When someone says to me, "My tailbone hurts, especially when I sit – I can hardly work or drive anymore," I know immediately: This is a massively underestimated problem. Tailbone pain isn't just "a little twinge," but can completely disrupt daily life.
I am writing this article deliberately from a subjective perspective—with honest opinions, clear recommendations, and practical solutions. No sugarcoating, no overly complicated medical explanations, but rather what truly helps those affected in Germany.
Legal notice & important information (Germany)
Medical disclaimer:
This article is not a substitute for a medical examination, diagnosis, or treatment. If your symptoms are severe, acute, or persistent, you should definitely consult your doctor or another healthcare professional.
Consultation with a general practitioner (recommended):
In Germany, the family doctor is the first point of contact for coccyx pain. They can determine the cause, rule out serious illnesses, order diagnostic imaging, and, if necessary, prescribe physiotherapy.
Physiotherapy – Costs covered by statutory health insurance:
Statutory health insurance (GKV) only covers physiotherapy with a doctor's prescription. The statutory co-payment is:
- €10 per prescription
- - 10% of the treatment costs
Without a doctor's prescription, physiotherapy must be paid for privately.
Ergonomic workplace – in accordance with the German Workplace Ordinance:
The ergonomic recommendations in this article are based on the Workplace Ordinance (ArbStättV), in particular Section 3a and Annex 6 (screen workstations). This ordinance requires, among other things, an ergonomic office chair , dynamic sitting , correct screen height , ergonomic arrangement of work equipment, and sufficient space for movement.
Note on the technical classification:
The following content is based on thorough research, practical experience in the healthcare sector, and established recommendations. However, it does not replace medical advice.
Quick overview – the most important points in 60 seconds
- Common causes: falls, poor posture, prolonged sitting, muscle tension, pregnancy/childbirth
- Main symptoms: Pain when sitting, standing up, pressure sensitivity
- Immediate measures: cushions, warmth, correct posture, gentle movement
- Exercises often help, but not always — if a fracture is suspected, consult a doctor immediately.
- Physiotherapy is only covered with a doctor's prescription.
What exactly is tailbone pain – and why is it so nasty?
The coccyx is a small bone, but biomechanically highly relevant. Muscles, fascia, and components of the pelvic floor attach here. If this area is irritated, you often feel it clearly when sitting or standing up – sometimes even when lying down.
I think tailbone pain is downplayed far too often. It's real, debilitating, and can become chronic without treatment.
Common causes – why your tailbone really hurts
1. Fall on the buttocks
The most common traumatic cause. A bruise or even a minor dislocation can cause discomfort for weeks. You should always consult your family doctor after a fall.
2. Too much sitting
We live in a country of home offices, cars, and desks. Prolonged sitting creates constant pressure on the tailbone. This is compounded by shortened hip flexors and tense gluteal muscles. For many sufferers, this is the main trigger.
3. Pregnancy & Birth
Hormones loosen the ligaments, the pelvis changes, and during the expulsion phase, the tailbone can be under enormous pressure. Women are often told, "That's normal." I consider that problematic.
4. Rare but important causes
Inflammation, tumors, anatomical variations, or deep disc herniations can also cause tailbone pain. That's precisely why persistent discomfort should be checked by a doctor.
Typical symptoms – how to recognize true tailbone pain
- Pain when sitting (especially on hard chairs)
- Stabbing pain when getting up
- Pressure pain over the tailbone
- Radiation to the buttocks, hips or lower back
If you constantly change your position while sitting or sit sideways, that's a typical sign.
What you can do immediately – before you do exercises
1. Sitting correctly – according to the Workplace Ordinance
The Workplace Ordinance (ArbStättV) sets minimum ergonomic standards. Pay attention to correct seat height , use of the backrest, monitor at eye level, and regular changes of position.
2. Seat cushion
A coccyx cushion with a cutout reduces pressure at specific points and is ideal for overstimulation.
3. Heat or cold?
Bruise: Cold. Muscle tension: Heat. Many people find heat particularly pleasant.
4. When you should see your family doctor
After a fall, in case of severe pain, nighttime discomfort, numbness or fever, or if it does not improve after 1-2 weeks.
Tailbone pain exercises – my 10-minute program
1. Pelvic mobilization (2 minutes)
Gentle pelvic tilt while lying on your back. Ideal as an introduction.
2. Piriformis stretch (2–3 minutes)
Relaxes gluteal muscles that often pull on the tailbone. Perfect for office workers.
3. Pelvic floor relaxation (2 minutes)
Take deep breaths, consciously let go. Often underestimated, but extremely helpful.
4. Child's position (2 minutes)
Relieves back and pelvic pressure. Good in the evening or after prolonged sitting.
5. Posture training in everyday life
Lift your sternum, align your head, and keep your pelvis neutral. Small exercise, big impact.
Common mistakes – please avoid them at all costs
- Training on hard ground
- Ignore pain
- Just stretch, but don't change your daily routine.
- Avoiding everything out of fear
Consistency is crucial.
When you need more than exercises
Sometimes exercises aren't enough. If your pain started after a fall, is very severe, worsens at night, or you experience numbness, you should see a doctor. These are warning signs that shouldn't be ignored.
The family doctor can identify the cause, rule out serious problems, and prescribe physiotherapy. This is often advisable if poor posture or muscular imbalances are the trigger.
If symptoms persist despite exercises and physiotherapy, additional measures may be considered – for example, manual techniques or targeted treatments. Surgical solutions are rarely necessary and are only considered as a last resort.
Prevention – staying pain-free in the long term
- Ergonomic workplace according to the Workplace Ordinance
- Dynamic breaks
- Strengthening the torso
- Soft surfaces during training
- Adjusting the bicycle saddle
FAQ – Quick Answers
Why does my tailbone hurt when I sit?
Because the pressure is directly on the lower part of the spine.
Which exercises are most helpful?
Pelvic mobilization, piriformis stretching, pelvic floor relaxation.
How long does it take?
From a few days to several weeks — depending on the cause.
When to see a doctor.
In case of falls, severe pain, nighttime discomfort, or red flags.
Conclusion
Tailbone pain is bothersome, but in many cases very treatable. With the right exercises, an ergonomic workspace, and timely medical evaluation, you can achieve a lot.
The most important step is to start at all.
