Comments from Adrian Good about treatment of coccydynia

Gluteus maximus syndrome

The gluteus maximus muscles are the powerful muscles in the buttocks that raise you from sitting to standing, and also lower you into a sitting position. The gluteus maximus is attached to the coccyx as well as to other bones. A spasm or tightness of this muscle can pull on the coccyx and cause pain when you move into a sitting position or raise yourself. It doesn't cause pain while you are sitting. The spasm, and the pain, is normally just on one side.


The features that distinguish gluteus maximus pain are:

  1. it hurts while raising or lowering yourself, even into a squatting position
  2. the pain doesn't depend on whether you actually put pressure on the coccyx by sitting - it goes away while you are sitting, instead of getting worse

If you have gluteus maximus pain, a manual practitioner who examines you will find muscle spasm, joint stiffness and tenderness at the lumbo-sacral joint on the same side as the pain. If the practitioner puts pressure on the point where the gluteus maximus is attached to the side of coccyx, this will reproduce the patient's pain.


Manual treatment of the back and buttock muscle should solve the problem, usually in 3 to 5 treatments, with clear improvement felt after the first treatment.

Adrian Good is an osteopath and physiotherapist in Melbourne, Australia (email:, and author of Pain Relief - Manual Therapies Can Help, Lothian Books, ISBN: 0734403240. The link is to the UK Amazon website, as it was not on the USA Amazon site.

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