Coccyx bones back view in red color with body 3D rendering illustration isolated on white with copy space. Human skeleton anatomy, medical diagram, osteology, skeletal system, science concepts.

Coccyx bones back view in red color with body 3D rendering illustration isolated on white with copy space. Human skeleton anatomy, medical diagram, osteology, skeletal system, science concepts. (Photo by 123RF)

Misalignment of the coccyx – sometimes called the tailbone – is a common but often overlooked cause of many health problems. Women and adolescent girls are more likely than men to be afflicted with coccyx-related problems, which commonly include:

-      Tailbone pain (coccydynia)

-      Pain at the anus

-      Painful bowel movements

-      Pain during intercourse

-      Back pain

Fast and Slow Causes

Coccyx misalignment can occur suddenly as a result of a slip-and-fall accident. In particular, a fall on the buttocks (a sit-down fall) will tend to drive the coccyx forward.

More gradual development of coccyx misalignment is often related to positions that maintain forward pressure on the bone. Long periods of sitting, especially with slumped posture on a hard surface, can cause coccyx problems to develop. Being overweight can speed up the appearance of these problems. Women are particularly vulnerable to coccyx misalignment during the third trimester of pregnancy, when the ligaments that stabilize the coccyx and other pelvic bones are loosened.

The Odd Nerve Bundle

One reason for the significance of coccyx misalignment is the presence of an important nerve structure right in front of the bone. This is the ganglion impar (from the Latin, meaning “odd bundle”). Internal organs within the pelvis are significantly influenced by the ganglion impar.

A number of years ago, a 12-year-old girl lost bladder control after a slip-and-fall during which her coccyx struck the ground. She was also suffering from low back pain. A series of four chiropractic visits including adjustments to correct coccygeal alignment brought relief from both symptoms.

The ganglion impar is connected to a series of nerve structures (the sympathetic chain) that help control the internal organs. One chiropractic author reported cases in which heart rate increased during bowel movements. This problem was alleviated by chiropractic adjustments to the coccyx. These patients may have been experiencing compression of the ganglion impar between the misaligned coccyx and the passing bowel movement. The resulting disturbance may have transiently traveled up the sympathetic chain to the ganglia influencing heart rate.     

The Tough Envelope

The brain and spinal cord are protected by a series of envelopes called meninges. The tough outer layer of the meninges is called the dura mater (Latin for the tough mother). A strand of connective tissue extends downward from the dura mater to fasten onto the coccyx. In other words, the coccyx is a sort of anchor for the dura mater.

This connection means that coccyx misalignment has the potential to disturb the dura mater. The tissue of the dura mater is very pain sensitive. For this reason, back pain, neck pain, and even headache can be intensified by coccyx-related disturbance of the dura mater.

Getting Help and Helping Yourself

As noted above, chiropractic adjustments can help restore coccygeal alignment. In severe cases, medical intervention can include injections to sedate pain or surgery to reposition the bone.

Prevention is best, of course. Avoiding long periods of sitting on a hard surface, especially in a slumped position is important for anyone, especially for those overweight or experiencing the third trimester of pregnancy. When sitting for long periods of time is unavoidable, use a cushion. If you already have coccydynia, a cushion with a hole in the middle (often called a “donut pillow”) can take pressure off the sensitized coccyx.

In terms of exercise, it is important to know that the gluteus maximus muscle attaches to the back of the coccyx. Therefore, toning this muscle helps prevent forward misalignment, and can help restore normal alignment. A simple exercise for this muscle is to stand with good straight posture while holding onto a kitchen counter or a sturdy piece of furniture. Maintaining good posture, bring one leg as far back as you comfortably can without bending your knee. Hold this extended position for a count of 10. Then, repeat with the other leg. When it becomes easy to do this, work up to 10 repetitions or more. Stair-climbing is another form of exercise that tones the gluteus maximus, especially if you can take the stairs two at a time. Gluteus maximus exercise can be modified for your personal situation in consultation with a Doctor of Chiropractic or a physical therapist.

A traditional yogic exercise that is helpful for the coccyx is the child’s pose. Kneel on a mat or other soft surface, with your buttocks sitting back on the heels. Place both hands on the floor, then slowly slide the arms and body forward without pulling the buttocks up from the heels. When you have gone as far forward as you comfortably can, hold the position for 20-30 seconds. This will create a good stretch, which you should feel to some extent in your tailbone area. For more details on the child’s pose and other yoga postures, see the Yoga Journal article listed below, and consult a good yoga instructor in your area.

About the Author

While serving as a medical specialist (MOS 91-B) in the U.S. Army Reserve, Dr. Masarsky earned his Doctor of Chiropractic degree from New York Chiropractic College in 1981. He is in the private practice of chiropractic in the Virginia suburbs of Washington DC with his wife and partner, Dr. Marion Todres-Masarsky. Visit his practice’s website:

Sources Consulted for This Article

Cleveland Clinic. Tailbone Pain (Coccydynia). Reviewed 8-14-2023:

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