Tailbone injury during childbirth
Emily, Massachusetts, USA
Posted 2026-06-14
I am a 35 year old woman living in the Worcester area of Massachusetts, USA. When I had my second baby, I suffered some kind of injury to my tailbone during childbirth (August 2023). I later learned that it was a subluxated coccyx (will get to that later). After childbirth, it took a few months to realize that it was not going away on its own. It hurt when I sat down, when I had been sitting for a little bit, and then hurt quite a lot when I stood up from sitting. I tried sitting on cushions, ibuprofen, sitting less often, but the pain persisted.
6 months after the injury I spoke to my primary care provider about my tailbone pain. I had done a little research, including on this site, and while my doctor didn't know what to do about it, I asked to be referred to pelvic floor physical therapy.
8 months after injury I attended PT at Spaulding with Laura Lapolla, PT. She was excellent and helped me with some basic pelvic floor strengthening (as I also had some weakness postpartum) and did internal and external stretches of the muscle groups near the coccyx. Internal stretching looks like the PT inserting fingers into the rectum or vagina and gently stretching the walls of those organs, as tightened muscles here can cause pain in the tailbone region. These things together helped very slightly with some of my pain but unfortunately only a very slight difference. I did PT for 19 visits (ending 16 months after injury).
15 months after surgery, at the prompting of my PT, I went back to my primary care and asked for an X-ray of my coccyx. This showed a clear "posterior subluxation of CY2 relative to CY1 with endplate degenerative changes". Basically, a partially dislocated coccyx, pushed backwards (which makes sense given the mechanics of childbirth. Often when you have a fall it is pushed the other direction). I returned to the remainder of the above described PT, which prompted a few slight changes to approach.
19 months after injury, I found a spine clinic that took my insurance (Emerson Hospital) and saw Renee Rickert, MD who is a PM&R (Physical Medicine and Rehabilitation) doctor, also called physiatrist. She reviewed xrays and recommended trying an injection. 1.5 months later we tried the injection. I had immediate almost total relief for the immediate few hours after injection from the numbing medication. I later learned that having this response was a good sign that my tailbone subluxation was the cause of the pain and that surgery was likely to help. Unfortunately the steroid injection itself was only very slightly helpful (standing up was previously 7-8/10 pain and it went down to 6-7/10 pain). We decided to not repeat the injection as it wasn't helpful enough.
21 months after injury, I got another referral for PT since my insurance had changed and tried different pelvic floor physical therapy with Giulia at Marathon Physical therapy. We did mostly strengthing exercises for my hips, legs, pelvic floor muscles, etc. I got stronger, but the pain did not decrease. She referred me to a slightly more specialized person at Marathon, Emma Recane, who did a little manual manipulation of the coccyx, trying to gently nudge it back into alignment (internal and external work). She also consulted about ways to sit and stand with less pain. She was very helpful and knowledgeable, but again no pain relief. I had a follow up x-ray which showed the exact same thing as the previous x-ray, indicating no improvement in the subluxation. She recommended a surgery consult, though it took me quite a while calling around to find someone. I finally asked my OB/GYN to make a referral to Brigham and Women's, which was ultimately where I found a surgeon. The surgeon's office recommended an MRI, which showed similar things to the original xray, and a tarlov cyst that was further up the spine and likely not causing any pain.
31 months after injury, I had a consult with Jay Zampini, MD at Faulkner Hospital which is part of Brigham and Women's (see Doctors and specialists in the USA, Massachusetts). He suspects that he is the only surgeon in MA who does this surgery, and after calling around to different hospitals, I think this is likely. He was fantastic and recommended a coccygectomy, given that I had tried all conservative management, the x ray and MRI showed clear displacement of the coccyx, and the injection resulted in pain relief only for the first few hours.
33 months after injury, I had a coccygectomy (removal of the coccyx). They put me under general anesthesia, the surgery lasted for about 45 minutes and then a little longer for me to wake up. I stayed for another hour or two after waking up and then was able to go home. I was nervous about riding home in the car, but with my cushion, it was only moderately painful. I took the first 1.5 weeks off of work, and during that time was taking the heavier pain meds. It was painful pretty much all of the time, even with the meds, but was tolerable. I could not sit for about 3 weeks, so when I started back at work after 1.5 weeks I worked from a standing desk from home. The wound was covered fully so I could shower right away and didn't have to change bandages. I was supposed to have a 2-week follow up in the office but had a stomach bug and did it over the phone. At that point, they said I could remove the bandage. There was never any significant bleeding as the incision site was glued? together. At about 2 weeks post surgery, the pain had gone down significantly and I only needed occasional ibuprofen. At about 3 weeks post surgery I rode in the car 45 minutes to get to work, with moderate pain. I am now 1 month post surgery, and can sit for 1-2 hours as long as I can sit more on my side/hip rather than flat (driving is the hardest for this). The pain while sitting is almost back to what it was before the surgery.
I am hoping this surgery will resolve my pain, given that the pain was mostly caused by the subluxation. In my research, I learned that when there is not as clear of an x-ray finding, surgery tends to be less successful on average. I will try to update after a few months post surgery. I am so ready to be done with the pain! Best wishes to everyone dealing with coccyx pain. I have learned that it is completely under recognized and there are not enough specialists!
