Active Physical Therapy

Buttock and Coccyx pain

Are you suffering from pain during or after sitting?

Pain in the buttocks commonly emanates from the spine, but can also stem from the sacroiliac joints and ligaments, and the muscles and bursae –fluid –filled sacs-of the hip. Most pain in the tail bone area originates in the coccyx.

Causes For Buttock and Coccyx pain

Lumbar and lower thoracic sources such as facet joist, disks, nerves and even muscles can produce pain in this area. Injuries to the lower thoracic vertebrae such as compression fractures also create pain lower down the back. The sacroiliac joint and ligaments of the pelvis can cause pain more locally-deep into the buttock, sometimes to the side of the hip and groin, and occasionally down the leg. Buttock muscles may develop tension, trigger points and tears and can rub the bursae between layers, leading to bursitis-inflammation of the bursa-in the side of the hip. The gluteus medius muscle can tighten and cause hip and buttock pain. The tail bone or coccyx can be painful long after a fall or blow, while the hip joint and associated structures such as the labrum can cause buttock pain.


Lumbar spine nerve-root irritation can radiate to your buttock, and may cause piriformis syndrome. Sacroiliac pain can cause spontaneous, severe pain in inflammatory conditions. Mechanical pain from the joint and ligaments is common and may rise from a fall, or more progressively from ligament laxity during pregnancy or often childbirth. It causes aching pain with sharp stabs, locking sensations, and a sense of instability and may interfere with walking-see hypermobility. Muscle dysfunction may also arise due to overload from sport, or from asymmetrical back, hips, or legs causing a dull ache that worsen the exercise. If hip is the source, walking or running will cause aching, stiffness and pain at night. Bursitis in the hip causes pain from pressure-lying, walking and sitting; coccydynia is painful mainly when sitting.


The main risk here is incorrect diagnosis: treatments for inflammatory and mechanical condition are quite different. Cancer from the pelvic organs can spread to the bony structure, so ruling out more serious problems is vital.

Physical Therapy for Buttock and Coccyx pain

Once your doctor has referred you, your therapist will perform a thorough assessment. Depending n the assessment your therapist may:

• Perform manual therapy such as manipulation of the coccyx, massage, and stretching of the ligaments attached to the coccyx.

• Perform electrotherapy or acupuncture.

Your therapist may advise you to:

Sit only for short periods of time and use a coccyx cushion to take the pressure off your tail bone. If you do not have a cushion, you can roll up a towel or fold a pillow.

• Apply ice packs for the first few days after the pain starts,

• Apply heat packs after the few days, several times a day.

• Take stool-softening medication and increase fiber and water intake in order to reduce the pressure on your coccyx during bowel movements

Once your pain has reduced, you may:

• Start a rehabilitation program.

You therapist may advice you to:

• Perform seated-to-seated chair squats, clams, McKenzie extensions; leg raises side-lying leg raises, one-leg circles, and supine and kneeling pelvic tilts.

You May:

• Start low-impact cardiovascular training on the cross-trainer or in the water in the form of aqua aerobics

• Perform deep breathing and relaxation exercises.

Once you are nearly pain-free you may:

• Increase the impact of cardiovascular training such as jogging or running on the treadmill, cycling and aerobics.

• Continue strengthening your hip with leg raises, side –lying leg raises and adductor gradually adding weights to your legs, such as ankle weights.

• Continue stretching your back, hip flexors and extensors with knees-to-chest stretches, McKenzie extenshions, kneeling hip flexors and hamstring flexors.

Resume sports, gradually increasing the load and duration


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One thought on “Buttock and Coccyx pain

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