Coccydynia is defined as pain at the coccyx, and although the exact prevalence of Coccydynia is unknown, it is five times more prevalent in women than in men. Coccydynia is often quite complex, with both the external structures and internal structure all attaching directly to coccyx. This means that the pelvic floor, gluteal muscles, hamstrings, bowel function can all be playing a role.

The coccyx is the final segment of the vertebral spine, sitting below the sacrum and is a weight-bearing surface which is why the most common symptoms of coccydynia being pain with sitting.


Symptoms of Coccydynia may include:

  • Localised tenderness 

  • Pain with prolonged sitting/standing

  • Pain when rising from a seated position

  • Pain with sexual intercourse

  • Pain/dysfunction with defecation (opening the bowels)


Research shows that 90% of patients with coccyx pain will have success with conservative treatment. (Ravi 2008)

As our therapists have the ability to assess the coccyx both internally and externally. Our approach ensures a thorough assessment to address all contributing factors for Coccydynia:

  • Assessment and treatment of the pelvic girdle, hips and pelvic floor

  • Soft tissue release of the muscles surrounding the coccyx/pelvis

  • Internal pelvic floor release or rectal release when indicated

  • Modifications to sitting/standing and sit to stand posture

  • Prescription of coccyx wedge cushion

  • Exercises to help promote return to normal, pain free function

  • Advice regarding bowel function and defecation


Coccydynia Ravi Patel, Anoop Appannagari, Peter G. Whang
Curr Rev Musculoskelet Med.2008 Dec;1(3-4): 223–226.Published online 2008 May 7.doi: 10.1007/s12178-008-9028-1



  • A history of trauma e.g. a fall onto a hard surface

  • Prolonged/repeated sitting on hard, narrow, uncomfortable surfaces

  • Pregnancy

  • Vaginal birth

  • Pelvic floor muscle hypertonicty (tight/overactive pelvic floor muscles)

  • Obesity or significant increased weight gain - degenerative/arthritic changes