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A pregnant woman in her second or third trimester with pregnancy tailbone pain

How to Ease Pregnancy Tailbone Pain: Tips, Stretches & More

If you're pregnant, you should definitely be sitting down more often. But if your tailbone is killing you, that's probably the last thing you want to do. You may be struggling to drive, work, or even relax and watch TV.

Talking to a doctor about your tailbone pain is important, especially if the pain wakes you up at night or doesn't improve when you change positions. Tailbone pain can sometimes be a sign of a serious underlying issue, so you'll want to rule that out right away.

When you talk to your doctor, be sure to advocate for yourself. Doctors often assume that pregnancy pain and discomfort is "normal." The truth is that pain is never normal. Ask for a referral for pelvic floor physical therapy to make sure you get the care you need.

In the meantime, we're here to help you get instant relief from pregnancy tailbone pain. By the end of this blog post, you'll have a toolkit full of strategies to ease your pain.

What does tailbone pain feel like?

Your tailbone, also called the coccyx, is the bone at the bottom of your spine. The coccyx is a triangular bone made up of 3-5 vertebral segments that share a joint with the bottom of your sacrum.

To locate your coccyx, place a finger at the base of your spine and move it down between your glutes to find the bottom of your tailbone. (If you've reached your anus, you've gone too far.)

If you've recently injured your tailbone, pressing your finger against it can elicit pain or tenderness. But, for many people with tailbone pain, touching it directly may not hurt at all. You may feel achy pain in the region of the sacrum, coccyx, and surrounding tissues.

As a pelvic floor physical therapist who treats pregnant patients with tailbone pain, I've heard it described in all of the following ways:

  • low back pain
  • pelvic pain
  • hip pain
  • sharp pain that comes and goes
  • dull pain that gets worse at the end of the day

This pain usually gets worse if you stand or sit for a long time or lean back in your chair. Pay may also feel more sharp when you move from sitting to standing, pas a bowel movement, or have sex.

Pregnancy tailbone can develop slowly over several months. It can also start after a period of prolonged sitting (like a 6-hour flight).

Why does tailbone pain occur in pregnancy?

The tailbone usually has minimal flexibility at the joint, only moving 5-15 degrees forward or backward. However, during pregnancy, this flexibility can increase, allowing the tailbone to move more than usual. Abnormal coccyx movement is found in 69% of people with tailbone pain.

As your baby grows, the pressure in your pelvis increases. This can push your tailbone back and cause strain on the joint. As a result, it may become harder for you to sit comfortably. All these changes can translate into increased tailbone pain during pregnancy.

How do I get instant relief from pregnancy tailbone pain?

To lessen tailbone pain and swelling and help it heal, you'll need to adjust how you sit. Start with the chair or seat you sit in most often (e.g. the driver's seat in your car, your desk chair, or your couch).

Follow these steps:

  1. Sit down and allow yourself to just sink into your seat.
  2. Roll your pelvis forward so that your belly comes forward, your back arches, and your tailbone lifts off the chair. Your sit bones and the backs of your legs should remain in contact with the seat.
  3. Place a rolled towel or wedge pillow underneath your tailbone to keep it in this position. Add a small pillow or rolled towel behind your back for added lumbar support.

In this new position, some weight will still be on your tailbone, but it should be less than if you were sitting normally.

If this helps, consider buying a cushion designed for tailbone pain. "Coccyx cushions" have a space cut out to relieve pressure on the tailbone while sitting.

Some other tips:

  • Buy some coccyx pillows for your favorite seats so you don't have to bring one with you everywhere.
  • Don't have a pillow? Use your scarf, sweater, or coat to prop up your tailbone and/or support your back.
  • Prop up your tailbone even when sitting on soft seats like a couch. Sitting on a soft surface may not hurt, but it still puts too much pressure on your tailbone.

My tailbone still hurts, what else can I do?

Relaxing your pelvic floor can also help relieve your tailbone pain. When contracted, the muscles of the pelvic floor can tug at the tender tailbone. Unlike other muscles in your body, the pelvic floor muscles can stay contracted, contributing to ongoing tailbone pain. This is even more likely to happen when you've had pain in or near your pelvis.

Below are 5 exercises you can do throughout your pregnancy to encourage your pelvic floor muscles to relax. (If your doctor has put you on 'pelvic rest' or giving you other exercise warnings, talk to them before doing these moves.)

1) Inhale into your pelvic floor

  1. Start lying comfortably on your back.
  2. Inhale deeply, allowing air to fill your lower belly and flow all the way down into your pelvic floor. Allow your pelvic floor to relax and lengthen down, away from your trunk.
  3. On exhale, allow your pelvic floor to return to its resting/neutral position.

Note: While it helps to begin by lying down, you can practice this breathing technique in any position. Try to do this before bowel movements and any time you feel increased tailbone pain to reduce tension at your pelvic floor.

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2) Stretch your pelvic floor

  1. Separate your knees so that they are slightly wider than hip distance apart.
  2. Sit back onto your heels and stretch your arms out in front of you.
  3. Hold this position and breathe, feeling your abdomen expand outward as you inhale and relax toward your spine as you exhale.

3) Release your pelvic floor

  1. Reach the top arm behind you to locate your sit bones.
  2. Place your thumb or finger tips on the inside wall of your bottom sits bone, just to the side of your perineum (the space between your anal and vaginal openings).
  3. Take several deep diaphragmatic breaths as you apply firm pressure to any tender areas.

4) Keep your hips mobile

  1. Lift one foot off the floor and rest it on top of your opposite knee.
  2. Keeping your back straight, lean your trunk forward, hinging at the hip.
  3. Apply gentle pressure downwards into your bent knee for a deeper stretch.
  4. Hold this position before sitting upright and returning your foot to the floor.

5) Move your body

  1. Tuck your tailbone, pressing your lower back into the wall, removing any space between your back and the wall, and forming a "C" position.
  2. Return to your starting position.
  3. Keep your pelvis in contact with the wall as you pull your low back further away from the wall, feeling your tailbone move towards the wall with this motion.
  4. Return to your starting position and repeat these motions in both directions.

Cushioning your tailbone and relaxing your pelvic floor can significantly reduce your pain, day to day. If your pain doesn't go away or gets worse, talk to your doctor and book a visit with a pelvic floor physical therapist at Origin. We're here to help you feel good in your body throughout pregnancy, postpartum, and beyond.

Celeste Compton, PT, DPT
Dr. Celeste Compton, PT, DPT, WCS

Celestine Compton, PT, DPT is a doctor of physical therapy at Origin with a board-certified specialization in women's and pelvic health. She continues to expand her knowledge and capabilities within the field of women’s health PT to provide her patients and community with the best care, advocate for her profession on local and national levels, and support the advancement of women’s health through contributions to research, public awareness, and education. As part of the Origin team, she hopes to do her part to raise the standard of care that all women receive at every stage of life and to improve patient access to quality care so that no individual, regardless of location, race, identity, education, sexuality, or economic status is left behind.

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