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Roel Wilbers

  • - Coaching
  • - Training
  • - Physio

Treatment of tailbone pain

Pain at the tailbone, also known as coccydynia, is a problem that can lead to a lot of discomfort and strong limitations in daily life.

The cause for pain in the tailbone area may vary. Often it is the fall on the buttocks, like demonstrated by my daughter in the video.

Although tailbone problems aren’t rare, in the medical world still little is known about how to treat them. The doctor, physiotherapist and manual therapist often is taugth that ‘it is there’ and often that is about it in their whole education. There is quite some knowledge available though about these problems and that they are often very well treatable.

Despite this, there are only few therapists and even fewe doctors aware of these possibilities. Even the pelvic therapist (bekkenfysiotherapeut) often isn’t able to treat these problems and the treatment in hospitals is mostly only aimed at treating the symptoms through medication with injections, that often only work temporarily.

For information and treatment, you often still need to go and look for a specialised therapist yourself. Fortunately also in the mainstream media it slowly is adressed that there is treatment possible. Through the button below you will find an article in het AD (a Dutch newspaper), which also was published in Het laatste Nieuws (Belgium newspaper) of June 2023 about taiilbone pain.

More and deeper info and explanations about tailbone pain

Do you want more and more specific info about this topic, continue reading below. On this page you’ll mainly find a lot of information and explanations, because tailbone problems are, even for people that work in healthcare, such an unknown terrain. For this reason, a lot of people unnecessaraly continue to have long periods of pain, and I see these people at a very regular basis in my practice.

With this page I like to provide a clear and wider view of what is possible for tailbone problems.

Below you will find:

  • What tailbone pain or coccygdynia is
  • What can be done about it
  • Data about the treatment effects
  • How and where to make an appointment for treatment
  • Exercises you can do yourself
  • More into depth info for collegue therapists
  • Reviews

If you have a question about where I work and if I know any therapists more close to where you live: all info about that you can find below under the paragraph ‘You are more than welcome for an appointment’.


The tailbone is the last part of the spine and consists of a few small vertebrae, that mainly move where they are attached to the sacral bone. It is probably called the tailbone because this is where our tail would be if we had one. There are quite some people though that think it is located at the level of the belt, but it is at the bottom of the pelvis, just a few centimeter behind the anus.

As mentioned, pain at the tailbone often is caused by falling down on it. Also after sitting in a not optimal position or childbirth can trigger it. Here a quick overview of the onset mentioned by the people I treated in the last period. You will see that in a lot of cases, it appeared without a clear reason.

The tailbone problems mostly presents themselves as pain locally just behind the anus. The pain mostly can easiliy can be triggered by applying direct pressure at that specific spot. Also sitting, getting up from a chair and riding a bike can be painful and also a visit to the toilet or sexual intercourse can become very unpleasant. The problems are often due to an increased or decreased mobility, and/or a disposition of the tailbone.

An altered position or functioning of the tailbone can lead to an altered functioning of the muscles of the pelvic floor, that are important for going to the toilet and the stability in the pelvic area. It can also lead to an altered function or position in the surrounding area, like the pelvic joints, the intestines, the lower back, the groin and the hips and even work its way to cause disposition or disfunction of the neck and feet.


The most used treatment methods for persistent problems of the tailbone were until not too long ago a resection through surgery, or internal correction with access via the anus by an osteopath or specialised therapist. Nowadays there are less invasive techniques available to influence the mobility and position of the tailbone which often reduce the problems quickly, even if they are present for a long period of time.

I received specialised training in treating the tailbone. As a manual therapist I am also able to effectively treat the surrounding areas that might be influenced by the problems around the tailbone.

Here a short demonstration of the technique:

Do you like to have some more info about tailbone pain? Watch my video presentation about it below.

A holistic approach

As you can read on the page about me as a physiotherapist, I approach physical problems from a broad and holistic perspective. I have a lot of trust in the natural wisdom of the body and the almost limitless recovery capacity of our system. In my view it is never the therapist or doctor that heals you, it is the body that does. We just help your system beyond factors that maintain problems or prevent recovery, if that is done nature does the rest.

Also tailbone pain I approach broader than what I learned in my training as a physiotherapist. Even though my treatment is primarily mainly mechanical and aimed at the mobility and position of the tailbone, there is always room for the psycho-emotional and energetic aspect around the problems. With every treatment and interpersonal interaction, inevitably also the psycho-emotional and spiritual/energetic layers are touched and even if a non-mechanical factor contributes most to the problems, local mechanical treatment of the tailbone can contribute to having more freedom in the entire system.

Is it also possible to see tailbone problems in a broader perspective than just a mechanical process?

From the more Eastern Philosophy and Medicine, the body has reflex points that are linked to the tailbone and from where the problems can be influenced. Here you can see examples of these points in the foot, ear and hand.

If one of these spots are more sensitive when you apply pressure on them, then it might be worth trying to massage them every now and then to see if the sensitivity reduces and it changes anything in your problems.

Also the tailbone is situated, coincidentally or not, exactly at the level of the first chakra. This root chakra is related to safety, feeling at home, allowing yourself to be worthy, grounding and connecting with ‘earthly’ matters. If you recognise that these things are a challenge for you, this might have a relationship with the origin and/or inability to recover from your tailbone problems.

The psycho-emotional link to problems

For physical problems I love to take a peek into ‘De Sleutel tot Zelf-Bevrijding’ of Christiane Beerlandt. This ‘bible’ of psycho-emotional explanations for physical problems, often provides clarity or insights about the origin of problems. For tailbone problems she indicates that they symbolise the lack of a secure basis within yourself, being separated from your intuition and strongly being focused on values coming from outside yourself (like from culture, society or religion). This has a strong overlap with what Indian wisdom connects to the first chakra. Also the author connects tailbone problems to being insufficiently rooted and living too much ‘in the head’. A fall down on the tailbone is often a sign that you got stuck in the related vicious circle and a wake up signal of life. As a solution to rebalance yourself, it is important to stop moving away from yourself, and ‘shining your own light and sun’ again so things start flowing again inside yourself. To place the authority in yourself again and becoming true to yourself and not to the external expectations or standards for success. So it is all about the process of moving towards your intuition and inner unity. I often hear from my patients that after a mechanical treatment of the tailbone, it also flows better and freer in the entire system.

What eventually causes the change is not important in the end and often hard to unravel. Of course I leave it to every individual themself how he or she wants to approach the tailbone problems. The choice for the treatment approach is always with the patient, but please know that in my treatments there is always room for talking about every desired approach.

Do you like to know more about the way I work? See the page about me as a physiotherapist.

Results of the treatment

I can imagine you are mainly curious about the treatment results and what to expect. Because there is not a lot of knowledge about the therapy yet and there are not a lot of data about tailbone pain, I decided to start to keep up statistics of my own treatments. Where I work with tailbone problems since 2018, the data here is about the finished treatments since around mid 2021.

In this period I started and finished 67 trajectories with people that suffered from tailbone pain. More than 80 percent was female. The age of the patients varies between 9 and 80 years old, where 85% was between 25 and 60 years of age when they were in treatment. Of this group of people, the great majority visited me, the tailbone pain was the primary reason they consulted me. There were just three people where tailbone pain was part of a bigger and not tailbone related problem picture, or that they were a secundary problem. The onset of the problems that people came in with I already mentioned above,

Then the results of my holistic approach. More than 80% of the people were completely problem free after treatment and in only six cases, the therapy had no effect at all. And this considering that more and more people with more complex and chronic problems come to me for consultation nowadays.

27 people didn’t finish the sessions due to circumstances (like moving to another city, being too busy at work or taking care of a sick person, no (more) coverage by the health insurance or other health problems), and it is unclear what the treatment result was. Of the people that had all the necessary treatments, nobody except the forementioned six, had a reduction of the problems lower than 50%. The people where we finished the treatment trajectory and had some rest problems, mostly knew what the reason was for that and what they could do for that themselves.

Of the over 80% that was completely problem free after therapy, this often was the case after only a few treatments. The duration of the problem before the first session was not really an indicator for that. Even people that experienced problems for over ten years, were often pain free after a few treatments. One out of four people cancelled the second session because their problem was gone (which because of intake and examination, means there had been only ten minutes of treatment time) and in more than half of the cases, the problems were fully gone in two sessions. No one needed more than eleven sessions so far. Where there was just a mechanical cause, the results were moslty quicker than where there were more underlying factors like stress, difficulty to be in the body or ground or with psychosomatic problems.

Often all it took was the tailbone correction. In other cases I also worked at the lower back, pelvis or took a psycho-emotional or more energetic approach.

Of these people only one that left the therapy problem free, returned because the problems came back. In this case it was only minor and after one treatment solved again.

For the experiences of the patients about the treatments, see below for reviews.

You are more than welcome for an appointment

If you like to make an appointment with me, the door is always open for you at the practice I work at in Amsterdam Zuid, just below the Vondelpark. The Practice for physiotherapy and manual therapy is located within the healthcentrum at the Dufaystraat 19.

More about me as a physiotherapist, as well as info about the insurance companies where we don’t have a contract with (so there will be a part of the treatment for own costs), you can find on this page.

If you have any questions or like to make an appointment, feel free to send me an email at roel@roelwilbers.nl.

I receive messages from all parts of the country and even from beyond from people that seek help for their tailbone problems. Not everyone is able to visit me in Amsterdam though.

Are you looking for a therapist more close to where you live, then you can visit this website. Here you can find therapists that just like me completed the course at Rost Therapy and should be able to apply the external correction technique. Although I personally approach the problem deeper and from a wider perspective, the techniques I learned in this course are the basis of my treatments. Make sure to check if the therapist attended the Coccygodynie course though.

Because of the many requests of people that still would like to hear my idea and advice for their problems, I started the option of online consultations. Of course I can’t treat over distance, but I can together with you clarify the current problems, analyse the problem and provide you with advise about treatment options and where specifically look for them, so you gain more clarity and overview over your problems and the therapy options.

This online consultation also is a good way to have an intake or get an idea if treatment byme would be something you want to consider. An e-consultation is coverd by healthinsurance if you have one that covers physiotherapy.

For now already some tips:

Reduce the pain during sitting

a) the pillow

There are special pillows available that reduce the pressure on the tailbone during sitting because they are made with extra space on the backside. Where this of course isn’t a solution for the problem, they do help to relieve the pain and are very useful if you have to sit a lot.

I have some at the practice where I work that you can try if you want. With treatment the problems are often quickly less or gone, so you don’t need to purchase one.

b) the towel

Where the special pillow reduces the pressure on th etailbone, a small towel often is as effective and a lot easier to take with you.

In the seated position there often is direct pressure on the tailbone. That is especially the case sitting slouched and sitting on hard surfaces. Because the pelvis is a bit different for women compared to men, women often experience more problems with this. By sitting upright the pressure often is reduced.

Further decrease of the pressure can be achieved by folding a small towel into a flat roll of around ten centimeters wide. If you place this under the sitting bones, it reduces the pressure on the tailbone. You can locate these sitting bones by sitting on your hands and moving back and forth a bit. You can feel the bony structures easily.

If you need to sit for a longer period of time, like in a car, an airplane or on a train, you can next to the towel under the buttocks, also place one in the lower back. Do this at the deepst point of the lumbar lordosis, there where the arm rests if you place it horizontally across your lower back. Be carefull not to put it too low because then you puch the pelvis forward and tilt it pelvis backwards, and that leads to sitting more slouched and more pressure on the tailbone. Relieve for the tailbone is when the bodyweight rests more of the front part of the buttocks.

Pain reduction during lying down

Lying on the back is often painful for people with tainlbone problems. This because the deep hip flexor, the psoas muscle is often tight or tensed (often due to too much sitting and/or stress), what makes the lower back more hollow. This pushes the tailbone more on the surface below and that can lead to a painfull pressure. A pillow or role underneath the knees often gives direct relive of this.

The most relaxed way is mostly on the side, if necassary with a pillow between the knees. In this position you can also try to apply a bit of stretch on the tailbone by pushing the upper leg a bit forward and aiming for stretch to occur at the tailbone (best felt when the kees and hips are both at a 90 degree angle). This is a very subtle movement and needs some practice often, but can ver very relieving.

Relaxation of the pelvic area through belly breathing

Every young child breaths towards the belly. Something we adults often have unlearned because of the stress we experience and ‘living in the head’. In both cases the breathing moves upwards in the body. Breathing low has many benefits. Next that it is our natural breath, it also quickly brings calm and balance into our system, also in the pelvic area.

There is a very simple exercise to get to belly breathing.

  • Lie down on your right side and pull the knees a bit up so you are in a stable posture.
  • Place the left hand underneath your neck so your fingertips rest on the backside on the vertebrae.
  • The right arm is now brought underneath the left arm and the right hand is placed on the backside of the armpit or the shoulder blade.
  • Bring the elbows close to the chest and let them rest on the surface below.
  • Relax your face, jaws and hands and fingers. Breathe through the nose and leave the breathing to the body and how it wants to breathe.
  • Notice that you will automatically start to breathe towards the belly. Because you actually give yourself a hug, it is less easy to expand in the chest and the breathing movement will move to a lower place. A form of breathing that matches calm and relaxation.
  • Feel if you can bring the breathing so low that the perineal area, the region between the anus and the reproductive organs, moves along. In this way you massage and relax the pelvic floor muscles.
  • With every exhale let all the tension and restlessness in you slide off, physically as well as mentally.

The more you practise this, the more the belly breathing will become normal and if it is is lost in the relaxt state for you as well, it will structurally bring more relaxation to the pelvis and pelvic floor.

Relax specifically the pelvic floor

The muscles of the pelvic floor attach directly onto the tailbone. When there is an increased tension (often also caused by a dysfunction or dysposition of the tailbone) that can lead to more discomfort because it pulls at a painful spot. The ‘bekkenfysiotherapeut’ is the specialist in training and relaxation of these muscles, but with some simple exercises often can help you already a lot.

One good exercise is this one. Sit down on the inside of your hands in a way that the fingers of both hands point towards eachother and the tips are just at the inside of the sitting bones. This helps you to ‘sit wide’. Now contract the muscles of the pelvic floor and let them relax again. Make sure you don’t tense up your whole buttocks which lifts you a bit up from the surface below, but focus on the deeper the pelvic floor muscles. This happens when you actively ‘hold in your urine’, tense your vagina (or lift your genitals for guys) and on the backside pull your anus a little bit inward. With the relaxation you can try to ‘let the tailbone go’ completely. Also you can try to breathe towards the pelvic floor to relax the area.

Stretching the deep pelvic floor muscles

The deep pelvic floor muscles, like of the anus, pull directly on the tailbone when there is a lot of tension. By stretching them you can create some relaxation of these forces.

Sit down on your hands and knees and make sure that your knees are spread apart. Also your feet are wide apart so you can sit inbetween them. The arms aim forward so it is like the child pose in yoga. Now you can stretch the deep pelvic floor muscles by (aim with the anus) moving to the left and right. You will feel yourself when there is stretch. By bringing your pelvis a bit up or down to the floor or arching or hollowing your back a bit, you can increase the stretch.

Sit on the rear end of your saddle while biking

Riding a bike often is painful with people that experience pain at their tailbone. Make sure you aren’t siting too much on the front part of your saddle (like most people do).

The more you position yourself toward the rear end, the less pressure there is on the tailbone and you use the saddle like it is meant to be used. The wide back part of the T-shaped saddle is what is supposed to support the sitting bones.


from Zorgkaart Nederland 01/12/2022

For years I wasn’t able to sit normally due to tailbone pain. After seeking help several times of my GP, I thought there was nothing left then accepting my “deviated” tailbone of to undergo a scary operation. Until I was referred to Roel. A problem he understood straight away, explained to me what he saw and it simply solved it in a completely painfree way and a minor movement. After 15 minutes I was outside again, freed of my pain by one simple and totally pain free session. A relief!

from Zorgkaart Nederland 9/2/2022

For years I had problems in my lower back and tailbone and I visited multiple physiotherapists and chiropractors for it. Roel made the right diagnose at the first appointment and after already 3 sessions the problems were gone. This was beyond all expectations. I thought I had to accept my pain but it turned out to be easily solvable. State of the art and treatments in a pleasant atmosphere.

from Zorgkaart Nederland 6/11/2021

After I fell at the iceskating track, I walked around with persistent tailbone pain for around 9 months. Through referral I ended up at Roel Wilbers. Where my GP told me there was nothing to do about tailbone pain, Roel helped me a lot within a few sessions. Already after the first treatment I had a significantly less pain at the tailbone. Also he is an extremely nice and friendly person. Tailbone pain? Don’t keep walking around with it, there are ways to treat it!

from Zorgkaart Nederland 7/5/2021

Treatment of tailbone pain. I got the tip to consult Roel for this and that’s something I am grateful for. Very professional and adequate treatment. After first a few questions about how the pain started, he figured out quickly what was wrong. And also how to directly fix it. I was impressed and felt immediate relief. The pain quickly decreased and after two days it was back to normal. Top! Kind regards, Tim

from Zorgkaart Nederland 5/5/2021

The therapists I was looking for for a long time! Not only he helped me surprisingly quick to get rid of my long lasting tailbone pain, he also gave me a broader perspective about how they occurred and why they didn’t go away. He goes beyond the just western approach and that’s what gave me a lot of insight. Thank you Roel!


from Zorgkaart Nederland 24/3/2021

Very good and knowledgeable therapist. He treated me for tailbone pain and sensed the problem and all around it very well. He listens carefully and looks beyond the just mechanical and treats it effective and adequate. Within three sessions I was problem free. I am very satisfied with Roel and can recommend him to everybody.

from Zorgkaart Nederland 01/08/2023

Had tailbone problems for over 3 years. After a long search eventually found this fantastic phtysiotherapist. After 1 treatment there was a huge difference and my daily activities were free of pain. I doubted to have a second session because I was able to do so much more already and after consulting with him, am happy I took that one. I am completely painfree, also after long distances of walking/biking or a lot of heavy lifting.  Roel wilbers is easy to get in touch woth and is able to help you quickly. Also the explanations about what he is going to do, what he noticed and what he did and that he likes to hear from you what you experienced, bring a nice flow to his treatments. My talbone was after two sessions completely aligned again!

from Zorgkaart Nederland 2/4/2020

I went to Roel with tailbone problems and pain. After the first treatment the problems already reduced significantly and the pain was gone. After the second treatment the problems were completely gone. Roel is one of the few therapists that is able to correct the tailbone from externally. Next to his quick and effective treatment, he is a nice and friendly therapist.

from Zorgkaart Nederland 29/7/2019

I ended up with Roel for my (spontaneous) tailbone pain because he specializes in this. I was very satisfied with the treatment and Roel listens very well to what you say and also to what the body communicates in the pain. The tailbone pain reduced significantly after each session. He is next to a professional and knowledgeable physiotherapist, someone that thinks with you, is empathetic and nice to communicate with; wherefore I can really recommend him.

from Zorgkaart Nederland 21/12/2018

Roel treated the problems in my tailbone very well and is next to a very good physio, also a very nice person!

from Zorgkaart Nederland 28/3/2022

After more than a year of pain in my tailbone after mainly long sitting, I visited Roel 4 months ago. Already after 1 treatment I was able to sit again and my problems disappeared for 70%! After a few (painfree) treatments with a pleasant and clear communication I am painfree now. I am very satisfied and super happy!