Tailbone Pain After a Fall or Car Accident: What Helps (and When to See a Chiropractor)

Tailbone pain (coccydynia) can be miserable—but most cases are treatable

If you’ve bruised your tailbone after a fall, sports impact, or a car accident, you’re not alone. Tailbone pain—also called coccydynia—commonly feels worse with sitting, getting up from a chair, or leaning back. Some people also notice pain with bowel movements or after long periods of sitting. 

The encouraging news: many cases improve with conservative care, especially when you reduce pressure on the area and address contributing mechanics (hips, low back, pelvic floor, posture). 

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What causes tailbone pain?

Tailbone pain isn’t one single injury. Common contributors include: 

• Contusion (bruise) after falling onto the buttocks
• Sprain/irritation of ligaments around the sacrococcygeal joint
• Joint hypermobility or hypomobility (too much or too little motion at the coccyx)
• Childbirth-related strain
• Repetitive pressure (cycling/rowing)
• Pelvic floor muscle tension or trigger points referring pain to the coccyx region
• Less common but important: infection, inflammatory disease, fracture/dislocation, or tumor

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When tailbone pain is a “red flag” (don’t self-treat these)

Seek medical evaluation promptly if you have any of the following: 

• Fever, chills, or feeling ill
• Unexplained weight loss, night sweats, history of cancer
• Significant trauma with inability to sit/walk normally
• New bowel/bladder changes, numbness in the groin/saddle area
• Increasing night pain, rapidly worsening symptoms
• Concern for fracture, infection, or tumor

A clinician may recommend imaging (often starting with X-ray, sometimes MRI/CT depending on the story) when symptoms or history suggest something more serious. 

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What actually helps tailbone pain? (Evidence-based treatment ladder)

Think of tailbone pain care as stepwise—starting with the simplest, lowest-risk options first. 

Step 1: Reduce pressure + calm irritation (first 1–2 weeks)

• Use a coccyx cut-out cushion (U- or V-shaped) to unload pressure
• Avoid prolonged sitting; stand/walk breaks every 20–30 minutes
• Ice or heat (whichever feels better) for symptom control
• Over-the-counter meds/topicals may help, when appropriate for you (check with your primary care clinician if you have medical conditions or take other meds). 

Step 2: Restore comfortable movement (weeks 2–6)

This is where rehab and manual care often help most:

• Gentle hip mobility, glute/core endurance, and graded return to sitting tolerance
• Addressing painful pelvic floor tension (often via pelvic floor physical therapy when indicated) 
• Manual therapy for surrounding structures (low back, SI joint, soft tissues) can be reasonable as part of a broader plan

Step 3: Target the coccyx more specifically (for persistent cases)

Some clinicians use coccygeal manual therapy, including intrarectal mobilization/manipulation in selected chronic cases. The research here suggests possible but typically modest benefit, not a guaranteed cure. 

Step 4: Interventional options (when conservative care fails)

If pain persists despite good conservative care, physicians may consider:

• Image-guided injections/nerve blocks (depending on pain generator)
• Other pain procedures in selected cases
• Surgery (coccygectomy) is reserved for refractory cases and can help some patients, but it carries meaningful wound-healing risk. 

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So… can a chiropractor help a tailbone injury?

A chiropractor may help—but the honest answer depends on what’s driving the pain.

Chiropractic care may be useful when:

• Your tailbone pain is part of a broader lumbar/SI/hip problem after trauma
• You need guidance on ergonomics, graded activity, and rehab exercises
• Soft tissue and joint restrictions around the pelvis are amplifying symptoms

What chiropractic care cannot claim:

• That an adjustment “heals” most tailbone injuries by itself
• That one adjustment provides “permanent” relief for most people
• That every case is a simple alignment problem

What the evidence suggests about direct coccyx manipulation:

The best-known randomized trial found mild effectiveness of intrarectal manipulation for chronic coccydynia, and broader reviews describe manual therapy evidence as limited. 

That doesn’t mean it never helps—just that it should be framed as one possible tool, not the headline promise.

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What to do right now (a starter plan)

1. Get the right cushion (coccyx cut-out) and take standing breaks
2. Use ice/heat for comfort
3. Start a gentle progression: short walks + light hip mobility
4. If you’re not improving in 2–4 weeks—or your pain is severe—get evaluated to rule out fracture/other causes and to build a targeted plan