Massage for tailbone pain

Massage for tailbone pain works on the muscles around the coccyx, the buttocks, deep hip rotators and low back, which often tighten when sitting hurts. It does not reach the tailbone joint itself: the hands-on techniques studied for coccydynia are internal and are done by pelvic health physiotherapists or physicians, not at Renu. Most tailbone pain improves within weeks; see a doctor if it does not, or if it comes with a fever.

Massage for tailbone pain helps in a limited but real way. The coccyx is the small triangle of bone at the very bottom of the spine, and when it is bruised or irritated, the muscles around it brace every time you sit down. External massage can ease that bracing in the buttocks, hips and low back. It cannot move or realign the coccyx, and the hands-on treatments that have been studied for it are internal procedures we do not offer.

So our role is supportive. We work around the tailbone, never on it, and we point you to the right clinician when a different kind of care is needed.

What tailbone pain feels like and why it starts

Tailbone pain, called coccydynia, has a recognisable pattern. The NHS describes pain and tenderness at the base of the spine, near the top of the buttocks, that can be dull with occasional sharp moments. It is usually worse:

• when sitting, especially on hard seats;
• when sitting down or standing up;
• when bending forward;
• when having a bowel movement.

Common causes include a fall onto the tailbone, pregnancy and childbirth, and sitting for long periods, for example while driving or cycling. In Calgary the first of those has a season: a backward slip on a sidewalk that thawed in a chinook and refroze overnight can land you squarely on the coccyx.

The NHS says the pain usually improves within a few weeks. A small group carry it longer; one clinical review notes that about 10 percent of cases become chronic.

What the hands-on evidence actually tests

It helps to know what the studies on manual treatment examined, because it is not the kind of massage a massage clinic does.

• Internal manipulation versus physiotherapy. In a 2006 randomised trial of 102 people with chronic coccydynia, three sessions of intrarectal manipulation gave good results about twice as often as low-power external physiotherapy at one month (36 percent versus 20 percent) and at six months (22 percent versus 12 percent). The authors called the effect mild. People did best when the coccyx was stable on X-ray, the pain was more recent, and it had started with an injury.
• Pelvic floor physiotherapy. In a university clinic chart review, 79 people who completed pelvic floor physical therapy aimed at relaxing those muscles, an average of nine sessions, saw average pain fall from 5.08 to 1.91 out of 10. This was not a controlled trial.
• Manipulation plus injection. A small comparison of 44 people found complete relief in 61.9 percent with manual therapy combined with a steroid injection, against 17.4 percent with the injection alone, and no relapses in the combined group.

All three involve treatment inside the pelvis by physiotherapists or physicians with specific pelvic health training. That is the referral we suggest when external work and self-care have not been enough. If you are postpartum, our comparison of postpartum massage and pelvic floor physiotherapy explains how the two fit together.

What external massage can do around a sore coccyx

External massage targets the muscles that tighten in response to the pain. When sitting hurts, people shift onto one hip, clench the buttocks and hold the low back stiff, and those habits create a second layer of soreness. A session usually includes:

• Gluteal muscles. Broad, slow work through the buttocks, staying clear of the tailbone and the cleft between the buttocks.
• Deep hip rotators, including piriformis. These sit under the gluteals and often tighten with altered sitting; our page on piriformis syndrome covers them in more detail.
• Low back. The muscles beside the lumbar spine take up slack when the pelvis is guarded; see our low back pain page if that is your bigger complaint.
• Hips and thighs. Easing the front of the hip can make getting out of a chair less of an event.

Positioning matters as much as technique. Lying face down puts no weight on the coccyx and suits many people. Side-lying with a pillow between the knees is the other option and is the position the NHS suggests for taking pressure off. We avoid lying on your back on a firm table early on.

Self-care that makes the biggest difference

The NHS self-care list is short and practical:

• use a coccyx cushion when you sit;
• sit with good posture and your lower back supported, and do not sit for long stretches;
• lie on your side when resting;
• try pelvic floor exercises;
• use ice for 20 to 30 minutes, or a heat pack, on the area;
• try anti-inflammatory pain relief if it suits you;
• use a stool softener if bowel movements are painful.

For desk days, our page on lower back stretches after a day of sitting gives you something to do when you stand up.

When to see your doctor first

See a doctor if tailbone pain has not improved after a few weeks of home treatment, if it is affecting your daily life, or if it comes with a high temperature and pain elsewhere such as the tummy or lower back. Fever with tailbone pain needs to be checked before any massage. Your doctor can arrange physiotherapy, steroid injections or, rarely, refer you for surgery to remove the coccyx when nothing else has helped.

Call 9-1-1 or go to emergency if back or tailbone pain comes with numbness around your genitals or anus, new trouble peeing or controlling your bowels, or weakness or numbness in both legs, or if it started after a serious accident. The NHS lists these as emergency signs of possible pressure on the nerves of the spine.

How this works at Renu

Book massage therapy with one of our Registered Massage Therapists through Jane. A 30-minute session ($80) keeps the time on the table short, which helps when lying still is hard, and is enough for the buttocks and low back. A 45-minute ($100) or 60-minute ($120) session adds the hips, thighs and upper back for people whose posture has shifted around the pain.

Mention the tailbone in your booking notes and tell us how it started. Bring your coccyx cushion if you have one; it helps for the drive. If you had your baby recently, postpartum massage is the booking that fits, and the same external approach applies.

Questions people ask

Will the massage therapist touch my tailbone?

No direct pressure goes on the coccyx at Renu, and we never use internal techniques. We work the large muscles of the buttocks, hips and low back, over the sheet or clothing if you prefer. You decide what areas are included, and you can change your mind during the session.

How long does tailbone pain last?

The NHS says it usually gets better within a few weeks. A review of transrectal manual treatment notes that about 10 percent of cases become chronic. If yours has not improved after a few weeks of self-care, a doctor can look at other options.

Is lying face down OK with a sore tailbone?

For many people it is, because nothing presses on the coccyx. If face down tugs at the area, side-lying with a pillow between the knees is the position the NHS suggests for taking the pressure off, and we can work that way.

Does a coccyx cushion actually help?

It is one of the first things the NHS recommends for a sore tailbone. The aim is to keep your weight off the coccyx when you sit. Pair it with sitting well supported and getting up often, since the NHS also advises against sitting for a long time.

Sources

1. NHS: Tailbone (coccyx) pain
2. Maigne et al., Spine 2006: The treatment of chronic coccydynia with intrarectal manipulation, a randomized controlled study
3. Scott et al., PM&R 2017: The treatment of chronic coccydynia and postcoccygectomy pain with pelvic floor physical therapy
4. European Spine Journal 2018: Management of persistent coccydynia with transrectal manipulation, results of a combined procedure
5. NHS: Back pain
6. Journal of Osteopathic Medicine 2024: Transrectal osteopathic manipulation treatment for chronic coccydynia

Page reviewed October 5, 2026. This page is education, not a diagnosis. For your own situation, talk to your doctor, surgeon or care team, or ask us.