear cause.
Common causes and aggravating factors for coccydynia.

How is coccydynia evaluated?

Evaluation usually begins with details of the symptoms and a focused examination for tenderness over the coccyx. X-rays or MRI may be advised selectively when the clinical findings or symptoms warrant them. Not every patient needs an MRI.

What usually helps?

Most patients improve with conservative care and lifestyle modification. Treatment may include:

  • Reducing pressure with a coccyx-relief or cut-out cushion and modifying sitting habits
  • Pain-relieving medication as advised by your doctor
  • Individualised physiotherapy and rehabilitation
  • Image-guided injections or other procedures for selected patients with persistent pain

Surgery to remove the coccyx—coccygectomy—is rarely needed and is considered only in carefully selected cases that do not improve with other treatments.

Spine Comics illustration explaining conservative care for coccydynia, including pressure relief, medication, physiotherapy and selected injections.
Most cases of coccydynia improve with conservative, non-surgical care.

Take-home message: Coccydynia does not mean automatic surgery. The right diagnosis comes from your history and examination, with selective imaging when required. Most patients improve with conservative care.

When should you seek evaluation sooner?

Arrange an early medical assessment if tailbone pain follows significant trauma or is accompanied by fever or systemic illness, a lump or swelling, unexplained weight loss, numbness, weakness or other nerve symptoms, or persistent, progressive or atypical pain.

Need a spine evaluation in Hyderabad?

Dr. Sudheer Kumar Pothu
D.Ortho, DNB (Ortho), FNB (Spine Surgery)
Consultant Orthopaedic & Spine Surgeon

Cygnet Superspeciality Clinics
Sanath Nagar, Hyderabad
Appointments: 7569970218 | 7997995500
cygnetclinics.com

This article is for general educational purposes and does not replace an individual medical consultation. Treatment recommendations require clinical evaluation.

Dr. Sudheer Kumar Pothu

Author at Cygnet Superspeciality Clinics

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