If radiating pain from your lower back that shoots down your leg wakes you up at night, you may have sciatica. The sciatic nerve runs from your lower back down through your hips and buttocks and branches down the back of each leg.
When irritated or compressed, the sciatic nerve can cause debilitating pain that can impact your mobility and quality of life. Many people with sciatica may also experience pain and tenderness not just on the back, but localized to the tailbone or coccyx. Understanding the connection between sciatica and tailbone pain is key to finding effective relief.
Can Sciatica Cause Tailbone Pain?
Sciatica is a common condition that affects up to 40% of adults. In general, an estimated 5%-10% of patients with low back pain have sciatica, whereas the reported lifetime prevalence of low back pain ranges from 49% to 70%.
Since the sciatic nerve passes so closely by the tailbone, patients with sciatica frequently experience pain and tenderness concentrated in their coccyx area. The tailbone pain occurs as a symptom of the overall sciatic nerve irritation.
Some specific causes of sciatica that can produce tailbone pain include:
- Herniated discs or bone spurs in the lumbar spine pinching the nerve roots, causing inflammation and pain at the point where they merge to become the sciatic nerve near the coccyx.
- Tightness or spasms of the piriformis muscle, through which the sciatic nerve passes below the tailbone on its way down the back of the leg.
- Injury or trauma directly to the tailbone area that also impacts the adjacent sciatic nerve.
- Childbirth injuries or pelvic floor dysfunction that affect the muscles, ligaments and nerves around the coccyx.
For many patients, the tailbone pain experienced with sciatica is among the most severe and debilitating aspects of the condition. Finding relief for this concentrated pain is key to effectively managing sciatica.
Can a Tailbone Injury Lead to Sciatica?
An injury or trauma directly to the tailbone can cause inflammation or compression that leads to sciatica pain radiating down the leg. The sciatic nerve sits very close to the tailbone as it exits the pelvis, so damage to the coccyx can directly impact the nerve.
A fractured, dislocated or bruised tailbone may press against, pinch or irritate the adjacent sciatic nerve. Tailbone injuries are most often caused by falls directly onto the coccyx, especially sitting down hard on a narrow surface. The abrupt trauma can fracture, dislocate or bruise the bony coccyx.
In most cases, tailbone injuries heal within a few weeks with rest, ice and anti-inflammatory medications. But if the injury is more severe, it can lead to lasting tailbone pain along with sciatica symptoms.
Signs You May Have a Tailbone Injury
The tailbone is vulnerable to injury given its position at the base of your spine. There are several signs that may indicate you have suffered a tailbone injury which include:
| Symptom | Description |
| Pain at the bottom of your spine | Pain right above the cleft of your buttocks, which is the hallmark of a tailbone injury. Can range from mild tenderness to severe, debilitating pain. |
| Discomfort while sitting | Pressure on the bruised, fractured or dislocated coccyx can cause significant pain while sitting. May need to sit leaned forward or stand frequently. |
| Pain when moving from sitting to standing | The act of sitting down or getting up from a chair can aggravate a tailbone injury. May also feel pain while jumping. |
| Swelling around the tailbone | A fractured or dislocated coccyx can cause external bruising and swelling over the injured bone. Severe internal inflammation can also occur. |
| Numbness or tingling down your legs | If a fragmented tailbone is impinging spinal nerves, may experience radiating numbness, tingling or pain down your legs, like sciatica. |
| Bowel movement pain | Tailbone injuries can make passing stools painful since the coccyx is behind the rectum. Some patients report worse pain with constipation. |
| Abnormal discharge or bleeding | A tailbone fracture penetrating the skin can cause drainage from the wound. Internal bleeding into tissues may occur with severe injuries. |
If you experience any of these symptoms after a fall or blow to your tailbone, see a doctor to assess for fracture or dislocation. Early treatment leads to the best outcome and avoids complications like sciatica.
Effective Home Remedies for Tailbone Discomfort
Whether your tailbone pain stems from a direct coccyx injury or radiates from an inflamed sciatic nerve, you can try these home remedies to find relief:
- Apply heat or ice packs to the painful area for 15-20 minutes several times per day to reduce inflammation and muscle spasms.
- Take over-the-counter analgesics like acetaminophen or NSAIDs to relieve pain and swelling around the tailbone.
- Use a specialized U-shaped cutout cushion when sitting to take pressure off the tailbone.
- Try gentle tailbone stretches and pelvic tilts to improve flexibility.
- Get a therapeutic massage to relax the muscles around the tailbone and increase blood flow.
- Avoid prolonged sitting and activities that aggravate the pain until the tailbone injury heals.
See your doctor if home remedies don’t provide improvement within 1-2 weeks. You may need medication or injections to address nerve inflammation related to an underlying back condition or tailbone fracture.
Choosing the Best Coccyx Cushion
Using a specially designed coccyx or donut pillow when sitting can help take direct pressure off your painful tailbone as it heals. Look for these features when selecting the best tailbone cushion for your needs:
- Cushion design – Donut or U-shaped cushions hold the tailbone suspended while wedge-shaped cushions tip the pelvis forward. Contoured memory foam also works.
- Seat depth – Choose a depth that relieves pressure without feeling unstable. Test cushions out.
- Firmness level – Firmer cushions tend to provide better support and pain relief. Avoid overly soft pillows.
- Materials – Gel, memory foam or hybrid cushions often outperform basic foam.
- Size – Measure the width your sitting area needs for a proper fit.
- Portability – If traveling, select a lightweight, deflatable cushion.
- Price – More expensive doesn’t always mean better quality. Focus on comfort and support.
Talk to your doctor about using a cushion and follow their recommendations for healing any actual fracture or dislocation. A properly fitted cushion can make sitting more bearable as you recover or manage chronic tailbone pain due to injury or sciatica.
Exercises to Relieve Sciatica and Tailbone Pain
Doing certain exercises can provide relief from sciatica and tailbone discomfort by stretching muscles that may be irritating the sciatic nerve. Staying active also promotes blood flow to aid healing.
Some helpful easy exercises for tailbone and sciatic nerve pain include:
| Exercise | Description |
| Knee to chest stretch | Lying on your back, bring one knee up to your chest until you feel a stretch in your lower back and buttocks. Hold for 30 seconds, relax and switch legs. |
| Figure four stretch | Cross one ankle over the opposite knee. Grasp behind the uncrossed knee and gently pull it toward your chest until you feel a stretch in your glutes and hips. Hold for 30 seconds, then switch legs. |
| Bridge pose | Lie on your back with knees bent and arms at your sides. Press down through your heels and lift your hips up off the floor. Hold for 30 seconds. Strengthens back and glutes. |
| Child’s pose | Kneel with toes together, knees hip-width apart. Lower your chest between your thighs and reach your arms forward with forehead to the floor. Hold for 1 minute. Stretches lower back. |
| Swimming | This no-impact exercise takes pressure off the spine and tailbone while stretching the muscles alongside the sciatic nerve. |
Be sure to check with your doctor before starting any new exercises if you have a pre-existing back condition. Proper form is important to avoid strain.
When Should You Consider Surgery?
Surgery for sciatica is only considered after more conservative treatments like medications, physical therapy and injections fail to provide pain relief. There are some important factors to weigh before undergoing surgery for sciatica-related tailbone pain:
- Clarify that the diagnosis of sciatica causing the tailbone pain is definitive. Get a second surgical opinion to confirm surgery is appropriate.
- Understand the potential risks and benefits of surgery versus continuing non-surgical treatment. Sciatica surgery may not relieve all back pain.
- Learn how invasive the surgery is and what the recovery process entails. You may have activity restrictions for several months post-surgery.
- Research the surgeon’s experience level with sciatica procedures. Outcomes are better with spine specialists who perform the surgery frequently.
- Consider that alternatives like chiropractic care or acupuncture may still provide relief post-surgery if pain persists. Explore these before repeat surgery.
- Discuss the circumstances where a second surgery may be warranted if the first fails to resolve your tailbone and sciatic nerve pain.
Having realistic expectations about sciatica surgery can help you make an informed decision about how to proceed with stubborn tailbone pain. Always exhaust non-surgical options first and view surgery as a last resort.
Managing Tailbone Pain for a Fuller Life
Living with chronic tailbone pain and sciatica can be exhausting and discouraging. But with the right treatment plan, you can find relief and improve your mobility and quality of life.
The key takeaway is that tailbone pain often arises in connection with sciatica, but can also occur independently after a direct coccyx injury. Understanding the source of your discomfort through medical evaluation is critical for getting proper treatment.
Conservative measures like targeted exercises, cushions, medications, stretches and rest can effectively ease many tailbone pain cases. For severe or unresponsive pain, injections or surgery may be considered.
At Kaly, we offer integrated healthcare plans that connect patients with top specialists to diagnose conditions like sciatica and tailbone injuries. Our dedicated Patient Care Team provides support through your treatment journey to reduce pain and get you back to regular activity.
Don’t let tailbone pain limit your mobility and independence. Kaly can help you access the right care providers and treatments to find lasting relief. Sign up today to learn more and take charge of your health!