Coccydynia (Tailbone Pain)

Common Symptoms

• Pain directly over the tailbone, worse with sitting, especially on hard surfaces
• Pain with the transition from sitting to standing
• Tenderness directly over the coccyx on exam
• Pain that can follow a fall onto the tailbone, childbirth, or develop without a clear cause

Why It Happens

Coccydynia can follow a direct fall onto the tailbone, childbirth, or repetitive strain from activities like cycling, or in some cases develops without any clear precipitating injury.

Why It Can Become Persistent

Because sitting — an unavoidable daily activity for most people — directly loads the coccyx, ongoing irritation can persist unless sitting posture and surface are specifically modified.

Who Commonly Gets It

Coccydynia is more common in women (partly related to childbirth and pelvic anatomy), and in people with a recent fall onto the tailbone or who spend long periods sitting.

How It Is Usually Diagnosed

Diagnosis is usually clinical, based on the classic location and pattern of pain; X-ray is sometimes used to rule out a fracture or assess coccyx alignment, particularly after a fall.

Traditional Treatment Options

• Cushioned or cutout seating (coccyx cushion): Offloading direct pressure on the tailbone is a foundational first step.
• Activity modification: Reducing prolonged sitting or aggravating activities like cycling during flare-ups.
• NSAIDs: Sometimes used for symptom control.
• Corticosteroid or local anesthetic injection: Can provide relief for some patients.
• Coccygectomy (surgical removal): Reserved for severe, persistent cases that don't respond to conservative treatment.

Why Someone Might Start Looking for Another Option

Coccydynia can be frustratingly persistent, and people who've tried cushioning and activity changes without full relief look for additional non-surgical options, including shockwave therapy.

Where Shockwave Therapy May Fit

Two case series — one of 23 patients, one of 14 — found meaningful pain reduction with shockwave therapy, with the larger series showing median pain scores dropping substantially and most patients no longer reporting moderate-to-severe disability by 6 months. Neither study had a comparison group, and the larger series had a notable dropout rate among people who weren't responding, which can make results look somewhat better than they'd be if everyone were counted — a real limitation worth knowing about.

How Shockwave Treatment Works for This Area

Acoustic pressure waves are applied to the area around the coccyx, generally alongside cushioned seating and activity modification.

What the Treatment Feels Like

Most patients describe a firm tapping or pressure sensation over the tailbone area, which can be quite tender given the location; your provider will discuss what to expect.

What Happens During Your First Visit

Your visit begins with a provider evaluation focused on your history and a physical exam relevant to your complaint. If shockwave therapy is determined to be clinically appropriate, your first treatment can typically be provided the same visit. See our What to Expect page for the full walkthrough.

Who May Not Be Appropriate

• Anyone who has not yet had a medical evaluation, particularly after a fall, to rule out a fracture
• Active infection, open wounds, or certain bone conditions at the treatment site
• Pregnancy, in the treatment area, unless specifically cleared by your provider

This list is not exhaustive. Your provider will screen for contraindications during your evaluation.