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Treatment of the tailbone

Pain at the tailbone, also known as coccydynia, is a problem that can lead to a lot of discomfort. Sitting, getting up from a chair and riding a bike become painful activities and also a visit to the toilet or sexual intercourse can become very unpleasant. In this way pain in the tailbone can lead to 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 in the video below. Although these problems aren’t rare, little is known about how to deal with them in the medical and paramedical world. The doctor, physiotherapist and manual therapist often is taugth that ‘it is there’ and often that is it. Fortunately the knowledge available about the diagnostics and treatment is growing. For now often only with specialised therapists though.


Coccydynia

The tailbone is the last part of the spine and consists of a few vertebrae. Problems often are caused by falling down or child birth and mostly present themselves as pain just behind the anus, that easiliy can de triggered by applying pressure at that specific spot. The problems often are because of 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 intestants, the lower back, the groin and the hips and even work it’s way to the functioning of the neck and feet.


Treatment

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

I have that 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 demonstration of the technique:

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


For now already some tips:


Reduce the pain during sitting

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. This small towel is easier to take with you that for example a sitting ring that is also often used (and effective). The Backjoy Core is a very comfortable sitting device that you can place into your chair and reduces the pressure on the tailbone.


Relax 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 the next. 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. You contract them by ‘holding in your urine’ or actively pulling your anus a little bit inwardly. With the relaxation you can try to ‘let the tailbone go’ completely. Also you can try to breath 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.