
- With Mayo Clinic obstetrician and medical editor-in-chief
Roger W. Harms, M.D.
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Roger W. Harms, M.D.
Roger W. Harms, M.D.
"Nothing helps people stay healthy more than the power of real knowledge about health." — Dr. Roger Harms
As medical director of content, Dr. Roger Harms is excited about the potential for Mayo Clinic's health information site to help educate people about their health and provide them the tools and information to live healthier lives.
The Auburn, Neb., native has been with Mayo Clinic since 1981 and is board certified in obstetrics and gynecology. Dr. Harms is a practicing physician and associate professor of obstetrics and gynecology, and his specialty areas include office gynecology, high-risk obstetrics and obstetrical ultrasound.
From 2002 to 2007, Dr. Harms was director for education at Mayo Clinic, Rochester, Minn. Dr. Harms was the 1988 Mayo Medical School Teacher of the Year and served as associate dean for student affairs and academic affairs. He is the co-author of the "Mayo Clinic Model of Education." In 2008, Dr. Harms was presented the Distinguished Educator Award, Mayo Clinic, Rochester.
Dr. Harms is vice chair of the Department of Obstetrics & Gynecology and medical editor of the Pregnancy section on this website. In addition, Dr. Harms is editor-in-chief of the "Mayo Clinic Guide to a Healthy Pregnancy" book, a month-by-month guide to everything a woman needs to know about having a baby.
"My medical education experience has grown out of a love of teaching, and that is what this site is about," Dr. Harms says. "If any visitor to this site makes a more informed and thus more comfortable decision about his or her health because of the information we provide, we are successful."
Question
Tailbone pain: How can I relieve it?
What causes tailbone pain, and how can I ease it?
Answer
from Roger W. Harms, M.D.
Tailbone pain — pain that occurs in or around the bony structure at the bottom of the spine (coccyx) — can be caused by trauma to the coccyx during a fall, prolonged sitting on a hard or narrow surface, degenerative joint changes, or vaginal childbirth.
Tailbone pain can feel dull and achy but typically becomes sharp during certain activities, such as sitting, rising from a seated to a standing position or prolonged standing. Defecation and sex also might become painful. For women, tailbone pain can make menstruation uncomfortable as well.
Tailbone pain, also called coccydynia or coccygodynia, usually goes away on its own within a few weeks or months. To lessen tailbone pain in the meantime, it might help to:
- Sit completely upright with proper posture — keeping your back firmly against the chair, knees level with your hips, feet flat on the floor and shoulders relaxed
- Lean forward while sitting down
- Sit on a doughnut-shaped pillow or wedge (V-shaped) cushion
- Apply heat or ice to the affected area
- Take over-the-counter pain relievers, such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin, others) or aspirin
If your tailbone pain doesn't improve (chronic coccydynia), consult your doctor. He or she might do a rectal exam to rule out any other conditions. Depending on the circumstances, he or she might refer you to a specialist in anesthesiology, physical medicine and rehabilitation, or orthopedic surgery. Your doctor or the specialist might recommend using magnetic resonance imaging (MRI) to find out if you have a fracture, degenerative changes or, in rare cases, a tumor.
Possible treatments for chronic tailbone pain might include:
- Physical therapy. A physical therapist might show you how to do pelvic floor relaxation techniques, such as breathing deeply and completely relaxing your pelvic floor — as you would while urinating or defecating. He or she might also show you exercises to strengthen your abdomen and pelvic floor.
- Manipulation. Massaging the muscles attached to the tailbone might help ease pain. Manipulation is typically done through the rectum.
- Medication. An injection of a local anesthetic into the tailbone can relieve pain for a few weeks. Certain antidepressants or anti-epileptic medications might relieve tailbone pain as well.
- Surgery. During a procedure known as a coccygectomy, the coccyx is surgically removed. This option is typically only recommended when all other treatments fail.
- Nathan ST, et al. Coccydynia: A review of pathoanatomy, aetiology, treatment and outcome. The Journal of Bone and Joint Surgery. British Volume. 2010;92:1622.
- Trollegaard A.M., et al. Coccygectomy: An effective treatment option for chronic coccydynia — Retrospective results in 41 consecutive patients. Journal of Bone and Joint Surgery. British Volume. 2010;92:242.
- Frontera WR, et al. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/208746819-6/0/1807/0.html. Accessed Jan. 16, 2012.
- Fletcher RH. Coccydynia (coccygodynia). http://www.uptodate.com/index. Accessed Jan. 16, 2012.
- Dorland's Illustrated Medical Dictionary. 32nd ed. Philadelphia, Pa.: W.B. Saunders; 2011. http://dorlands.com/index.jsp. Accessed Feb. 16, 2012.
- Stolp KA (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 28, 2012.
- How to sit at a computer. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00261. Accessed April 12, 2012.
- Everett T, et al. Human Movement: An Introductory Text. 6th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2010:61.


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