At the very bottom of your vertebrae is a pointy bone called the coccyx, also known as your tailbone.

When it’s bruised, just sitting down can shoot a sharp pain right up your spine. An injury can bruise your coccyx, or even fracture it if the harm to the bone is severe.

If you experience tailbone pain from a bruise or fracture, the condition is known as coccydynia.

A tailbone injury often results from a fall. Ice skaters, gymnasts, and other athletes who jump and can land hard on their backsides are all at risk. Other trauma, such as vaginal childbirth, may also lead to a bruised coccyx.

Sitting for a long time on a hard, narrow surface may also trigger tailbone pain. Cyclists who put in long hours on a bicycle seat are also at greater risk of bruising their tailbone.

Osteopenia, a bone-weakening condition more common in older adults, can make a person more like to suffer a tailbone fracture in a fall, car accident, or other event.

The most prominent symptom is pain when you put pressure on your tailbone, such as when you sit. Leaning forward often helps as it takes pressure off the area. You could experience other symptoms, such as:

A medical evaluation is necessary to determine the severity of your tailbone injury and the best course of treatment.

Your doctor will review your symptoms, examine your tailbone region, and ask you questions about any trauma to your coccyx recently. X-rays can help determine if there’s a fracture.

Whether you have a bruised or fractured tailbone, the following treatments may help you feel better:

  • Pain-relieving medications. Your doctor may prescribe a short course of painkillers. Over-the-counter medications may also be appropriate. Be sure to talk with your doctor about how often you should take a painkiller. Some antidepressant and antiepileptic medications may help some people ease their bruised tailbone pain.
  • Doughnut pillows. These seat cushions have a hole in the middle, which takes the pressure off your coccyx. A wedge or V-shaped pillow may also help.
  • Physical therapy. A physical therapist can teach you exercises that stretchthe ligaments and strengthen muscles that support the back.
  • Steroid injections. Steroids injected near the site of the injury can help reduce inflammation, pain, and swelling. A local anesthetic injected into the area may also help relieve pain.

In rare cases, a surgical procedure called a coccygectomy may be necessary. If all other treatments fail to improve symptoms, surgery to remove the coccyx may help.

While you’re healing from your injury, there are some simple steps you can take at home or work to find relief:

  • Simply leaning forward while you’re sitting can help ease the pressure on your tailbone. Along those lines, getting up and walking around more frequently will help prevent pain from prolonged sitting.
  • Wearing loose clothing that doesn’t bind or put pressure on your tailbone may help you prevent unnecessary discomfort. You should also try to avoid activities that might bring on pain, such bicycle riding.
  • If you’ve fallen or experienced some type of injury, icing your lower back may provide fast relief: Place an ice pack wrapped in a thin cloth your lower back for about 10 minutes every hour or two for the first three days after the injury. For the next few days, alternate between 10 minutes of ice and 10 minutes of heat from a heating pad every few hours. A 20-minute warm bath a few times a day may be soothing, too.
  • Gentle massage may be appropriate if your tailbone is bruised, but may not be right for a fracture. Be sure to get clear guidance from your doctor on physical therapy, massage, or ultrasound — a type of therapy that involves the use of sound waves applied directly to the injured area.
  • Constipation can sometimes result from a coccyx injury. If you’re constipated, try the following treatments:
    • Take a laxative or stool softener so bowel movements are easier.
    • Don’t strain on the toilet since it puts more pressure on your tailbone.
    • Drink fluids throughout the day to help soften your stool.
    • Get light exercise, such as walking, every day. Swimming or water exercises may be easier because there’s less pressure on your lower back.

The cause and severity of your tailbone pain will determine how long it will take for you to feel better. In general, recovery time is about 4 weeks for a bruised tailbone and about 8 to 12 weeks for a tailbone fracture.

If your pain lingers past the target date your doctor provides or you develop new symptoms, such as numbness in your back or legs, tell your doctor immediately. Tests can be done to see if any nerves were injured or if there are any other related injuries that need attention.

A bruised tailbone usually just needs time to feel better, but adjusting how you sit and using a doughnut pillow will make that recovery time a little easier. Try pain-relieving medications under your doctor’s supervision.

Also, make sure you have a time frame for when your pain should subside. If you assumed you only had a minor injury and never sought medical care but your pain is still intense after a few weeks, see a doctor. You may have a fracture without knowing it.