Comfortable positions

The problem with coccydynia is that every time you sit down you are aggravating and prolonging the problem. So the solution is not to sit, but to find a more comfortable position: walk, stand, lean, kneel, squat or lie. But we are expected to sit down to work, to eat, to travel, to relax. You can't very well go out for a meal with friends and stand up all the time. Coccydynia therefore makes it painful or impossible to carry on a normal social or working life. Here are some ideas to help:

• Change positions It is best not to stay in one position (whether sitting, standing or kneeling) too long - you could easily cause other aches and pains. A tip given to me by the pain clinic is to use a timer to remind you to change position every 15 or 20 minutes. If you don't want to have a timer beeping at you, you can use a timer that vibrates in your pocket instead. Cell/mobile/handheld phones have a timer function that you can use. Or here are the results of a Google search for vibrating timers.
• Lean forward Leaning forward in your seat may lessen the pain. It helps if you have a table to rest your arms on. It needs to be the right height, and you need to be careful to avoid straining your back. Sally Cowell writes: With two chairs, one in front of the other, I sit leaning forward and rest on the back of the other. I always take a small air cushion which I place well forward on the chair.
• Lean to one side Many people find that leaning to one side while sitting, taking all the weight on one buttock, reduces the pressure on the coccyx and lessens the pain. If you do this, don't do it too much, or you can cause yourself low back pain from the strain of keeping that position. I overdid it, and had to go to a chiropractor to sort out the low back pain, which he did successfully. Leaning sideways works better if you have a supportive easy chair with high sides, and you can bring your feet up beside you. Or you can bring up one foot underneath the opposite buttock. With all of these you need to keep swapping sides to avoid strain, and avoid spending too much time in these positions anyway.
• Find comfortable clothes Some clothes can make the problem worse, such as tight jeans. Loose clothes that do not squeeze your bottom together are the most comfortable.
• Standing while others sit One of the most difficult things is deciding what to do when you are in a room full of people and everyone else sits down. At first I generally chickened out either by sitting down and putting up with the pain, or by making an excuse to leave. When things got worse, I decided that I had to explain the problem, and remain standing. I found that people have always been sympathetic and helpful. I still didn't like doing it. Now, after my operation, I can sit again so long as I don't lean back, and that makes things much easier. Sally Cowell writes: To avoid sitting at meetings, I find a chair and stand behind it with my hands on the back, or I place my air cushion against a wall and lean my lumbar region against it. When asked if I have a back problem I say no, but I have arthritis in my coccyx joint and it hurts when sat on. This is simplified but usually brings the conversation to an end.
• Sitting aids

  Here is a selection of cushions and seat supports

  Here is a selection of comfortable chairs.

• Comfortable position for sex A woman writes: The "Lover's Cushion" at www.gadgetuniverse.com alleviates pressure on the tailbone while it supports your back and hips during those "special moments" which could otherwise be quite painful. (Pay attention to the orientation since it is counterintuitive and I had it backwards at first. The thicker part is by your legs and the thinner part by your back.)
• Exercises Jane writes: I was taught pelvic floor strengthening exercises at antenatal classes, and have tried doing these again. Initially I felt sharp pain in the coccyx area when I did the exercises, but have since noticed that contracting the pelvic floor muscles seems to help relieve the pain when I'm sitting down.

Updated 2008-04-20