Grey memory foam coccyx seat cushion with a cut-out on a white office chair

Tailbone Pain When Sitting: Causes, Seat Cushions and What Helps

Short answer: tailbone pain, or coccydynia, is pain at the very bottom of the spine that is worst when sitting, especially leaning back on a hard surface, and at the moment you stand up. Common causes are a fall onto the buttocks, prolonged sitting on hard or narrow seats, and childbirth. Mayo Clinic and Cleveland Clinic recommend the same first steps: sit on a wedge or U-shaped cushion with a cut-out at the back, lean forward when sitting, limit sitting time, apply heat or ice, and use over-the-counter pain relief if suitable. Most cases improve within a few weeks to a few months.

What causes tailbone pain?

  • A fall or knock directly onto the tailbone, which can bruise, dislocate or, rarely, fracture it.
  • Prolonged sitting on hard or poorly shaped seats, including long drives and cycling.
  • Childbirth.
  • Body weight. Both obesity and being very thin (less natural padding) raise the risk.
  • Age-related joint changes at the tailbone.
  • It is about five times more common in women. Often no clear cause is found.

How does a coccyx cushion help?

When you sit upright or lean back, part of your weight rests on the tailbone. A coccyx cushion has a cut-out or channel at the rear, so the tailbone hangs free over the gap while your sit bones and thighs take the load. A wedge shape, higher at the back, also tips the pelvis slightly forward, which moves pressure away from the tailbone.

  • Place the cushion with the open end toward the back of the chair.
  • Choose firm, high-density memory foam or a gel and foam combination. If it flattens completely under you, it cannot offload the tailbone.
  • A non-slip base and washable cover are worth having. A carry handle makes it easy to take to the car, office or restaurant.
  • Avoid ring or "donut" cushions for tailbone pain. They are designed for other problems and can still press on the coccyx.

See the Ergonomic Memory Foam Seat Cushion and other options in our back support collection.

What else relieves tailbone pain?

  • Lean forward when sitting, with your weight on your thighs and feet flat on the floor.
  • Stand up often. Get up every 20 to 30 minutes, and alternate sitting with standing or walking.
  • Heat or ice on the tailbone area for 15 to 20 minutes, several times a day. Use whichever feels better. Ice is usually best in the first few days after a fall. See heat or ice for pain.
  • Sleep on your side with a pillow between your knees, or on your front, rather than flat on your back.
  • Avoid constipation. Straining worsens the pain. Eat plenty of fibre and drink enough water.
  • Loose clothing rather than tight jeans that press on the area.
  • Gentle stretches for the hips and pelvic floor, such as knees-to-chest and child's pose, within comfort. A pelvic floor physical therapist can help with stubborn cases.

For pain higher in the back from sitting, see lower back pain from sitting. For pain that runs down a leg, see sciatica relief at home.

How long does tailbone pain last?

A bruised tailbone typically improves over several weeks. Persistent coccydynia can take a few months. Consistent use of a cushion and avoiding long periods of sitting make the biggest difference to how quickly it settles.

When should I see a doctor about tailbone pain?

See a doctor if pain has not started to improve after a few weeks of self-care, if it is severe after a fall, or if you have fever, a lump or swelling, redness or discharge near the tailbone, which could be an infection or cyst. Seek urgent care for numbness around the groin or buttocks, leg weakness, or loss of bladder or bowel control.

Key takeaways

  • Tailbone pain is worst when sitting back and when standing up from sitting.
  • A firm cushion with a rear cut-out takes the weight off the tailbone. Donut cushions are not ideal.
  • Lean forward, stand up every 20 to 30 minutes and use heat or ice.
  • Sleep on your side and avoid constipation.
  • Most cases settle in weeks to months. Fever, a lump, discharge or numbness need medical attention.

Sources

This article is general wellness information and is not medical advice. It does not replace an examination by a qualified healthcare professional. If your pain is severe, sudden or getting worse, please see a doctor.

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