How to Know If You Have a Bruised Tailbone, and What You Can Do About It

If you’ve ever had a tailbone injury, you know how painful it can be. The tailbone, also called the coccyx, is a triangle-shaped bone at the end of the spine. And it connects to several muscles in the pelvis for support, which means it hurts with basic activities like sitting or standing. There are ways you can help your body recover from a tailbone bruise. And ways to know if you might have a more serious injury, like a broken bone.

What is a bruised tailbone?

A bruised tailbone happens when there’s trauma to the area at the very bottom of the spine (around the buttocks). This can happen in a number of different ways, which we discuss below.

This trauma can lead to swelling, inflammation, and damage to the small blood vessels surrounding the tailbone. This causes pain that’s usually located at the bottom of the spine, around where the lower back meets the buttocks. The pain tends to worsen when you:

• Sit down

• Sit for long periods of time

• Go from sitting to standing

• Bend forward

What causes a bruised tailbone?

The most common way that people bruise their tailbones is when they fall backward into a seated position. But this can happen in other ways, too. A tailbone injury can happen with:

• Minor trauma, like sitting on an uncomfortable surface for an extended period of time or riding a water park slide

• Repetitive trauma, like riding a bike or horse

• Childbirth, especially a prolonged or difficult delivery 

How can you tell the difference between a bruised and a broken tailbone?

If you have a tailbone injury, it’s common to wonder if it’s bruised or broken. Often, a bruised tailbone is less painful than a fracture. But not always.

Severe pain can be a sign that your tailbone is fractured (broken) and not just bruised. But there isn’t any way to know for sure just based on symptoms. 

The only way to know for sure is to get an X-ray or a CT scan. These studies take a picture of the tailbone to see if there’s a fracture. A broken tailbone will usually take longer to heal than a bruised tailbone. But the treatment is essentially the same in most cases. 

How do you treat a bruised tailbone?

A bruised tailbone will eventually heal itself over time. But there are things you can do to help the recovery process:

• Avoid activities and movements that make the pain worse. But be sure to still stay active while healing. 

• Sit on a donut-shaped pillow. This keeps pressure off the tailbone, and will make sitting more comfortable.

• When sitting, alternate shifting weight from one side of the buttocks to the other. This can also alleviate pressure on the tailbone.

• Avoid sitting on hard surfaces.

• Apply ice to the affected area to reduce pain and inflammation. This will be most helpful in the first 48 hours, but it’s safe to continue using it if it helps.

• Over-the-counter (OTC) pain relievers can help a lot. These include acetaminophen, ibuprofen, or naproxen.

Some people may also benefit from physical therapy if the symptoms are not improving.

How long does it take a bruised tailbone to heal?

A bruised tailbone should heal in about 4 weeks. It might be shorter or longer, depending on the person. But you should have a steady improvement in pain over that time period as the injury heals.

When should I see a healthcare provider for a bruised tailbone?

Most bruised tailbones will heal on their own. But you should consider reaching out to your healthcare provider if you’re experiencing:

• Severe pain

• Pain that’s not improving

• Inability to walk or do daily activities because of your symptoms

• Difficulty urinating

• Difficulty passing a bowel movement, or any leaking of stool

• Numbness or weakness in your legs

These symptoms could be signs of a broken tailbone, or a different injury that’s causing your pain. In this case, your healthcare provider may recommend an X-ray or CT scan to take a closer look.

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Written by:

Michael Dreis, MD

Dr. Dreis is an emergency medicine physician currently practicing in Milwaukee, Wisconsin. He went to medical school at the University of Wisconsin – Madison and completed his residency at Henry Ford Hospital in Detroit, Michigan.

Edited by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

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