What Causes Tailbone Pain During Pregnancy?

Tailbone pain during pregnancy comes from loosened pelvic ligaments, tighter pelvic floor muscles and a posture that puts more of your weight on the base of the spine. UT Southwestern Medical Center reports that it becomes a significant problem for approximately one-third of pregnant patients, most often in the late second and third trimesters.

The standard advice is to sit on a donut pillow, and UT Southwestern's physical medicine team advises against it. They write that a donut pillow "can sometimes create pressure in other areas" and recommend "a wedge-shaped cushion with a cutout for the tailbone region" instead. This post explains why the tailbone hurts in pregnancy, how to sit and sleep with less pain, which treatments are available, including chiropractic care, and when to call your provider.

What Is the Tailbone and Why Does It Hurt in Pregnancy?

The tailbone, or coccyx, is the small bone at the very bottom of the spine, and tailbone pain is called coccydynia. Several muscles and ligaments of the pelvic floor attach to it, which is why pregnancy affects it so directly.

UT Southwestern describes three changes working together:

• The body releases a hormone called relaxin, which makes the pelvic ligaments looser and more flexible.

• As those ligaments loosen, the pelvic floor muscles connected to the tailbone contract more tightly.

• As the abdomen expands, your center of balance is altered and your posture shifts, adding pressure in the low back and tailbone.

Cleveland Clinic adds that during the third trimester the body secretes hormones that soften the area between the tailbone and the sacrum. It also notes that tailbone pain is five times more likely to occur in females than in males, pregnant or not.

What Does Pregnancy Tailbone Pain Feel Like?

Cleveland Clinic describes tailbone pain as dull and achy or sharp and piercing, felt at the very base of the spine. It typically worsens when you go from sitting to standing.

Long stretches of sitting are the usual trigger in pregnancy. UT Southwestern notes that being in the same position for a long period of time can make the pain worse, especially when sitting.

Pain that travels down the leg, or pain felt more at the front of the pelvis, usually points to a different problem. Our posts on chiropractic care for sciatica and on prenatal chiropractic safety cover those.

How Should You Sit With Tailbone Pain?

How you sit matters more than any other single change, because sitting is when the tailbone carries load.

UT Southwestern's guidance:

• Use a wedge-shaped cushion with a cutout for the tailbone region. The cutout sits at the back, so the tailbone hangs over open space.

• Sit upright with your feet flat on the ground.

• Get up and move around often. Staying in one position for a long time makes the pain worse, especially when sitting.

A wedge cushion is easy to carry between the car, the office and the dining table. If you only buy one thing for tailbone pain, make it that.

How Should You Sleep With Tailbone Pain?

Sleep on your side with a pillow between your legs. UT Southwestern explains that this positions the hips and knees in a more comfortable, neutral position, which takes tension off the pelvis and the muscles attached to the tailbone.

The pillow is the part that gets skipped. A pregnancy pillow or two standard pillows both work.

What Treatments Help Tailbone Pain During Pregnancy?

Start with the simple things, and add hands-on care if they are not enough.

Heat or cold. Cleveland Clinic suggests hot or cold packs on the lower back for 20 to 30 minutes, several times a day, and notes that a hot bath can relax the muscles. During pregnancy, check with your provider about bath temperature and how you use heat.

Pelvic floor physical therapy. UT Southwestern describes a personalized plan that can include stretching and breathing exercises to relax the pelvic floor muscles, pelvic stabilization belts and myofascial release.

Medication. Many general tailbone pain guides recommend anti-inflammatory drugs. Pregnancy changes which medicines are appropriate, so ask your OB or midwife before taking anything.

Chiropractic care. The joints of the pelvis and lower back sit right above the tailbone. A prenatal chiropractic visit checks how those joints are moving and uses gentle, low-force adjustments to ease the ones that are restricted. A 2015 Cochrane review of 34 randomized trials involving 5,121 pregnant women found that a multi-modal approach of manual therapy, exercise and education may be of benefit for low back and pelvic pain in pregnancy, with no lasting side effects in the studies that reported on them. That review did not study tailbone pain on its own, so treat care as something to try and reassess, not a sure fix.

Cleveland Clinic reports that for tailbone pain in general, 90% of people find relief with home treatment alone.

How Does Prenatal Chiropractic Care Approach Tailbone Pain?

At Barto Family Chiropractic, prenatal chiropractic care is built around keeping the pelvis balanced and the spine moving well through each trimester, using pregnancy-safe techniques and specialized positioning.

For the lower back of pregnant patients, Dr. Stephanie recommends Activator adjustments. The Activator is a handheld instrument that delivers a quick, low-force adjustment, which suits an area that is already sore.

A visit also covers the sitting and sleeping habits in this post, because what you do between appointments matters as much as the visit. If your back was bothering you before pregnancy, our article on whether a chiropractor can help with chronic back pain explains how longer-standing problems are approached.

When Should You Call Your Provider?

UT Southwestern advises talking with your Ob/Gyn if tailbone pain lingers or worsens, or if it stays severe after you have tried cushions and position changes.

ACOG's guidance on back pain in pregnancy says to contact your ob-gyn if back pain lasts more than two weeks, is severe, or comes with fever, burning during urination or vaginal bleeding. Those symptoms need a medical evaluation, and they are not something to stretch through.

FAQ

When does tailbone pain start in pregnancy?

UT Southwestern reports that it is more common in the late second and third trimesters, when the belly is larger and the pelvic ligaments are at their loosest.

Is tailbone pain normal during pregnancy?

It is common. About one-third of pregnant patients have significant tailbone pain, according to UT Southwestern.

Is a donut pillow good for tailbone pain?

It is the cushion most people think of first. UT Southwestern's physical medicine team recommends a wedge-shaped cushion with a tailbone cutout instead, because a donut can create pressure in other areas.

Will tailbone pain go away after delivery?

For most women it does. UT Southwestern says tailbone pain subsides soon after delivery for most, and that looser ligaments and the stress of delivery can sometimes lead to ongoing tailbone pain and pelvic floor problems afterward. If pain is still there at your postpartum visit, bring it up.

Can childbirth itself cause tailbone pain?

Yes. Cleveland Clinic notes that childbirth can overstretch the muscles and ligaments around the tailbone. Pain that begins after delivery deserves the same attention as pain during pregnancy.

Can a chiropractor adjust me if my tailbone hurts?

Yes, with a gentle approach. Tell the chiropractor exactly where it hurts and how far along you are. The visit can be done with low-force techniques and positioning that keeps weight off the tailbone.

Prenatal Chiropractic Care in Monroeville, PA

Dr. Stephanie Parrish has focused on prenatal and pediatric care since starting her practice in 2014, and she holds Webster certification through the International Chiropractic Pediatric Association. As a mom herself, she knows how much a sore tailbone can take out of an ordinary day.

If sitting has become something you dread, we can check how your pelvis and lower back are moving and give you a plan that fits your pregnancy.

Visit Barto Family Chiropractic or call 412-793-3300 today. Contact us for more information.