Coccydynia can be a very painful and debilitating condition of the coccyx. Sometimes there is no history of injury at all. It can be related to childbirth or there can be a history of a fall.


Usually all of the following need to be addressed in order to resolve the presenting coccyx pain.

  • Restricted movement in the thoracic spine
  • Restricted movement / poor alignment lumbar spine
  • Restricted movement hips and hip rotator muscles
  • Pelvic floor muscle tension

This presents like a kite shape with all edges of that shape exerting a pull on the coccyx pain at the tip. The longer part at the top is the spine, the wider part is the pelvis out to the hips and the tip at the bottom is the coccyx.


The spine and pelvis need to be evaluated and treated by a skilled physiotherapist and the pelvic floor needs to be released as part of the overall management. This may be under the care of the same or another physiotherapist depending on the training of the therapist.  Pelvic floor release will involve using the breathing techniques as well as manual therapy where it is accessible.