The causes of coccydynia are multifactorial. They include:

• Falls: A bad fall can bruise, break (fracture) or dislocate your tailbone.
• Repetitive strain injuries (RSI): Sports like bicycling and rowing require you to lean back and forth. Too much of that repeated motion can strain the tissues around your tailbone.
• Pregnancy or childbirth: During the third trimester of pregnancy, your body secretes hormones that soften the area between your tailbone and sacrum. This gives your tailbone more flexibility during childbirth. It’s a natural process. But in some cases, this can stretch the muscles and ligaments around your tailbone too far, causing additional pain.
• Carrying extra weight: Extra weight places additional pressure on your tailbone.

Treatment for coccydynia aims to control pain, minimize joint damage, and improve or maintain function and quality of life. The treatment plan will depend on the cause of your coccydynia.

• Medications: Over-the-counter pain relievers and anti-inflammatory medications can help to reduce pain and swelling. In some cases, prescription medications may be necessary.
• Physical therapy: A physical therapist can teach you exercises to help improve flexibility and strength, and to reduce pain.
• Lifestyle changes: These can include regular exercise, a healthy diet, and weight loss if the person is overweight.
• Surgery: In some cases, surgery may be necessary to repair damage to the tailbone.
• Exercises to improve strength and flexibility: These can help to reduce pain and improve joint function. Specific exercises can include strengthening of the pelvic floor muscles, stretching and mobility exercises, and core stabilisation exercises.
• Advice on managing daily activities: This can include learning new ways to do everyday tasks, such as cooking or cleaning, to reduce strain on affected joints.
• Assistance with pain management: This can include learning relaxation techniques or other methods to help manage pain.

Physiotherapy is often recommended to help patients maintain mobility through exercises designed to strengthen muscles and improve flexibility. The physiotherapist may give you advice on posture, movement, exercises and stretches. They may also use manual therapy and taping to treat the local problem. Manual therapy can include mobilising the coccyx, either externally or sometimes internally via the back passage. This usually provides good relief from the symptoms.