5 Things That Make Tailbone Pain Worse (and What Helps Instead)

If your tailbone pain seems to flare with certain activities and ease with others, you're picking up on real patterns — coccydynia is very sensitive to daily habits. Here are five of the most common culprits, and what to do instead.

1. Sitting on Hard, Flat Surfaces

Hard chairs, bleachers, and car seats put direct pressure right on the coccyx, especially if you tend to sit leaned back.

Instead: Use a cushion with a cutout or "U" shape at the back — not a standard donut cushion, which can actually increase pressure around the tailbone rather than relieving it. Sit slightly forward with your weight on your sit bones rather than leaning back.

2. Slouched Sitting Posture

Slumping shifts your pelvis into a position that tilts the tailbone directly into the seat, increasing pressure exactly where it hurts most.

Instead: Sit with a slight forward pelvic tilt, shoulders stacked over hips, and feet flat on the floor. A small lumbar support can help maintain this without you having to consciously hold it all day.

3. Prolonged Sitting Without Breaks

Even good posture becomes a problem if it's held for hours without movement. Tissue around the coccyx doesn't like sustained compression.

Instead: Stand or shift position every 30–45 minutes. Short walks or simply standing to work for a few minutes can meaningfully reduce flare-ups over the course of a day.

4. Constipation and Straining

Straining during bowel movements increases pressure through the pelvic floor and can directly aggravate coccyx pain, especially if the pelvic floor muscles are already tense.

Instead: Stay well hydrated, prioritize fiber, and consider a footstool to elevate your knees above your hips while on the toilet — this position reduces straining and pelvic floor tension.

5. Avoiding All Movement Out of Fear

It's a natural instinct to move as little as possible when something hurts, but staying still can allow the surrounding muscles to stiffen and guard further, prolonging the problem.

Instead: Gentle, guided movement — not necessarily targeting the tailbone directly — helps keep the pelvic floor and hips from becoming more restricted. This is exactly where a personalized physical therapy program makes the difference between "resting it" and actually healing it.

The Common Thread

Most of these factors have one thing in common: they all put pressure or tension on the pelvic floor, not just the tailbone bone itself. That's why home remedies like cushions and posture tweaks can help but rarely resolve the pain completely — the muscles around the coccyx usually need direct, hands-on treatment to fully calm down.

If you've tried the cushion, the posture fixes, and the breaks from sitting, and you're still hurting, that's a sign it's time for a proper evaluation rather than another home remedy.

Learn more about tailbone pain and coccydynia treatment at Sharp Ortho & Pelvic Physical Therapy, or call 205-515-0258 to schedule an evaluation.

Sharp Ortho & Pelvic Physical Therapy Kaye Sharp, MPT, WHC | 2481 Valleydale Rd, Hoover, AL 35244 | 205-515-0258 | sharpphysicaltherapy.com

Tailbone Pain vs. Lower Back Pain: How to Tell the Difference

"My back hurts" can mean a lot of different things — and one of the most commonly confused (and mistreated) pain patterns is tailbone pain that gets lumped in with general low back pain. They're not the same condition, and treating one like the other usually means treatment that doesn't work.

## Where the Pain Actually Is

**Tailbone pain (coccydynia)** is felt at the very base of the spine — the small, pointed bone you can feel if you press just above where your glutes meet. It's typically:

- Sharp or localized directly at the tailbone

- Worse with direct sitting pressure, especially on hard surfaces

- Aggravated by leaning back while seated

- Often painful when standing up from sitting

- Sometimes worse during bowel movements

**Lower back pain** is felt higher up, across the lumbar spine and often into the hips or buttocks. It's typically:

- Broader and less localized

- Worse with bending, lifting, or twisting

- Often accompanied by stiffness in the morning

- Sometimes radiating down one or both legs (which tailbone pain rarely does)

## Why the Distinction Matters

Lower back pain is frequently addressed with core strengthening, spinal mobility work, and general postural correction. While that approach can be part of a coccydynia treatment plan too, it misses the piece that actually resolves most tailbone pain: the pelvic floor.

The muscles and ligaments that attach to the coccyx are part of the pelvic floor, not the lumbar spine. If those muscles are tight, guarded, or imbalanced — from an old injury, childbirth, prolonged sitting, or postural habits — general back exercises won't touch the source of the pain, and can sometimes aggravate it.

## Can You Have Both at Once?

Yes, and it's fairly common. Pelvic floor tension and lumbar spine dysfunction often develop together, especially after pregnancy, prolonged sitting jobs, or a fall. This is exactly why a thorough evaluation matters — treating only the back when the tailbone is the real driver (or vice versa) leaves you stuck in a cycle of partial relief.

## How to Know Which One You're Dealing With

A few quick self-check questions:

- Does pressing directly on your tailbone reproduce the pain? → Points toward coccydynia

- Is the pain worse with bending or lifting rather than sitting? → Points toward lumbar back pain

- Does pain radiate down your leg? → More typical of lumbar spine involvement

- Is standing up from a chair the worst part of your day? → Common with coccydynia

These are starting points, not a diagnosis — an in-person evaluation is the most reliable way to know for sure.

## Getting the Right Evaluation

A pelvic floor physical therapist is trained to assess both the coccyx and the surrounding pelvic floor musculature — something general orthopedic back treatment typically doesn't include. If your "back pain" isn't responding to standard treatment, it may be worth asking whether the tailbone, not the lumbar spine, is the actual source.

*Learn more about tailbone pain and coccydynia treatment at Sharp Ortho & Pelvic Physical Therapy, or call 205-515-0258 to schedule an evaluation.*

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**Sharp Ortho & Pelvic Physical Therapy**

Kaye Sharp, MPT, WHC | 2481 Valleydale Rd, Hoover, AL 35244 | 205-515-0258 | sharpphysicaltherapy.com

Postpartum Tailbone Pain: When to Worry (and When It’s Normal)

If you had a baby and now can't sit through a meal, a car ride, or a nursing session without wincing, you're not imagining it — and you're not alone. Tailbone pain after childbirth is common, but that doesn't mean you have to just wait it out.

Why Childbirth Affects the Tailbone

During vaginal delivery, the coccyx (tailbone) has to move out of the way to make room for the baby to pass through the pelvis. In most deliveries, it flexes and returns to its normal position without lasting issue. But in some cases:

• The coccyx is bruised or strained from the pressure of delivery

• It becomes excessively mobile or shifts out of alignment

• In rarer cases, it fractures or dislocates

• The surrounding pelvic floor muscles tighten and guard in response to labor, referring pain to the tailbone even when the bone itself is fine

That last point is one people miss most often. Postpartum tailbone pain isn't always about the tailbone — it's frequently about the pelvic floor muscles that attach around it.

What's Normal in the First Few Weeks

Some tenderness and discomfort sitting during the first two to six weeks postpartum is common as tissues heal. Ice, supportive cushions, and avoiding long stretches of sitting on hard surfaces can help in this early window.

When It's Worth Getting Evaluated

Consider a pelvic floor physical therapy evaluation if:

• Tailbone pain is still significant beyond six to eight weeks postpartum

• Sitting pain is getting worse rather than better

• You notice pain radiating into the hips, low back, or with bowel movements

• Standing up from sitting is sharply painful

• You feel like something "shifted" during delivery and hasn't felt right since

These aren't signs to push through — they're signs a proper evaluation can identify what's actually going on and get you on a faster path to relief.

What a Pelvic Floor Evaluation Looks At

A thorough postpartum tailbone assessment considers the coccyx itself, but also:

• Pelvic floor muscle tone and symmetry

• Scar tissue from delivery (including perineal or C-section scarring, which can refer tension to the pelvic floor)

• Sitting posture and weight-bearing patterns

• Core and hip strength as they relate to pelvic support

Treatment is typically hands-on and gradual — manual therapy, guided breathing and relaxation work for the pelvic floor, scar mobilization when appropriate, and a return-to-activity plan that doesn't aggravate the area.

The Bottom Line

Tailbone pain after childbirth is common, but "common" doesn't mean you have to live with it for months. If it's not improving on its own, a pelvic floor physical therapy evaluation can pinpoint the cause and get you moving — and sitting — comfortably again.

Learn more about tailbone pain and coccydynia treatment at Sharp Ortho & Pelvic Physical Therapy, or call 205-515-0258 to schedule an evaluation.

Sharp Ortho & Pelvic Physical Therapy Kaye Sharp, MPT, WHC | 2481 Valleydale Rd, Hoover, AL 35244 | 205-515-0258 | sharpphysicaltherapy.com