Tailbone pain when sitting: What to know
The long and the short: if you have tailbone pain while sitting, seek out pelvic floor therapy to help you determine your best next steps.
What is tailbone pain or coccydynia?
Tailbone pain, also known as coccydynia, is pain that affects the region of your coccyx bone, which is at the very bottom of your spine.
Coccydynia can affect more than those who have had a direct injury to the tailbone region and can be classified as:
post-traumatic (likely secondary to an accident/injury/fall)
non-traumatic (hypermobility of the coccyx bone, structural differences, spine changes)
or idiopathic (what they call it when there is no injury and no abnormalities of the bony structure of the coccyx)
...the idiopathic kind of coccydynia is typically related to your pelvic floor muscles and something that our pelvic floor therapists are specialized in treating.
Tailbone pain symptoms
When you have coccydynia, sitting for long periods will often flare up your pain. Some folks will also feel flare-ups in pain when moving from a sitting to standing position.
The pain that is felt is often described as one or more of the following:
Dull achiness
Sharp pain
Throbbing pain
The frustrating part about tailbone/coccyx pain is that it affects your daily life pretty significantly. And whether you are having pain secondary to an injury or out of the blue, it's important to get a full pelvic floor assessment to determine what treatment options would work best for you.
Relevant anatomy
You may be wondering why, exactly, tailbone pain can be helped by pelvic floor therapy.
The coccyx is an attachment site for several ligaments and muscles. Just like your biceps is attached to your upper and lower arm bone to allow your arm to bend at the elbow, your coccyx has muscle (and ligament) attachments for your pelvic floor muscles.
There are even some big well-known muscles, like your glutes, that attach to the coccyx.
The pelvic floor ligaments and muscles around the coccyx contribute to bowel control and provide direct support for your pelvic floor.
In addition to this, the coccyx is also what we call weight-bearing, like your sit bones, especially while leaning backward.
You can check out some photos of the coccyx and the relevant anatomy in this article from the Journal of Clinical Orthopedic Trauma and the NIH.
Now, let's put the anatomy together: if the pelvic floor muscles attach to the coccyx, we know that the coccyx can be affected by the muscles being too tight or tense and also vice versa, if the muscles have too much flexibility, or laxity (like during pregnancy!)
It should be no surprise that:
If your tailbone is hurting, then prolonged sitting would increase that pain
If your pelvic floor muscles are tight/have increased tension, you may feel that pain in your tailbone
If you do not address your tailbone pain, other muscles around that region may start to take over, compensate, and then cause problems elsewhere, like back pain, hip pain, etc.
When your pelvic floor muscles are unable to function properly as supportive musculature that contracts and relaxes, bowel control may be affected.
Common causes of tailbone pain
We've already discussed that there are different types of tailbone pain based on what the root cause is, but let's talk about some of the causes of tailbone pain, or coccydynia:
Trauma or injury: e.g. falling on your bottom
Prolonged sitting on hard surfaces
Pregnancy and childbirth
Postpartum/post-delivery changes
Poor posture or spinal alignment
Degenerative joint changes or arthritis
Pelvic floor dysfunction
How pelvic floor therapy helps with tailbone pain
Pelvic therapy is a great resource for anyone who is experiencing debilitating tailbone pain (if you had a traumatic accident, please find a medical provider that will assess you for any serious injury, first).
We know that avoiding sitting and any other movements, daily activities, or sitting postures that flare your pain is not a great long term solution.
During the early stages of tailbone pain, try applying heat or ice (whichever you prefer), decrease the amount of time you spend sitting, and avoid placing too much pressure on your coccyx. Activities like biking, repetitive motions like running, and potentially deep squatting may cause your pain to increase.
If you are unable to find pain relief long term, our suggestion is to find a pelvic floor therapist.
Pelvic floor therapy will focus on determining what could be the root cause of your tailbone pain. An internal examination helps your pelvic therapist know exactly what muscles may be contributing, which directly informs treatment as well.
If during your examination your therapist finds that a specific muscle is tight/tense and unable to lengthen and relax accordingly, the treatment will focus on using manual therapy to help alleviate the muscle tightness and decrease pain, coordination work to improve the muscles ability to contract and relax while you move and breathe, and education around at-home techniques and exercises so you can maximize your time between sessions.
Literature shows that conservative pelvic therapy treatment for coccydynia, especially in the short term, has promising results for pain relief and improved function (Sidiq et al., 2025).
What we find is that once we're able to help our patients have less pain overall, both less in frequency and also less intensity, they feel more empowered to get back to daily life tasks, which allows them to move more overall.
Where to find treatment for tailbone pain and pelvic therapy in St. Pete and Tampa, FL
At Bloom Pelvic Therapy, we specialize in treating tailbone pain and pelvic pain. We have locations in Lutz, St. Pete, and South Tampa for convenient access to care.
If you are struggling with tailbone pain and subsequent pelvic floor concerns like loss of bowel control, pain with defecation, or constipation, we'd love to help you.
Get started by booking a call, submitting a contact form, or booking online today.
Next on your reading list:
How to Start Pelvic Floor Therapy: 5 Steps to Jumpstart Your Journey
Finding the Root Cause: Can Hormones Be Responsible for Your Pelvic Pain?
Literature Cited:
Sidiq, M., Ravichandran, H., Janakiraman, B., Chahal, A., Rai, R. H., Alotaibi, A. H., Alotaibi, A. H., Alotaibi, A. S., Ibrahim, A. A., Alharbi, E. A., Kashoo, F. Z., & Vats, H. (2025). Effectiveness of physical therapy interventions for coccydynia: a systematic review with a narrative synthesis. Archives of physiotherapy, 15, 77–89. https://doi.org/10.33393/aop.2025.3233
Lirette LS, Chaiban G, Tolba R, Eissa H. Coccydynia: an overview of the anatomy, etiology, and treatment of coccyx pain. Ochsner Journal. 2014 Mar 20;14(1):84-7.
Garg, B., & Ahuja, K. (2021). Coccydynia-A comprehensive review on etiology, radiological features and management options. Journal of clinical orthopaedics and trauma, 12(1), 123–129. https://doi.org/10.1016/j.jcot.2020.09.025