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Tailbone pain after birth

Tailbone pain after birth could be caused by loose ligaments from your pregnancy, or an injury that happened during delivery. You're more likely to have a bruised or broken tailbone if you had an instrumental delivery, or your baby was in the face-up position. Most tailbone injuries can be treated at home with ice and over-the-counter pain relievers. If the pain doesn't improve in a few weeks, you might need corticosteroid injections or a nerve block.

Postpartum woman with back pain in bed
Photo credit: iStock.com / PixelsEffect

What causes tailbone pain after birth?

A sore tailbone after birth could be caused by loose ligaments from your pregnancy, or an injury during delivery. You might hear your doctor use the term coccydynia to describe pain in your tailbone.

The tailbone (or coccyx) is a small triangular bone that sits at the base of your spine, right at the top of your butt. It's made up of the last three to five vertebrae of your spinal column, and it's attached to the base of your spine by fibrous cords called ligaments. Your tailbone helps to stabilize you when you sit.

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During pregnancy, your body releases the hormone relaxin to loosen up your pelvic ligaments and give your baby room to get down the birth canal during childbirth. Looser ligaments can cause tighter pelvic floor muscles.

Because the pelvic floor muscles are attached to your tailbone, that's where you might feel the pain. The weight of your growing baby puts added pressure on your tailbone.

Tailbone pain should improve after you deliver. But if you have a bruised or broken tailbone, the pain could last for a few weeks after your baby's birth.

How does the tailbone get injured during childbirth?

Hormones released during your third trimester make your tailbone more flexible so it can move around and give your baby room to pass through. Ligaments that are attached to your tailbone also become more flexible toward the end of your pregnancy. Looser ligaments can more easily get twisted (sprained) or stretched (strained) during delivery.

The pressure of your baby's head passing through the birth canal can cause a bruised tailbone. It might even lead to a dislocated (pushed out of position), or broken tailbone. Fractures aren't common, but some women hear a crack or pop when their tailbone breaks during delivery.

You're more likely to injure your tailbone in labor if your baby is very large or in the posterior position. Tailbone pain after birth is also more likely if your doctor used a vacuum or forceps during the delivery.

What are the signs of a bruised or broken tailbone?

Some common symptoms of a tailbone injury include:

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  • Aching or tenderness in your lower back
  • Pain that gets worse when you stand up, stand or sit for a long period of time, or strain during a bowel movement
  • Pain during sex
  • Significant discomfort that leads to trouble sleeping

Tailbone pain after birth can be a problem because it gets in the way of being a new mom. It's harder to focus on your baby when your lower back aches or it hurts every time you stand up.

Your doctor can do a physical exam to find the source of your pain. Depending on the injury, the doctor might send you for an X-ray or CT scan to make the diagnosis before recommending a treatment.

How to heal a bruised or broken tailbone

If you're wondering what to do for a bruised tailbone, know that most of these injuries heal on their own. However, there are some things you can try. 

  • Holding an ice pack on the sore area for 20 to 30 minutes at a time a couple of times a day and taking a nonsteroidal anti-inflammatory drug (NSAID) like ibuprofen can help to reduce swelling and pain.
  • A warm sitz bath may also provide some relief by relaxing your pelvic floor muscles.
  • While the injury heals, sitting on a donut-shaped cushion may be more comfortable. Some women use a special wedge-shaped cushion that causes them to lean forward slightly. The cushion has an area cut out of the back to take pressure off the coccyx.
  • Sleeping on your belly or side instead of your back will take pressure off your tailbone.
  • Stretching exercises are sometimes helpful. A physical therapist can show you how to do them correctly, so you don't aggravate the injury.
  • Constipation can be especially painful if you have a bruised tailbone. Drinking extra fluids, eating plenty of fiber, and using a stool softener, if you need one, can make bowel movements more comfortable.
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How long does it take a bruised or broken tailbone to heal?

A bruised tailbone should heal on its own within about four weeks. A broken tailbone can take up to eight weeks to heal, although pain from muscle tension or inflammation in the surrounding ligaments can last longer.

Avoiding any physical activity that causes you pain and following your doctor's instructions will help you heal. If you're still in a lot of pain after a few weeks, check in with your doctor.

Some people need extra relief from corticosteroid injections or a nerve block. Surgery can be done to remove part or all of the coccyx, but only after several months have passed without other treatments helping. Surgery doesn't always work, and it carries a risk of complications.

Will a tailbone injury affect future pregnancies?

It's a good idea to make sure the injury has fully healed before you get pregnant again. Some treatments for a bruised tailbone may not be safe once you're pregnant.

Just because you had a tailbone injury with one delivery doesn't necessarily mean you'll have one with your next. But if you do become pregnant again, let your doctor know that you had a bruised or broken tailbone during a past delivery, so they can help you plan for delivery. Together, you can discuss the pros and cons of trying a vaginal birth or opting for a c-section this time around.

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If you delivered a very big baby the last time and this one seems a lot smaller, you may decide to go for a vaginal delivery. Trying different delivery positions may help you avoid reinjuring the area, although there's no guarantee that it won't happen again.

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Cleveland Clinic. 2020. Coccydynia (tailbone pain). https://my.clevelandclinic.org/health/diseases/10436-coccydynia-tailbone-pain#symptoms-and-causes [Accessed February 2022]

Cooper G, et al. 2003. Poster 56: Fracture of coccyx during childbirth: a case report of an unusual cause of coccygodynia. https://www.sciencedirect.com/science/article/abs/pii/S0003999303005896Opens a new window [Accessed February 2022]

Kaushal R, et al. 2005. Intrapartum coccygeal fracture, a cause for postpartum coccydynia: a case report. https://pubmed.ncbi.nlm.nih.gov/16216182/Opens a new window [Accessed February 2022]

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MedlinePlus. 2020. Tailbone trauma – aftercare. https://medlineplus.gov/ency/patientinstructions/000573.htmOpens a new window [Accessed February 2022]

NHS. 2019. Causes: coccydynia (tailbone pain). https://www.nhs.uk/conditions/tailbone-pain-coccydynia/causes/Opens a new window [Accessed February 2022]

NHS. 2020. Coccyx pain following childbirth. https://www.royalberkshire.nhs.uk/media/jxpjwfvu/physio-coccyx-pain-following-childbirth_oct20.pdfOpens a new window [Accessed February 2022]

UT Southwestern Medical Center. 2020. What to do when pregnancy becomes a pain in the tailbone. https://utswmed.org/medblog/tailbone-pain-during-pregnancy/Opens a new window [Accessed February 2022]

Stephanie Watson
Stephanie Watson is a freelance health and lifestyle writer based in Rhode Island. When she’s not busy writing, Watson loves to travel, try new cuisines, and attend as many concerts, shows, and plays as she can fit into her busy schedule.
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