Causes and Ideas for Reduction

Low-back pain during pregnancy is a pretty common complaint. And it’s no surprise: Your growing baby bump adds extra weight (that your back must support and shifts your center of gravity, screwing with your posture. But for some expectant birthing parents, the aches and pains also linger a little lower in the tailbone (read: in the rear).

Your tailbone, or coccyx, sits right above your butt and behind your uterus—aka, your womb. It’s also connected to your pelvic floor muscles. When you’re pregnant, this area goes through a lot of changes (more on this later), making it a hot spot for potential pain. In fact, approximately one third of pregnant people get tailbone pain, also known as coccydynia, according to UT Southwestern Medical Center. Though it usually goes away once you deliver your baby, tailbone pain after giving birth, and throughout postpartum, is possible.

Here, learn more about your tailbone and pelvic floor in pregnancy, how long tailbone pain lasts, and postpartum care tips to relieve this (literal) pain in the butt.

What causes tailbone pain after birth?

“The pelvis goes through a lot” during pregnancy and childbirth, says Christine Greves, MD, an OB/GYN at Orlando Health Women’s Institute Center of Obstetrics and Gynecology in Florida. “From the bones, to the muscles, to the vagina, to the ligaments,” all these changes can coccyx pain after birth, Dr. Greves says. Some more specific examples include:

Looser ligaments

In the third trimester, your body releases hormones that soften the spot between your tailbone and sacrum—the part of your pelvis above your tailbone, according to the Cleveland Clinic. This makes the tailbone more flexible so it can move (to give your baby room to grow and enough space to pass through during birth). Problem is, the muscles and ligaments around your tailbone may grow a little too loose, Dr. Greves says. When this happens, they can no longer properly support the tailbone, which may cause muscle tension and pain.

Tight pelvic floor

To compensate for loose pelvic ligaments, your pelvic floor muscles—the basket of muscles that sit at the bottom of your pelvis—can contract to stabilize your body, according to UT Southwestern Medical Center. Thing is, your pelvic floor muscles are also connected to your tailbone, so if they become tight, it can cause pain in this area.

Extra weight

During a healthy pregnancy, you gain weight as your baby grows. But these extra pounds can put pressure on your tailbone and make it lean backwards, according to the Cleveland Clinic. Plus, your bigger belly alters your center of balance and shifts your posture, which can both add strain on the tailbone, per UT Southwestern Medical Center.

Tailbone injury during birth

While uncommon, it is possible to have a bruised or broken tailbone after birth, from the delivery itself. Pressure on your tailbone during birth (from the baby passing through the birth canal) is typically the cause.

Other causes of pregnancy and postpartum tailbone pain can include the following, according to the Cleveland Clinic and UT Southwestern Medical Center:

• Prolonged sitting: With swollen feet and ankles, you may find yourself taking a load off a lot more during pregnancy, especially towards the end. But sitting for long stretches can put excess pressure on your tailbone.
• Constipation: Thanks to pregnancy (and postpartum) hormones, you might be a bit backed up in the bathroom department. Unfortunately, constipation can play a part in tailbone pain.
• Not getting enough exercise: Pregnancy fatigue is real, and it might be tough to muster the energy to exercise like you usually do. But lack of physical activity can contribute to tailbone pain.

Can tailbone pain happen after a C-section, too?

“Anything is possible,” Dr. Greves says. Even if you end up having a cesarean, you still have some of the same risk factors for tailbone pain post birth:

• Your body still releases the same ligament-loosening hormones to prepare your pelvis for a growing baby and a vaginal birth. Your ligaments can stretch too far —and strain your tailbone—even if your little one doesn’t make an exit through your birth canal.
• Weight gain during pregnancy still puts you at a higher risk for prenatal and postpartum tailbone pain regardless of how you deliver your baby.

On top of this, many people push for a long time before they have a C-section, which can add extra strain on the tailbone and produce pain, Dr. Greves says.

Who’s at risk for tailbone pain after birth?

While pregnancy and postpartum tailbone pain is pretty common, some birthing people are more likely to feel it after birth. Here are a few risk factors, per Dr. Greves:

• A larger baby: Depending on your body (read: the size and shape of your pelvis), it might be more difficult to deliver a bigger baby vaginally. And this can put more pressure on your tailbone. Plus, a larger little one may mean you’re carrying more weight. As we know, extra weight can contribute to coccyx pain.
• Prolonged labor: If the baby’s head puts pressure on your tailbone for a long period of time, you’re more prone to get butt pain after delivery.
• Your baby is “sunny-side up:” This means your baby is positioned head-down in the pelvis but facing up (rather than face-down, which is a more ideal birthing position). When this happens, your baby’s occipital bone (part of the skull) presses against your spine and tailbone, which can produce pressure and pain there.

Other symptoms of tailbone pain after birth

The most common symptom of coccydynia is a dull/achy (or sometimes, sharp/piercing) pain in your tailbone. But there are other signs, too. These include the following, per the Cleveland Clinic:

• Tailbone pain that worsens when you go from sitting to standing
• Pain when you poop
• Pain during sex

Ongoing tailbone pain that’s worse after birth can also come with symptoms like:

• Back pain
• Sciatica
• Sleep disorders
• Depression
• Anxiety

How to tell tailbone pain from typical postpartum pain

Pregnancy and birth put your body through a lot. That means, you can expect some aches and pains in the postpartum period whether you delivered vaginally or by C-section. Sometimes, early postpartum pangs can even overlap with tailbone pain (for example, discomfort when you poop or during sex). So how can you tell the difference between the two? Location of the primary pain is key, Dr. Greves says. Tailbone pain happens in (and originates from) the bottom of your spine near your butt where you sit, she says.

On the other hand, pain from:

• A C-section usually happens in your abdomen around your incision site
• A vaginal birth usually happens in the vaginal or perineal area (the spot between your vagina and anus)

How long does postpartum tailbone pain last?

Luckily, not long in most cases. For many people, tailbone pain typically resolves quickly after birth, according to UT Southwestern Medical Center. Still, this can range anywhere from a few days to a few weeks depending on the degree of your issue. If you have a serious injury (say, a dislocation or fracture) the healing process can take longer.

For others, tailbone pain can become a more chronic condition. This happens when loose ligaments or trauma to the tailbone continue to cause instability in the area and persistent pain, per UT Southwestern Medical Center.

How to heal tailbone pain after birth

After nine months of physical and hormonal changes and giving birth, your body will need time to recover from tailbone pain. The good news is 90 percent of people with tailbone pain feel better with home remedies, according to the Cleveland Clinic.

Hear are a few tips to cope with coccydynia, per the Cleveland Clinic and the Mayo Clinic:

• Take NSAIDs (nonsteroidal anti-inflammatory drugs) to reduce pain and swelling.
• Lean forward while sitting down.
• Sit on a donut pillow or wedge-shaped gel cushion to take pressure off your tailbone.
• Take a hot bath to relax your muscles and ease pain.
• Apply hot or cold packs to your lower back for about 20 to 30 minutes, several times a day.
• Take stool softeners if you have pain when you poop.

If home remedies aren’t cutting it, and your tailbone pain persists, your provider might recommend one of the following treatments, per the Cleveland Clinic:

• Coccygeal nerve block: An injection of numbing medications and steroids to relieve pain and inflammation.
• Massage therapy: which usually only provides temporary relief.
• Physical therapy: to stretch your muscles and improve your posture. A physical therapist can even provide you with tailbone-pain-after-birth exercises to try at home.
• Acupuncture
• TENS (transcutaneous electrical nerve stimulation): A small device that uses low-voltage electrical currents to relieve pain.
• Surgery: to remove part of or the whole tailbone (only in rare cases).

When to see a doctor about postpartum tailbone pain

Ultimately, you may still be wondering, “Is tailbone pain normal after birth?” In some cases, yes, and while unpleasant, it typically resolves on its own within a few weeks after birth. That said, if your pain doesn’t improve, affects your quality of life, and/or isn’t managed with home remedies, reach out to your doctor, Dr. Greves says. You could be dealing with chronic coccydynia.

Your doctor will also check for other conditions and make sure you don’t have more serious problems like tailbone fracture, joint issues, or in rare cases, a tumor, per the Mayo Clinic.

FAQ

What are the best exercises for tailbone pain?

Postpartum tailbone pain is often tied to tight muscles. When your pelvic ligaments loosen during pregnancy (to make space for your baby to grow), certain muscles in this region—like your pelvic floor—contract to better stabilize your body. But if they become too tight, you can feel pain.

Stretching can help reduce this muscle tension and coccyx pain. Dr. Greves recommends trying this simple stretch to lengthen the pelvic muscles and ligaments. You can do it in bed (think: before you start your day or before going to bed at night). Here’s how:

• Lie down with your legs extended.
• Hug one leg to your chest and breathe deeply.
• Switch legs and repeat.

If this doesn’t help, you should consider seeing a physical therapist. They can teach you other pelvic floor relaxation techniques (including stretches and breathing exercises) to temper your tailbone pain. They can also offer postpartum workout suggestions that won’t aggravate your tailbone.

How do I know if my tailbone pain is serious?

Most times, tailbone pain is temporary and nothing to worry about. But if tailbone pain is severe and accompanied by other symptoms, you might be dealing with a more serious health issue. See your doctor right away if you have the following symptoms, per the Cleveland Clinic:

• Tailbone pain that doesn’t go away.
• Pain in other areas of your body (like your hips or lower back).
• A fever of 103 degrees Fahrenheit (39.4 degrees Celsius) or higher.

How is tailbone pain or fracture diagnosed?

First, your doctor will review your symptoms and your medical history to see if you’ve had any prior injuries or trauma to your tailbone. They’ll also want to take a better look at your tailbone area to determine whether you have any inflammation, abscesses (pockets of infection), lumps, tumors, or fractures. To figure out what’s going on, they may recommend tests like the following, per the Cleveland Clinic:

For a suspected fracture:

• X-ray: A quick, noninvasive test that uses radiation to create an image of your tailbone.
• CT scan: A painless, noninvasive test that uses a series of X-rays to create detailed images of your bones and soft tissues.

For inflammation, abscesses, or tumors:

• MRI: A painless test that produces detailed images of the organs and structures inside your body by using a large magnet, radio waves, and a computer.
• Bone scan: A painless nuclear medicine test that checks your bones for issues or changes.