Tailbone Pain Is Rarely Just About the Tailbone
Coccydynia — pain at or around the coccyx, commonly called the tailbone — is one of the more frustrating musculoskeletal conditions to navigate within the standard healthcare system. Patients with tailbone pain are frequently told that nothing can be done, that the coccyx is a vestigial structure with limited treatment options, or that the pain will resolve on its own with time. When it doesn't — and for many patients it doesn't — they are left managing a condition that significantly affects sitting, driving, using the bathroom, and in some cases sexual function and exercise.
What is almost never assessed in standard care is the pelvic floor. The coccyx is the attachment point for several pelvic floor muscles — including the levator ani, coccygeus, and the anococcygeal ligament — and pelvic floor hypertonicity is one of the most common and most consistently overlooked drivers of tailbone pain. When the muscles attached to the coccyx are in a state of chronic tension, they pull on the coccyx continuously — producing pain that feels structural but is primarily muscular in origin.
At Bray Chiropractic & Wellness in Glastonbury, tailbone pain is evaluated as a musculoskeletal problem with pelvic floor, spinal, and soft tissue contributors — not as an untreatable structural complaint.
What Is the Coccyx?
The coccyx is the terminal segment of the vertebral column — a small, triangular structure consisting of three to five fused or partially fused vertebral segments. It serves as an attachment point for several important muscles and ligaments, including the pelvic floor musculature, the gluteus maximus, and the sacrotuberous and sacrospinous ligaments.
Despite its small size, the coccyx plays a meaningful functional role. It contributes to the distribution of body weight during sitting, serves as an anchor for the pelvic floor, and is connected to the sacrum above via the sacrococcygeal joint — a joint that can be a source of pain when dysfunctional.
What Causes Tailbone Pain?
Tailbone pain can develop from a variety of causes and contributing factors:
Trauma
A fall onto a hard surface, a direct impact to the tailbone, or a difficult labor and delivery are common traumatic causes of coccydynia. Trauma can produce coccygeal fracture, dislocation, or bruising — but even after the acute injury has healed, persistent pain is common and frequently has a pelvic floor and soft tissue component that perpetuates symptoms long after the initial injury.
Pelvic floor hypertonicity
Excessive tension in the pelvic floor muscles — particularly the levator ani and coccygeus — is one of the most common drivers of persistent tailbone pain. These muscles attach directly to the coccyx, and sustained tension in them produces continuous traction force on the coccygeal segments that is experienced as tailbone pain. This is a clinical connection that is almost never assessed in standard care — and it is one of the primary reasons tailbone pain persists despite conservative management. Learn more about Pelvic Floor Dysfunction.
Sacrococcygeal joint dysfunction
The joint between the sacrum and the coccyx can become restricted, hypermobile, or inflamed — producing localized pain that is worsened by sitting and relieved by standing. Chiropractic assessment and treatment of the sacrococcygeal joint is an important component of tailbone pain care that is frequently not included in standard management.
Postpartum coccydynia
Delivery — particularly prolonged pushing, instrumental delivery, or macrosomic infants — can produce direct trauma to the coccyx. Postpartum tailbone pain is common and frequently undertreated, often attributed to delivery trauma without assessment of the pelvic floor contribution. Learn more about Postpartum Pelvic Floor Care.
Referred pain from the pelvic floor and surrounding structures
Trigger points in the pelvic floor, gluteal, and piriformis musculature can refer pain directly to the tailbone region — producing symptoms that feel as though they originate from the coccyx but are actually driven by myofascial dysfunction in the surrounding tissues. Learn more about Pelvic Pain.
Prolonged sitting
Sustained pressure on the coccyx from prolonged sitting — particularly on hard surfaces — can sensitize the coccygeal structures and contribute to ongoing pain. For patients who work at a desk, drive long distances, or cycle, modifying sitting mechanics is an important component of tailbone pain management.
Symptoms of Coccydynia
Tailbone pain typically presents as:
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Pain at the base of the spine that is clearly localized to the tailbone region
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Worsened by sitting — particularly on hard surfaces or during prolonged sitting
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Worsened by the transition from sitting to standing
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Worsened by activities that increase intra-abdominal pressure — including bowel movements, straining, and sometimes sexual activity
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Relieved by standing or walking
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Sometimes associated with referred pain into the buttock, pelvic floor, or perineum
How Tailbone Pain Is Evaluated at This Practice
Assessment of coccydynia at Bray Chiropractic & Wellness includes:
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Detailed health history — onset, mechanism, symptom behavior, prior treatment, and obstetric or trauma history
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Sacral and coccygeal orthopedic assessment — sacrococcygeal joint mobility, tenderness, and provocation testing
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Lumbar spine and SI joint assessment — evaluating contributions from adjacent structures
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External pelvic floor assessment — evaluating tone, tenderness, and trigger point activity in the pelvic floor musculature attaching to the coccyx
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Internal pelvic floor assessment when clinically appropriate and with full informed consent
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Soft tissue assessment of the gluteal and piriformis musculature
How Tailbone Pain Is Treated at This Practice
Treatment for coccydynia at Bray Chiropractic & Wellness is individualized based on assessment findings and may include:
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Chiropractic manipulation and mobilization of the sacrococcygeal joint and surrounding sacropelvic structures
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Pelvic floor manual therapy — external and internal soft tissue treatment targeting the pelvic floor muscles attaching to the coccyx
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Soft tissue therapy and orthopedic massage for gluteal and piriformis contributors
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Dry needling for pelvic floor and surrounding musculature trigger points
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Rehabilitative exercise targeting pelvic floor relaxation and sacropelvic stability
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Sitting modification guidance — cushion recommendations and postural strategies to reduce coccygeal loading
Learn more about Pelvic Floor Therapy, Chiropractic Care, and Dry Needling at this practice.
Tailbone Pain Treatment in Glastonbury, CT
Patients with tailbone pain and coccydynia in Glastonbury, South Glastonbury, Hebron, Marlborough, East Hartford, Manchester, and the surrounding Hartford County area will find a musculoskeletal and pelvic floor-integrated approach to tailbone pain care at Bray Chiropractic & Wellness that addresses the contributors most providers miss.
No referral is required. New patients can schedule directly online or by calling or texting (203) 303-4760. Bray Chiropractic & Wellness is in-network with Aetna, Anthem BCBS, Cigna (ASH), and CT Medicaid (Husky). Self-pay and HSA/FSA options are also available.