Are you sitting in your home office all day?  Your chair might not be as “ergonomic” as your office chair, you might not be sitting in a chair suited for you, or you might not be sitting in an office chair at all.

Sitting for too long, especially in a maladjusted chair can put your entire body out of whack.  One of the more common symptoms is pain in your tailbone. This is known as coccydynia.  With more and more people working from home, we spend more time sitting without changing positions.    The pain can be so bad that it mentally distracts you from your work.

What is the coccyx?

The coccyx is the lowest part of the spine.  It’s located inferior to the sacrum. Typically, the lower coccyx curves forward, into the pelvis. The coccyx, along with the two sit bones or ischial tuberosities, supports weight when you are sitting.  Your coccyx takes more weight when you lean backwards or partially recline, while sitting

There are muscles and ligaments that insert on the sacrum and coccyx, including the levator ani and its component parts.  These support the pelvic floor and give you voluntary control of the bowel.

What is coccydynia?

Tailbone pain is often difficult to deal with. One reason this pain is an issue is that it often goes hand in hand with pelvic girdle and sacroiliac joint pain. The tailbone forms a joint with the sacrum at the base of your spine, which becomes an attachment point for many pelvic structures. Problems stem from this joint that causes pain in the region of the coccyx. If you are putting extra stress on these joints, you are also putting more strain on the pelvic ligaments; the sacrotuberous and the sacrospinous ligaments.  These ligaments originate above this joint, and when irritated, can contribute to tailbone pain. When you are standing from a sitting, or sitting for too long, this can irritate these ligaments.

The more pressure you put on your tailbone and the longer you sit on it, the more likely you are to develop coccydynia.  It can start as a dull pain and can get more and more intense as time goes on.

Tailbone pain can be hard to treat because a direct blow to the area can lead to serious inflammation. When the tailbone and surrounding structures become inflamed, it causes a deep bruise sensation. This also causes the pelvic floor muscles to contract, which further irritates the tailbone. This muscle dysfunction often happens due to the pain, which is further irritated from certain positionings, like standing or sitting down.

So how do you alleviate coccydynia?

About 90% of cases of coccydynia get better with conservative management. (1)

The best way to prevent coccydynia while you are working is to use a chair that can lean backwards and forward.  This will allow you to move more freely and adjust the pressure and weight placed on your spine and hips. If you are using a chair seat that is stuck in one position, you can only sit, putting pressure on one area of your pelvis.  A chair seat that lets you sit forward helps to take the pressure of your coccyx.  If you’re sitting a feels one boy spot in the middle near the back, that’s your coccyx.  Now if you lean forward slightly, you should feel the pressure distributed more to 2 bony spots under your hips.  These are the ischial tuberosities, or “sit bones”.  Your chair seat should be set so that you are putting more pressure on your sit bones, rather than your coccyx.

If your chair doesn’t tilt, you can use some protection while you sit.  A wedge cushion can help by moving your body forward on your sit bones and upper thighs, taking the pressure off your tailbone.   A “Donut” cushion is another option that can distribute weight away from your coccyx.  There are many types and styles of cushions available.  If you are a do it yourself, and have some foam rubber, you can cut a wedge out of a 2-4 inch piece to make your own wedge cushion.

In order to prevent tailbone pain, get up and move around.  Simply by changing positions, you take the pressure off your coccyx and move the area around.  This also helps to loosen up the muscles, joints and ligaments, including the sacrotuberous and the sacrospinous ligaments, sacroiliac joints.

You may want to consider a sit to stand desk.  You can use a computer workstation that rises and lowers through the day, so that you can transition from standing to sitting at the workstation to avoid a sore tailbone.  You also have the option to sit if your legs and back are tired from standing.

You can also try heat or ice to help alleviate pain in your tailbone, based on your preference.

Pain in your coccyx can also be managed with manual therapy.  Working on the surrounding muscles can be helpful.  Depending on the problem with your coccyx, manipulation can be helpful.    Coccygeal manipulation can lead to a quicker recovery. (2)

Don’t forget, tailbone pain is characterized by flair ups when your tailbone is aggravated.  So, if you aren’t sitting much one day, you will probably feel much better.  But if you have a day filled with meetings the next day, you’ll most likely regress.