Coccydynia — pain at the tailbone (coccyx) — is a condition that profoundly disrupts daily life yet is frequently dismissed or left untreated. Sitting, transitioning from sitting to standing, and cycling become agonizing. Physiotherapy is the most effective evidence-based treatment.
The coccyx is the terminal segment of the vertebral column — typically 3–5 fused or partially fused vertebrae. It serves as an attachment point for the pelvic floor, gluteus maximus, and coccygeal ligaments. Injury or dysfunction here affects the entire pelvic floor and causes pain with every transition involving sitting.
Coccydynia is more common in women than men (5:1 ratio), partly due to the greater prominence of the female coccyx and the forces of childbirth. Many cases go undiagnosed for months or years while patients are told “there is nothing to do for a broken coccyx.”
Internal and external assessment and treatment of the pelvic floor muscles and ligaments attaching to the coccyx.
External coccygeal mobilization and sacrococcygeal joint manipulation — supported by strong evidence for coccydynia.
Deep tissue laser therapy reducing local inflammation and promoting healing of traumatized coccygeal tissue.
Pelvic floor and deep gluteal trigger point release to reduce the muscle tension perpetuating coccydynia.
Sitting posture, weight distribution, and cushion guidance to reduce load on the coccyx during prolonged sitting.
Comprehensive pelvic floor relaxation and coordination training — particularly important for hypertonicity-driven coccydynia.
Assessment includes a detailed pain history, sitting and standing provocation testing, lumbar and sacroiliac examination, and pelvic floor assessment. We identify whether your coccydynia is primarily structural, muscular, or a combination.
Most patients with coccydynia see significant improvement within 6–10 sessions of targeted physiotherapy. Chronic cases (>12 months) require a longer course of treatment, and postpartum coccydynia typically responds well within 8–12 sessions.