Pain in the Butt…like, really, right there so close to the butt.

It’s called coccydynia, and it’s not fun.

Many people, especially women, can get pain from falling on the butt. Other things can cause this pain, like snowboard falls or horseback riding. It tends to hurt when a motion similar to a sit-up or crunch is performed, or when someone rocks on a chair.

Quite often it’s slightly off to one side, but it can be directly in the center, also.

The coccyx is the small bone at the bottom of the sacrum. If you can think about where your anus is, then the coccyx is pretty much right there, maybe a few centimeters “north” of that spot. When this bone is impacted, for example in a fall, it can be pushed forwards or sideways. This injures the ligaments that hold it in place, and this can also cause a bone bruise or swelling.

Quite often, this pain becomes chronic. We sit on our butts a lot, and this can prevent proper, timely healing. Also, if it is misplaced forward or to the side, this can make sitting painful and also can make sitting an impediment to healing.

If you have coccyx pain then consider trying chiropractic care.

What can we do? Good question.

The first step, which is the least challenging, is to adjust the sacrum. That is a large bone, is easy to adjust, and may fix the issue. There are a few different techniques and therapies we can use to get the sacrum moving properly, which may be enough to resolve the coccyx issue. On top of adjusting, we can apply traction force with our hands or with a flexion-distraction table. We can also apply manual therapy such as trigger point or active release, or cross-friction massage, to any involved ligaments or muscles. Sometimes a muscular approach will fix the coccyx.

The next step is perhaps applying a focused pressure on the ligaments that attach directly to the coccyx, and this means a thumb pressing firmly adjacent to the coccyx. This can be uncomfortable for some people, for good reason! By the time we are at this step then you will also get home therapy advice for ways to reduce the problem with your own hands. Many people can be shown a home technique that can work.

And…if that doesn’t work we will need to come up with Plan C. We will refer you to a pelvic floor physical therapist. They may need to get more, *ahem*, in depth to solve your issue.