Coccyx Pain During Pregnancy: What Causes It And How To Treat It
Pregnancy comes with some unique aches and pains in the body, including back pain. Anywhere from 50%-80% of individuals experience moderate to severe low back pain during pregnancy. Though less common than back pain, coccyx pain, also known as tailbone pain, is also common during pregnancy.
Coccyx pain isn’t permanent but it can create extreme discomfort for many pregnant individuals. In this guide, we’ll cover what coccyx pain is, what causes it, and different exercises for relief.
What is Coccyx Pain (Tailbone Pain)?
Tailbone pain, also known as coccydynia or coccyx pain is a condition where pain is experienced at the base of the spine.
The coccyx is attached to the base of the spine by the various ligaments and the “levator ani” muscle, which is part of the muscle group that makes up the pelvic floor. This means that coccyx pain not only creates discomfort in the tailbone area but it can also lead to a tight pelvic floor postpartum.
Why Does Coccyx Pain Occur During Pregnancy?
During pregnancy, a person’s posture is altered. The pelvis tilts forward from the growing weight of the baby. This additional weight and change in posture can create a significant amount of pressure on the coccyx — the small triangular bone that consists of 3-5 vertebrae at the base of the spine.
Additionally, activity levels tend to change, leading some to become more sedentary which places added stress on the tailbone. Sleep positions also tend to change as pregnancy progresses which can further contribute to coccyx pain.
What Makes Coccyx Pain Worse?
Coccyx pain can develop as a result of pregnancy, but there are a number of factors that might make someone more susceptible to the condition or make the pain worse. Things that tend to make coccyx pain worse include:
Prolonged periods of sitting
Poor posture
Lifting heavy items
Bending over
Climbing stairs
Passing a bowel movement
Birth injury
How to Ease Tailbone Pain During Pregnancy
While tailbone pain during pregnancy can’t necessarily be prevented, there are a variety of ways to relieve the pain such as:
Lying down on your side to help take pressure off your tailbone
Sleeping with a pillow between your legs and one under your belly
Sitting on gel pillows or donut-shaped pillows to relieve pressure, especially if you have to sit for an extended period of time
Wearing flat, supportive shoes with a wide toe box
Alternating between applying ice and heat to your tailbone
If your doctor says it’s safe, take an OTC pain reliever such as Tylenol
With your doctor's approval, taking stool softening medication if bowel movements tend to aggravate the pain
Trying yoga and stretching exercises
Working with a pelvic floor PT
How can pelvic floor PT help tailbone pain?
Pelvic floor physical therapy treatment for coccydynia is highly effective and should be a first line defense for tailbone pain, once cleared by your medical provider. Physical therapy treatment focuses on determining the root cause of the pain you’re experiencing and designing a treatment plan to treat the underlying cause so the pain doesn’t continue or return. Pelvic floor PT treatment for coccyx pain can include:
Tailbone joint mobilization performed internally and externally
Pelvic floor soft tissue release performed internally and externally
Dry needling the pelvic floor, glutes and surrounding musculature
Lumbar spine mobilization
Hip mobilizations
Cupping and instrument assisted soft tissue release
Stabilization exercise typically include core, glute and balance work
6 Stretches for Coccyx Pain
Not only is stretching a great and gentle way to get your body moving during pregnancy, but it can be your best friend if you’re suffering from pregnancy tailbone pain.
Below are six key stretches to try on your own at home.
1. Figure 4 Stretch
Figure 4 helps stretch the muscles surrounding and in the hip, thigh, and leg. This stretch helps to relax the posterior wall of the pelvic floor as well as your piriformis, a muscle that often spasms long with the pelvic floor.
To perform this stretch follow these steps:
Start by lying on your back
Bend your knees so they’re pointed up towards the ceiling with your feet flat on the floor
Take your right leg and bend it closer to the body and fold your leg so the ankle rests across the left knee
Loop the hands around your right thigh and pull towards your body
Hold the stretch for 30 seconds to 1 minute
Repeat with the opposite leg
Perform this stretch 2-3 times on each side, 2-3 times a day
2. Single-Leg Knee Hug
If a Figure 4 Stretch is too much for you, try the single-leg knee hug. This is a bit more gentle of a stretch while still stretching the hip and pelvic floor muscles and can help relieve pressure at the tailbone. This stretch can be a great way to build up to a Figure 4 stretch if it’s too big a jump to start with.. Follow these steps:
Lie down on the back
Bend one knee and gently pull it down to your chest
Extend the opposite leg out in front of you, or if that’s uncomfortable, bend the knee and place the foot flat on the floor
Hold the stretch for 30 seconds to 1 minute, gently rocking your knee back and forth or side to side
Repeat on the other side
Perform this stretch 2-3 times on each side, 2-3 times per day
3. Kneeling Hip Flexor Stretch
Hip flexor muscles often become stiff with prolonged periods of sitting, particularly if you work at a desk job. Pregnancy then further shortens the psoas, or hip flexor muslce, due to the tilt the pelvis naturally assumes as your belly grows.
Stretching the hip flexors can also help relieve tailbone pain. To perform a kneeling hip flexor stretch, follow these steps:
Start by kneeling upright on the floor. Move one leg in front, placing the foot flat on the floor, with the knee bent at a 90-degree angle. The shin and knee of the opposite leg should be resting on the ground with toes pointed backward
Hold your chest upright and place your hands on your hips
Tuck your tailbone under your body and drive your front knee forward Hold the stretch for 30 seconds to 1 minute
Repeat on the other side
Perform this stretch 2-3 times on each side, 2-3 times per day
4. Pigeon Pose
Another common hip opening stretch in yoga is Pigeon Pose. This stretch targets the iliopsoas muscle on the straight leg and the glute muscles on the bent leg, and the lower back.
While this pose is an excellent deep stretch post for relieving tailbone pain, it can be difficult on the knees and requires quite a bit of flexibility! If you suffer from knee problems or feel too stiff to assume this position, it’s recommended to skip this stretch and supplement with the Figure 4 stretch as a modification.
To perform a Pigeon Pose stretch, follow these steps:
Start by kneeling on all fours
Bring the left knee forward and place it slightly behind and to the left of the left hand
Fold the leg down towards the ground so the left knee is by the left hand and the right ankle is flat on the floor and parallel with the right hip bone
Slide the right leg back and keep it straight
Check your alignment and square off your hips by tucking your back toe under and making sure the leg is rotated so the thigh faces down towards the floor
Gently lower your chest forward. To increase the stretch you can fold your arms on the ground and rest your head on your arms. If you’re not that flexible but still need the deep stretch, you can rest your head or chest on a yoga block or stack of blankets
Hold the stretch for 30 seconds to 1 minute
Repeat on the other side
Perform this stretch 2-3 times on each side, 2-3 times per day
5. Child’s Pose
Child’s Pose is an excellent yoga pose and stretch that helps lengthen the spine and creates space in the low back and hip muscles. This can be especially helpful for people experiencing a tight pelvic floor as a result of tailbone pain, or vice versa.
Find a comfortable place to kneel such as a padded yoga mat
Spread your knees apart in a wide fashion and sit back on the heels
Slide your arms and body forward as far as you can reach
With your head facing down, bring your forehead to the floor
To target your pelvic floor, take slow, deep, belly breaths
Hold the stretch for 30 seconds to 1 minute
6. Foam Rolling Glutes
Foam rolling is a great way to relax the external muscles that may be contributing to your pain, like your glutes and piriformis. Foam rolling is a great way to bring blood flow into your tissue and can be really helpful for pain management. To foam roll your glutes, try this:
Place the foam roller on the ground and sit down on it with your feet facing the same direction
Cross one ankle over the opposite knee, so you’re in a seated figure 4 position
Take the hand on the same side of the crossed leg and place it behind the foam roller, lean back
Gently rock back and forth rolling out the glute on the side that’s crossed over
Continue for 30 seconds to 1 minute
Repeat 2-3 times each side
FAQs
What do I do if my tailbone pain is severe?
You should contact your doctor immediately if you’re experiencing any of the following symptoms:
A sharp and sudden increase in pain or swelling in the low back
Sudden onset of tingling, numbness, or weakness in either one of both legs
Constipation lasting longer than a few days
The inability to control your bladder or bowels
When should I consider seeking treatment for tailbone pain?
Unfortunately, it’s so common for folks experiencing pain to be told by their providers to just wait until after pregnancy to seek help for their pain. If you’re experiencing tailbone pain, there is no reason to not seek help during pregnancy. Physical therapy is highly effective at treating tailbone pain during pregnancy and treating pain during pregnancy reduces the likelihood this pain continues postpartum.
Will tailbone pain improve after childbirth?
For most people, tailbone pain is specific to the pregnancy stage and subsides shortly after giving birth. However, in some instances, tailbone pain can continue postpartum as a result of trauma during delivery or a weakened pelvic floor.
This post was written by Dr. Rebecca Maidansky, PT, DPT, owner and founder of Lady Bird Physical Therapy. Rebecca is a pelvic floor physical therapist in Austin, TX and founded Lady Bird Physical Therapy in 2019. She is the creator of Birth Preparation and Postpartum Planning, Baby Steps Fitness and the head writer and editor of The Pelvic Press.
Rebecca is a passionate writer and vocal advocate for pelvic health and the importance of improving access to perinatal care. She believes strongly that many common pregnancy pains and postpartum symptoms can be eased or even prevented with basic education and care.
She created this blog to help all birthing people manage common pregnancy pains, prepare for birth and recover postpartum.