A broken tailbone can be very painful, especially in certain positions, such as when sitting or having a bowel movement. Treatment usually involves rehabilitation over surgery.

The tailbone, or coccyx, is a group of small bones forming the lower end of your spine. It attaches to the large gluteus maximus muscle and several other muscles and ligaments. Depending on the person, it comprises between three and five vertebrae.

The medical term for pain in the tailbone is coccydynia. It can result from a bruise, a dislocation, or a full fracture (break). A fracture to the coccyx can be very painful, especially when you sit down.

According to 2020 research, there were about 120 cases of tailbone fractures per 100,000 people in 2018. Of those, roughly 33 occurred in males and the rest in females. These injuries were most common during puberty for males ages 10 to 14 years and menopause for females ages 50 to 54 years.

Learn more about how to identify and treat a broken tailbone and what you can do to recover faster.

[the terms “male” and “female”]

In this article, we use “male and female” to refer to someone’s sex as determined by their chromosomes and “men and women” when referring to their gender (unless quoting from sources using nonspecific language).

Sex is determined by chromosomes, and gender is a social construct that can vary between time periods and cultures. Both of these aspects are acknowledged to exist on a spectrum both historically and by modern scientific consensus.

Tailbone pain is usually localized. Actions that may set off the pain include:

  • prolonged sitting
  • leaning back while seated
  • prolonged standing
  • getting up from a seated position
  • bowel movements or urination
  • sexual intercourse

Lower back pain or pain radiating to the legs may occur but isn’t common. You may feel a frequent need to defecate.

Without an imaging test, it can be difficult to distinguish between a bruised or dislocated tailbone and a fracture. That said, the more pain you feel, the more likely it is that you’ve broken your tailbone, but only a doctor’s examination and an imaging test will be able to tell you for sure.

Broken tailbone pictures

Fracture can be seen at the bottom of the sacrum.

A broken tailbone is most likely to result from injury or trauma to the area such as when falling backward on a hard surface or getting injured while cycling or playing contact sports.

While anyone can have a fall or other accident that injures the tailbone, certain factors may predispose some people to it more than others. This includes:

Generally, a broken tailbone is more common in adults than children because children’s bones are more flexible. However, injuries to the coccyx can still happen in children because of children’s level of activity in sports and play.

Your doctor will use a physical exam and X-rays to diagnose your tailbone pain to determine if there’s damage to the range of motion of your tailbone.

X-rays are done in both standing and sitting positions. Comparing the angle of the coccyx in the two positions helps your doctor determine the degree of motion.

In some cases, your doctor may do a rectal exam, in which they grasp the coccyx between the forefinger and thumb. By moving it, they can tell if there’s too much or too little mobility in the coccyx. Too much more or too much less can signal a problem.

In addition, it’s important to know if something other than a traumatic injury is causing the pain. Your doctor will feel the soft tissue around your coccyx and the lower spine (sacrum) to find out. They may be able to detect a pointy growth of new bone, known as a bone spicule, which could be the source of the pain. They’ll also look for other possible causes of the pain, such as a tumor, an ingrown hair cyst, or pelvic muscle spasms.

Broken tailbone vs. bruised tailbone

X-rays can also reveal whether the tailbone is broken or just bruised. A fracture is usually visible on an X-ray. Although the treatment may be the same, the recovery time is longer for a fracture than for a bruise. That said, because the treatment is often the same, doctors won’t usually perform an X-ray.

A broken or bruised tailbone is usually treated without surgery, but may require it in severe cases.

Surgery can involve total removal of the coccyx (coccygectomy) or removal of only one or more segments. The best outcomes occur in two instances:

  • where a person has hyper-mobility (too much freedom of motion) of the coccyx
  • where a person has spicules (sharp-pointed, new bone growth) on the coccyx

That said, nonsurgical treatments include:

Exercises for a broken tailbone

Research suggests that exercises that stretch the piriformis and iliopsoas muscles may help reduce tailbone pain.

Generally it can also help to strengthen the muscles around the coccyx. These include your stomach muscles, including the pelvic floor. Kegel exercises help strengthen the pelvic floor in both males and females assigned at birth.

Proper posture when sitting can also help. Sit with your back against the chair and avoid slouching. Keep your feet flat on the floor, using a book or other support if your legs don’t reach.

However, only your doctor or physical therapist can tell you if these or other exercises are a good idea given the degree of your injury.

Can I prevent a broken tailbone?

Accidents happen, so injuries that can cause a broken tailbone aren’t always preventable. That said, there are things you can do to reduce the chance. This includes being careful where you step, especially in higher-risk situations like walking down the stairs, playing sports, or walking outside in icy weather. When outdoors, wear proper shoes that will help you avoid unintended slips.

How do I sleep with a broken tailbone?

To lessen the pain of a broken or bruised tailbone, consider sleeping:

  • on a firm mattress
  • on your side with a pillow between your knees
  • on your back with a pillow under your knees

How long does it take for a broken tailbone to heal?

Recovery time from a bruised or broken tailbone depends on your age and the severity of the injury. It can take anywhere from a few weeks to a few months.

Will a broken tailbone heal on its own?

In many cases, a broken tailbone can heal on its own, while more severe cases may require more treatment to support healing and even surgery.

What is the fastest way to heal a broken tailbone?

Tailbone injuries take time to heal. That said, there are things you can do in the immediate aftermath to support healing. This includes avoiding sitting on hard surfaces and using heat or ice packs on the injured area.

What happens if a broken tailbone goes untreated?

If you don’t get timely medical treatment, it’s possible for your tailbone pain to become chronic, which makes it harder to treat.

A broken or bruised coccyx will usually heal on its own. Physical therapy, exercises, and a special cushion can all help ease the pain and speed recovery.

See your doctor if the pain is severe or if you have trouble with bowel movements or urination.