Tailbone pain is a troublesome problem for many members of MyMSTeam. Members sometimes wonder if their tailbone pain is related to multiple sclerosis (MS). But there’s limited information on whether the two are connected.

Fortunately, tailbone pain can often be managed with special cushions or tailbone-friendly stretches and exercises. Finding what works for you may take some trial and error, though.

What Does Tailbone Pain Feel Like?

Tailbone pain arises in or around the bone at the base of the spine just above the anus. This pain is also called coccydynia, after the scientific name of the tailbone, the coccyx. Tailbone pain can be difficult to deal with because it affects everyday life.

For example, sitting normally on a hard chair — or any chair, for that matter — can be intolerable. Symptoms of tailbone pain include:

• Aching or a shooting pain in the tailbone area
• Pain that worsens when standing up from sitting
• Pain while sitting, especially for long periods
• Pain during a bowel movement
• Discomfort during sex

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It’s unclear how long tailbone pain lasts. Some MyMSTeam members say that it comes and goes, whereas others report having it for years.

MyMSTeam members describe their tailbone pain in a variety of ways:

• “I started with neck pain in the beginning. Then moved to severe tailbone pain that I still have and cannot sit. I have to sit on my sides.”
• “This is the first time I’ve read of someone else who has severe tailbone pain. This is in addition to nerve pain running through the butt, entire crotch, down legs into my feet (soles/toes), especially on the side.”
• “I have had this problem for over 30 years. But last night was the worst episode ever. For over an hour, my tailbone hurt so bad that I ended up crying through it. It seemed as though there was nothing I could do to get relief.”
• “I have that problem sometimes where my tailbone hurts real bad. It takes a while to get up off the chair, and I have to stand for a bit before moving.”
• “I was riding my bike, and my tailbone started hurting very soon into the ride. I had that pain for a few months, and then it went away. It does come back if I sit on a hard chair or if my desk chair has a bump and I sit too far up, it starts to hurt.”

What Are the Causes of Tailbone Pain in MS?

Some MS pain is related to demyelination, which is damage to the protective myelin coating around nerve fibers in the central nervous system, including the spinal cord. But it isn’t clear if MS directly causes tailbone pain. In fact, tailbone pain isn’t typically considered a direct symptom of MS.

Here are some possible connections between tailbone pain and MS:

• Prolonged sitting — Lack of movement due to MS, such as sitting for a long time, can cause tailbone pain.
• Muscle spasms — Muscle spasms may be felt in the lower back, tailbone area, and leg muscles.
• Spasticity — Spasticity, or muscle tightness, one of the most common symptoms of MS, may also cause lower back pain or pain in the tailbone area.
• Falls — As many as 70 percent of people with MS experience falls. Having a fall can also lead to tailbone pain.
• Decubitus ulcers — These sores develop from the pressure of staying in the same position for long periods, and commonly form over the coccyx. People with significant immobility, prolonged pressure, or reduced sensation are most affected.

Non-MS Causes

Tailbone pain may also be unrelated to MS. One common cause is joint hypermobility. This means that one or more of the coccyx bones can move too much. Abnormal movement of the coccyx can occur while sitting, leading to pain as weight or pressure is applied.

People also experience this kind of pain for other reasons, including sports injuries, pregnancy and childbirth, and prolonged sitting.

Research and Diagnosis

Research on MS and tailbone pain is limited. In fact, there’s no strong evidence that MS directly causes coccyx (tailbone) pain. Most studies focus on back pain or muscle spasms in MS.

There is shared frustration among MyMSTeam members that some doctors do not attribute tailbone pain to MS. For example, one member wrote, “My first neuro said [tailbone pain] is not MS related. I plan on asking my new neuro at my next visit. It has to be MS related.”

Although tailbone pain in MS is not well understood, there are numerous management strategies to try.

Managing Tailbone Pain With MS

Tailbone pain can often be managed with at-home interventions. However, it’s important to tell your neurologist or another healthcare professional if you’re having ongoing pain. Your doctor can help you find a pain management approach that relieves your discomfort.

Coccyx Cushions

Special coccyx cushions, as well as doughnut and wedge-shaped pillows, may help relieve tailbone pain. These types of pillows and cushions allow you to avoid putting too much pressure on the tailbone and ultimately help relieve tailbone pain.

You can find cushions designed for this type of pain relief online. Inflatable pillows and other similar pillows are also commonly available at pharmacies.

As for U-shaped pillows, MyMSTeam members have had mixed results. They work for some, but another wrote, “I do have those with the U opening for the tailbone and to promote circulation. I still have the pain.”

Heat and Cold

Taking a hot bath or applying heat or ice packs can sometimes relieve tailbone pain. A MyMSTeam member shared, “I sit on a heating pad. That seems to soothe it.”

However, be careful when using these types of treatments. Using packs or baths that are extremely hot or extremely cold can injure your skin.

Physical Movement

Slow movement, such as yoga, may be a good option for people with MS who have tailbone pain. There’s also chair yoga, which is an option for people who have limited lower body mobility or use a wheelchair.

Exercise that gets you up on your feet or moving in your chair may also alleviate pain. Or, you can try stretches performed while lying on your back. Stretches designed specifically for the muscles in your hips and buttocks may be particularly helpful.

Gentle movements and yoga-like stretches can be beneficial, as long as they don’t worsen your symptoms.

Physical Therapy and Complementary Medicine

Physical therapy may be an option for relieving pain in the back and the muscles around the tailbone. A physical therapist can provide exercises tailored to your specific pain. For instance, they may recommend pelvic floor therapy, which can alleviate tailbone pain. The therapist can also advise you on correct sitting posture to help reduce pain.

Some people also try treatments such as chiropractic therapy, acupuncture, massage therapy, or osteopathic therapy. Research on these approaches for tailbone pain is limited, although some types of hands-on therapy may provide short-term relief. Talk with your healthcare provider before trying a complementary treatment.

Over-the-Counter Painkillers

An over-the-counter painkiller such as ibuprofen can be taken to reduce tailbone pain. Keep in mind that while ibuprofen is sometimes used for certain types of MS pain, it isn’t effective for neuropathic pain. If your pain is neuropathic or related to MS spasticity, your treatment may need to address the underlying nerve or muscle problem rather than just the coccyx.

Ask your healthcare provider before adding medications to your regimen.

If your tailbone pain continues even after trying simple treatments, your healthcare provider may consider options like local steroid or anesthetic injections, a ganglion impar block, or other procedures to help relieve the pain.

When To Contact a Healthcare Provider for Tailbone Pain

Most of the time, tailbone pain isn’t a serious medical concern, although it’s definitely uncomfortable and frustrating. That said, if your tailbone pain is persistent, severe, or getting worse, contact your doctor.

Seek help right away if your tailbone hurts after a fall and it’s accompanied by:

• Fever
• Pain in hips and lower back
• Bowel or bladder symptoms
• Numbness

Not only can your medical provider rule out a fracture from a fall, but they can also determine if you have an infection, abscess, tumors, or other non-MS causes.