Coccyx Pillow

The purpose of the coccyx pillow is to take the pressure off the little bone whilst sitting.

There's a need to take the pressure off a bruised or fractured bone in the acute phase after injury. Coccydynia is one of the most debilitating conditions. If not managed correctly it leaves the victim unable to sit comfortably for months and even years.

Where exactly is this little so called vestigial bone? Slide your finger down between the buttock crease and eventually, deep, just before you reach the anus, you will feel a hard bony prominence. That's it; it's not normally tender at all.

It lies beyond the end of the vertebral column, consisting usually of four bones lying below the sacrum. It’s incorrectly been considered a vestigial tail that has no real function in the human, which is far from the case.

There are many muscles that have their origin on the coccyx; muscles that are vital in bearing down on the toilet, child birth, orgasm, sneezing. Coccyx removal, I think you'll agree, should be the very last option.

The coccyx is vulnerable to a bruise or fracture.

So what are the causes of coccygeal pain and why is a coccyx pillow so useful? About the only time the coccyx seems to give trouble is after direct trauma, and sometimes after child birth. And then it certainly let’s you know of its presence. It hurts, and prevents us doing what first comes to hand, namely sitting. When a person can’t sit, they are supremely miserable.

So, how many muscles might be affected by a bruised or fractured coccyx? Nine muscles, including one of the largest muscles in the body, the gluteus maximus, and numerous ligaments are attached to the coccyx. These muscles are used during defecation, urination, orgasm, childbirth, walking and running. The coccyx is important.

These deep pelvic muscles are vital part of stabilising the pelvis and lower back too. They can be best strengthened using the updated Kegel exercises.

This page was last updated by Dr Barrie Lewis on 8th July, 2019.

Deep pelvic muscles attach to the coccyx.

Can you see the coccyx in this picture; it's written in tiny letters, see it? And I'm sure you then can see the levantor ani and the coccygeus muscles attached to it. Well there are seven other muscles, all attached to the coccyx.

The coccyx is only rarely fractured as it is fairly mobile, able to flex forwards and backwards. But a violent force directly to the coccyx like falling on the lip of a stairs may subluxate the coccyx and sprain its ligaments, and cause pain for months and even years.

Here's an important tip. Make sure your child knows that pulling a chair out from under someone about to sit, is a very mean trick to pull. I have patients who have suffered from coccyx and low back pain for the rest of the lives. Intended as a joke, it has caused a lifetime of misery. Mind you, knowing some kids, perhaps you will be putting ideas into their heads. Some people's children. Not yours, of course.

Owing to its attachment to so many muscles, the coccyx, when injured, can have a detrimental effect on movement, sitting, bearing down on the toilet may be painful and urinating may also be affected.

Some women may even experience pain during sexual intercourse. The coccyx is not without some importance.

Coccyx fracture

A young woman slipped and fell hard on her sacrum and coccyx. Apart from the bruising it was a terrible injury. She has a hairline fracture through the coccyx, serious sacroiliac joint sprain and a L4 lumbar spine slipped disc.

Whilst this is a worse case than one would normally see on an average day at the chiropractic coalface, three separate injuries, all impacting on each other, it was gratifying this morning, six weeks after the fall, to examine her and find that she has almost no pain or disability. She is faithfully doing her lower back exercises and is more than happy, no longer needing the coccyx pillow, though her coccyx is still tender on palpation.

Now we have made a start with chronic severe migraines obviously emanating from TMJ anatomy ... the jaw joint is a major cause of facial pain and severe headaches. Often there is also upper cervical pain since the sensory nucleus of the nerve supplying the jaw joint (the Trigeminal nerve) is found in the neck. Often it is a chicken-and-egg situation. Does the TMJ anatomy cause the Atlanto Occipital joint subluxation, or vice versa. In her case it's clearly the former - she grinds her teeth at night (bruxism), a major cause of migraine headache migraine headache ...

A coccyx pillow is essential after a fracture, or even displacement.

Sacral fracture

Sacral fracture is not common but it's potentially very serious, and is often missed simply because it's rare. The injury will certainly affect the sacroiliac joints and most likely the lumbar spine above; often there will be others above and a coccyx pillow may be part of the solution.

It comes from a very hard fall on the behind.

The sacral nerves pass down the canal and since any fracture always involves swelling, they too may be affected. You simply have to stop, and it may be for two months or more; it won't go in a cast!


So much for the doom and gloom. The good news is that this little tailbone responds well to chiropractic, and the treatment is not particularly painful. Coccyx pain relief is at hand. It's only very rarely that coccyx amputation is indicated.

The first phase of chiropractic care is no different to any other acute joint injury. It needs to be iced to reduce any swelling and inflammation, the subluxations should be reduced as soon as possible, and you need to avoid sitting directly on it for a few weeks. Fortunately there are several aids in the form of a coccyx pillow that take direct pressure off the offended dignity of this little group of bones.

The donut cushion has its merits too for an injury of the coccyx.

Coccyx pillow

The bruised coccyx (and a fracture coccyx of course) causes " coccydynia ". Sitting in the car is often painful, but this little coccyx pillow does wonders.

Really this injury should be considered as a syndrome, as trauma to the coccyx often affects the sacrum, the sacro-iliac joints and the myriad of muscles around the coccyx. And of course, the trauma may well have affected the spinal joints as well.

A coccyx cushion for the car.

So, chiropractic begins with a thorough examination. Has there been fracture of the coccyx or even the sacrum? Is it black and blue? The sacroiliac joint anatomy, the lumbar facet syndrome, the hips, and the superficial muscles all need to be considered. A piriformis syndrome in particular as it's origin is the sacrum and often during a fall on the buttocks there is direct trauma to the piriformis and the sciatic nerve.

Fortunately, the skin is very tight around the coccyx, and can be used in most cases to correct the subluxated coccyx. The treatment is not usually particularly painful, despite the fact that the general area is so sore - as your chiropractor uses the skin away from the joint to correct the subluxation.

Occasionally, it has to be done rectally. This also is not painful, but obviously awkward and embarrassing. I have never seen research, but on the odd occasion when I have had to do an internal correction of the coccyx, I have been of the opinion that it can be treated even more quickly. This is perhaps because at the same moment one can do cross friction of the adjacent ligaments and deep pelvic muscles.

Thereafter a coccyx pillow is usually a good idea for a few weeks.

I recently had a patient referred by another chiropractor, because it's generally known that when necessary I will do an internal coccyx treatment. The man had two years of unremitting coccyx pain that had not responded to medical or an external manipulative treatment.

Within three treatments he was 90 percent better and at the fourth consult a month later had no coccyx pain at all.

It made me wonder why it is that I, and others, are so reluctant to do an internal coccyx treatment; perhaps we should start there. It's the only way to address the local muscles associated with this nasty injury.

Here's an important suggestion; if you are male, and over 45, ask your chiropractor to check your prostate at the same time. It's right there.

Prostate cancer is the most common serious cancer in men; and, talking of this little walnut sized gland, it's obligatory that every man eats a tomato a day. More, a phytosterol called beta sitosterol prevents an enlarged prostate. It's particularly high in avocado.

For an interesting case history from the Chiropractic Coalface, click here: CHIROPRACTIC COALFACE

Before removal, don't you think it might be an idea to pay your local chiropractor a visit? Reducing the subluxation together with a coccyx pillow is far less misery. The arrow below points to the coccyx. Or, what remains of it.

Internal coccyx treatment

No doctor, or patient likes a rectal treatment. For this reason, I always recommend first doing an external coccyx treatment that is usually effective. However it takes a long time, and more treatment.

Just recently I had a patient with severe coccyx pain of some weeks duration. It had not responded well to her doctor's treatment. She was traveling overseas in one week. Reluctantly I recommended the internal treatment as we didn't have time on our sides. After just one treatment, lasting less than two minutes she declared the pain was more than 50 percent less.

That is just an anecdote, but I'm thinking that perhaps doing the external treatment for some weeks is perhaps not the best treatment of choice. Discuss this with your chiropractor.


  1. Take any piece of old material 100cm x 25cm + a little for the seam. (longer if you have large rear-end!)
  2. Sew it into a tube.
  3. Stuff it with old pantyhose, warn socks, bit of foam...
  4. Sew the two ends together. What could be easier?
  1. Chiropractic Help
  2. Coccyx Pillow

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Chronic coccyx pain 
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Dr Barrie Lewis answers questions regarding the coccyx 
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A bit saucy, not for the faint-hearted! But as an eBook that you can read it on your computer for only 99 cents, a snip. I guarantee you will finish it! How do I know? It's a trilogy, and Book I is available for free on the web. Just as many people are reading chapter one, JAN JANSEN so you can get a taste before purchasing.

Or, how about writing a book? I've just finished my fourth, A Family Affair. This my first non-chiropractic volume.

Useful links ...

Safety on the Stairs ... public enemy no. 1 of the coccyx.

  • Sacroiliac Joint Case File ... use the site search function above.

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