That sharp pain at the very base of your spine.
Tailbone pain — coccydynia — is a persistent ache or sharp pain right at the base of the spine that's often worst when sitting, getting up from a chair, or any pressure on that area. It can follow a fall, a prolonged difficult delivery, or even develop gradually without a clear cause. The good news is it almost always gets better with the right care.
Your doctor may call this coccydynia.
Often seen within a few days — sometimes as soon as tomorrowRequest your first visit
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What tailbone (coccyx) pain really is.
The coccyx — your tailbone — is the small triangular bone at the very bottom of the spine, made up of three to five fused vertebrae. It's the attachment point for several muscles and ligaments, and it bears a significant share of your body weight when you sit. When it's injured, inflamed, or hypermobile, sitting becomes genuinely painful and daily activities feel difficult in a way that's hard to explain to people who haven't experienced it.
The most common causes are a direct fall onto the tailbone, prolonged pressure during childbirth, repetitive friction from cycling or rowing, or a gradual onset without any single event. Occasionally, pain in the coccyx area is referred from another structure — the sacroiliac joint or pelvic floor — which is why a careful exam matters for getting the cause right.
The good news
Most coccyx pain resolves within a few weeks to months with conservative treatment. Persistent cases respond well to image-guided injections into the coccygeal area. Surgical removal of the coccyx exists as a last resort but is rarely needed — most people reach a comfortable baseline well before that point.
Static vs. dynamic instability
We evaluate the coccyx both at rest and during the transition from sitting to standing, because some patients have a coccyx that moves excessively (dynamic instability) while others have pain from a fixed, angulated position. Dynamic X-rays (sitting vs. standing) help distinguish these. The finding guides whether the treatment target is the coccygeal joint, the surrounding ligaments, or the nerves in the area — and whether a caudal epidural, a ganglion impar block, or a coccygeal injection is the right tool.
Common signs we treat.
Pain when sitting
A localized ache or tenderness right at the base of the spine that worsens with sitting, especially on hard surfaces, and eases when standing.
Sharp pain standing up
The transition from sitting to standing — when load shifts rapidly off the coccyx — is often the sharpest, most predictable moment of pain.
Tenderness at the tailbone
Direct pressure over the coccyx — even light pressure when sitting, or touch during examination — reproduces the familiar pain.
From hurting to healed.
We work from the least-invasive options upward, escalating only if you need it. Most patients improve well before surgery is ever discussed.
Diagnose the cause
A physician examines you and, if needed, reviews imaging to pinpoint exactly what's driving the pain.
Calm it down
Targeted physical therapy, activity guidance, and medication to settle the irritation and reduce inflammation.
Image-guided injections
If pain persists, a precisely targeted injection delivered to the source under imaging.
Advanced options
For the few who need more, minimally invasive interventional procedures — with surgery as a last resort.
Treatment is matched to your specific diagnosis at your visit. The options shown reflect NASPAC's general approach and should be confirmed against the practice's verified procedure list.
Still have questions?
The most common cause is a direct fall onto the tailbone — from slipping on ice, missing a step, or a hard landing. Prolonged, difficult vaginal delivery is another frequent cause. Less dramatically, coccyx pain can develop gradually from repetitive pressure (cyclists and rowers are more prone), prolonged sitting on hard surfaces, or even without any identifiable trigger. Occasionally it's referred pain from a nearby structure.
Acute coccyx pain from a fall or injury often improves substantially within four to eight weeks with simple measures — a coccyx cushion, activity modification, and over-the-counter anti-inflammatories. Pain that persists beyond that, or that was never improving, benefits from a proper evaluation to confirm the source and target treatment more specifically.
A donut or wedge cushion to offload the coccyx when sitting is a practical first step. Targeted physical therapy addressing the pelvic floor and surrounding muscles helps many people. For persistent cases, a physician-administered injection — either a corticosteroid injection directly at the coccygeal joint or a ganglion impar block for pain at the very tip — can provide lasting relief for months.
See a physician if the pain has been present for more than a few weeks without improvement, is severe enough to disrupt sleep or daily activity, or follows significant trauma. It's also worth ruling out other causes — including rare ones like a tumor in the presacral space — when pain is persistent, worsening, or accompanied by other symptoms.
Stop living with the tailbone pain.
Book with a board-certified pain physician near you — most patients are seen within days.
Book an appointment → Or call (855) 862-7767