Pregnancy brings many wonderful changes, but it can also introduce unexpected discomforts. One particularly troublesome condition that affects many expectant and new mothers is coccyx pain, also known as tailbone pain. This often-overlooked aspect of pregnancy-related discomfort can significantly impact daily activities and quality of life. If you are also experiencing other discomforts, such as left side back pain during pregnancy, it may be worth exploring how posture, bone health, and pelvic changes work together to influence your symptoms.
Understanding the Coccyx and Its Role
The coccyx, commonly referred to as the tailbone, is a small triangular bone located at the very base of your spine. Consisting of three to five fused vertebrae, this seemingly insignificant structure plays several essential roles in your body's function.
Your tailbone serves as an attachment point for various ligaments, tendons, and muscles, including the levator ani muscle, which forms part of your pelvic floor. When you sit down, the coccyx helps stabilise and support your body weight, particularly when leaning back in a chair.
What Is Coccydynia?
Coccydynia is the medical term for tailbone pain. This condition affects women five times more frequently than men, making pregnant and postpartum women particularly susceptible. The pain typically manifests as discomfort at the base of the spine, near the top of the buttocks.
Common Symptoms of Coccyx Pain
Primary Symptoms
Women experiencing coccyx pain during pregnancy or after childbirth typically report several characteristic symptoms:
- Pain and tenderness at the base of the spine
- Aching sensations that may range from dull to sharp
- Increased discomfort when sitting, especially on hard surfaces
- Difficulty rising from seated positions
- Pain when bending forward
Secondary Symptoms
Additional symptoms may include:
- Discomfort during bowel movements
- Pain during intercourse
- Increased pain during menstruation
- Sleep difficulties due to discomfort
- Pain when climbing stairs
- General difficulty with daily activities
Some women may also experience visible swelling or bruising around the tailbone area, particularly if the pain results from birth trauma.
Causes of Coccyx Pain During Pregnancy
Hormonal Changes
One of the primary culprits behind pregnancy-related coccyx pain is the hormone relaxin. Your body produces this hormone to soften and loosen the ligaments in your pelvis, preparing for childbirth. While this process is essential for delivery, it can lead to increased mobility in the coccyx area, resulting in instability and pain.
Postural Adjustments
As your baby grows and your centre of gravity shifts, you naturally adjust your posture to maintain balance. Many pregnant women find themselves leaning backwards to counterbalance their expanding belly. This postural change places additional stress on the lower back and tailbone, areas that typically aren't designed to bear significant weight. Over time, such changes can lead to similar issues as those seen with bad posture and chronic back pain.
Increased Weight and Pressure
The growing baby, expanding uterus, and retained fluids add considerable weight and pressure to your pelvic region. This additional load can create direct pressure on the tailbone, particularly when sitting for extended periods or maintaining poor posture.
Direct Pressure from Baby
In later pregnancy stages, your baby's position can exert direct pressure on the tailbone. This is particularly common when the baby is in a breech position (feet or bottom first), which can cause uncomfortable pressure against the coccyx.
Lifestyle Factors
Changes in activity levels during pregnancy often lead to more sedentary behaviour, resulting in prolonged sitting periods. This increased pressure on the tailbone, combined with hormonal changes, can exacerbate pain symptoms.
Coccyx Pain After Childbirth
Birth-Related Trauma
During vaginal delivery, the coccyx is pushed backwards as your baby moves through the birth canal. This natural process can lead to various degrees of trauma, including:
- Bruising of the tailbone
- Dislocation of the coccyx joints
- In rare cases, fracture of the coccyx
- Strain on surrounding ligaments and muscles
Women who are breastfeeding may also face changes in bone density and posture that can influence healing — insights on this can be found in our guide on pregnancy, breastfeeding, and bone health.
Risk Factors for Postpartum Coccyx Pain
Several factors increase the likelihood of experiencing tailbone pain after delivery:
High-Risk Deliveries:
- Traumatic vaginal births
- Instrumental deliveries using forceps or vacuum extraction
- Prolonged pushing stages
- Delivery of a large baby
Other Contributing Factors:
- Previous tailbone injuries
- Multiple vaginal deliveries
- Complications from episiotomies
- Vaginal haematomas or significant bruising
When Coccyx Pain Typically Occurs
During Pregnancy
Coccyx pain can begin at any point during pregnancy, though it's most commonly reported during the second and third trimesters. The timing often depends on individual factors such as body size, pelvis type, and previous pregnancy history.
After Birth
Postnatally, pain frequently becomes apparent when new mothers attempt to sit for the first time after delivery. This immediate discomfort can be particularly challenging when trying to breastfeed or care for your newborn.
Duration and Recovery Timeline
Expected Recovery Period
For most women, coccyx pain resolves within several weeks following delivery. However, more severe cases involving bruising, dislocation, or fracture may require six to twelve weeks or longer for complete healing.
Factors Affecting Recovery
Several elements can influence your recovery timeline:
- Severity of the initial trauma
- Previous history of tailbone problems
- Individual healing capacity
- Adherence to treatment recommendations
- Overall physical fitness and health
Self-Care Strategies for Relief
Immediate Pain Management
Cushioning and Support:
- Use U-shaped or gel cushions when sitting
- Avoid prolonged sitting periods
- Choose softer seating surfaces when possible
Temperature Therapy:
- Apply ice packs wrapped in towels for 15-20 minutes to reduce swelling
- Use heat packs for longer periods to soothe muscle tension
- Alternate between heat and cold therapy as needed
Medication Options:
- Take paracetamol for pain relief (safe during pregnancy and breastfeeding)
- Consider ibuprofen postnatally if not breastfeeding
- Always consult your healthcare provider before taking any medication
Lifestyle Modifications
Postural Awareness:
- Maintain good sitting posture with back support
- Keep feet flat on the ground when seated
- Avoid crossing your legs
- Stand and move frequently throughout the day
Sleep Positioning:
- Sleep on your side with pillows for support
- Place a pillow between your legs for hip alignment
- Avoid sleeping on your back if it increases pain
Bowel Care
Constipation can worsen coccyx pain due to the proximity of the tailbone to the rectum. Maintain regular bowel movements by:
- Drinking plenty of water
- Eating high-fibre foods
- Taking approved stool softeners if necessary
- Avoiding straining during bowel movements
Beneficial Exercises and Stretches
Pelvic Floor Exercises
Gentle pelvic floor exercises can help relieve tension in muscles attached to the coccyx:
Basic Pelvic Floor Activation:
- Contract your pelvic floor muscles gently
- Hold for three to five seconds
- Relax for six seconds between contractions
- Repeat ten times, three to four times daily
Gentle Stretching
Pelvic Tilts:
- Lie on your back with knees bent
- Gently tilt your pelvis to flatten your lower back
- Hold for a few seconds, then relax
- Repeat ten times
Gentle Back Stretches:
- Try cat-cow stretches on hands and knees
- Perform gentle spinal movements to maintain mobility
- Focus on slow, controlled movements
When to Seek Medical Help
Contact your healthcare provider if you experience:
- Severe or worsening pain
- Pain that interferes significantly with daily activities
- Numbness or tingling in your legs
- Difficulty with bladder or bowel control
- Signs of infection, such as fever
- Pain that doesn't improve after several weeks
Professional Treatment Options
- Physical Therapy: Pelvic health physiotherapists can provide specialised treatment, including manual therapy, targeted exercises, and postural correction techniques.
- Medical Interventions: In severe cases, your doctor might recommend corticosteroid injections or other advanced pain management techniques.
Prevention Strategies
During Pregnancy
- Maintain good posture throughout the day
- Use supportive cushions when sitting
- Stay active with gentle, approved exercises
- Avoid prolonged sitting or standing
- Practice proper body mechanics when lifting
Preparing for Birth
Working with a pelvic health physiotherapist during pregnancy can help prepare your pelvic floor muscles and potentially reduce the risk of birth-related coccyx trauma.
Emotional and Practical Considerations
Coccyx pain can significantly impact your emotional well-being, particularly during the already challenging postpartum period. The discomfort may interfere with bonding activities like breastfeeding or simply holding your baby comfortably.
Remember that seeking help is important not just for physical relief but also for your overall mental health and ability to care for your family.
Long-term Outlook and Recovery
The majority of women who experience coccyx pain during pregnancy or after childbirth see significant improvement with time and appropriate management. Early intervention with proper self-care strategies and professional guidance when needed can substantially improve outcomes and prevent chronic pain development.
Conclusion
Coccyx pain in pregnant women and new mothers is a common but often undertreated condition. Understanding the symptoms, causes, and available treatments can help you manage this discomfort more effectively. With appropriate self-care measures, professional guidance when needed, and patience during the healing process, most women find significant relief from their tailbone pain.
Don't hesitate to discuss your symptoms with your healthcare provider. Effective treatment options are available, and you don't have to endure unnecessary pain during this critical time in your life.
References
- NHS - Tailbone (coccyx) pain - https://www.nhs.uk/conditions/tailbone-coccyx-pain/
- Cleveland Clinic - Tailbone Pain (Coccydynia): Causes, Symptoms & Treatment - https://my.clevelandclinic.org/health/diseases/10436-coccydynia-tailbone-pain
- Royal Berkshire NHS Foundation Trust - Coccyx pain following childbirth (postnatal) - https://www.royalberkshire.nhs.uk/media/upmlgnnc/physio-coccyx-pain-following-childbirth.pdf
- UT Southwestern Medical Center - What to do when pregnancy becomes a pain in the tailbone - https://utswmed.org/medblog/tailbone-pain-during-pregnancy/
- The Bump - How to Ease Tailbone Pain During Pregnancy - https://www.thebump.com/a/tailbone-pain-during-pregnancy
- Pronatal Fitness - When Does Tailbone Pain Start During Pregnancy? - https://pronatalfitness.com/2024/03/06/when-does-tailbone-pain-start-during-pregnancy/
