Ever wondered about why you still have a “tailbone” but cannot wag it? Once you learn the importance of this small yet mighty bone you will no longer take it for granted.

Your tailbone, known as the coccyx, is the small triangle shaped bone at the base of your spinal column that connects to the sacrum. It is typically made up of three to five vertebrae that may eventually “fuse” or “semi-fuse” together by about age 30. Though the coccyx is often stated as a “vestigial” bone (remnants of what would have been our tail), this bone continues to serve important functions:

1. Sitting: When we are sitting, the tailbone along with our sitting bones (ischial tuberosities) provide support so that we can bear weight through our natural cushion. 
2. Site of muscle and ligament attachment: Some muscles of the pelvic floor (levator ani and coccygeus) as well as the gluteus maximus attach onto the coccyx. Also, many ligaments, including the anococcygeal ligament that helps keep our anal sphincter muscle in place attaches onto the cooccyx. Our tailbones serve as an important anchoring point for many muscles and ligaments.  
3. Anchor of the spinal cord: Our spinal cord runs from the bottom of the brain stem, travels down the spine then ends at the lower back in an area called the conus medullaris. At this end of this conus medullaris is a fibrous band called the filum terminale that anchors the spinal cord and dura mater onto, you guessed it, the coccyx. 
4. Pelvic floor function: As previously mentioned, muscles of the pelvic floor attach onto the coccyx. These muscles serve an important role in bowel, bladder, and sexual function. Additionally, these muscles create a sling from front (pubic bone) to back (tailbone) to support our organs and the pressure of our abdomen through our pelvis. 

So now that you know the functions of the tailbone, it is also important to know when and how the coccyx can lead to dysfunction.

1. Pain at the tailbone: Localized pain around the coccyx is a condition known as coccydynia. This type of tailbone pain can come on because of trauma (fall, childbirth, etc) or for unknown reasons. This pain can be constant or increased with sitting, bending over, while having a bowel movement, or even during sexual activity. 
2. Pelvic floor muscle tension: The tailbone pulls tension on the pelvic floor muscles that attach to it. If there is too much tension between the tailbone and these muscles, this can lead to issues with bowel, bladder, or sexual function. 
3. Diffuse pain in other regions of the body: Some people with coccyx dysfunction may also have back pain, shooting pain in the legs or upper body, pain into the buttocks and hips or even neck pain. Since the coccyx has connections to the nervous system (see above), the tailbone can sometimes be the culprit of this type of radiating pain throughout multiple regions of the body. 

Luckily, there are many strategies in managing the dysfunctions of the tailbone – and physical therapy can help! 

1. 1. Adjust sitting positions: Improving posture, altering sitting supports or using coccygeal cushions can help to improve the load through the pelvis and tailbone to decrease pain.
   2. Pain management strategies: Reducing tailbone pain can help you get through your everyday activities. Self-care strategies for pain may include avoiding prolonged positions, use of heat or ice, and/or topical or over-the-counter medications. 

• Manual Therapy: Manual treatment performed by a trained professional can help to identify and treat the dysfunction from the coccyx. This type of treatment can involve soft tissue release, as well as joint mobilization. 

• Therapeutic Exercise: A physical therapist can help guide you in exercises to train your pelvic floor, trunk, and hip muscles to help address any pain or dysfunction.  

There are several anatomical variations of the shape and size of the coccyx though sometimes the position can be dysfunctional. If you suspect you might be suffering from a tailbone issue or that your tailbone is in a dysfunctional position, contact us at Beacon Physical Therapy for evaluation and treatment. 

At Beacon Physical Therapy, we support our patients in leading a healthy life and establishing a healthy lifestyle. We’d love to meet you and get you back to doing what you love.