After being diagnosed with lupus, it’s common to scour the list of lupus symptoms to anticipate what you might expect from this autoimmune disorder. But one symptom you may not have heard about is tailbone pain — even though some MyLupusTeam members say it affects them frequently.

“I get pain (soreness) in my tailbone after sitting, even if only for a brief period,” one member wrote. “It does not feel bruised, and I have not fallen. I have noticed it is increasing in frequency and severity over time.” Another member replied, “I suffer with pain often in my tailbone and lower back. It usually disturbs my sleep during bedtime.”

Managing chronic pain in the tailbone (coccyx), also known as coccydynia, requires lifestyle changes and possibly medical attention. Before you can find the best pain relief plan, you’ll need to discover what’s causing your symptoms in the first place.

Several factors can cause a person to develop coccydynia. If you’re experiencing pain in your tailbone area, a careful examination will likely be necessary to figure out the specific cause.

Symptoms of Tailbone Pain

Coccydynia may cause lower back pain symptoms that vary in severity from a dull ache to an intense stab. Tenderness and pain on the tailbone may worsen when you’re:

• Sitting
• Going from sitting to standing
• Having a bowel movement
• Engaging in sexual intercourse

Although a doctor may diagnose coccydynia based only on your reported symptoms, they may also rely on an MRI, a CT scan, and X-ray imaging to look for fractures, torn ligaments, cysts, or other visible causes of your pain.

Common Causes of Tailbone Pain

Tailbone pain can have many origins. A fall that causes fracture, dislocation, or bruising is a common explanation for coccyx pain. Intense childbirth or sitting on a hard or narrow surface, like a bicycle seat, for a long time can also cause this pain.

Tailbone pain is rarely caused by cancer. Your doctor may suspect cancer if you’re also experiencing numbness or tingling in your groin, legs, or arms, difficulty urinating or having a bowel movement, or if there’s a mass that can be seen near your tailbone.

People from different backgrounds and groups may face varying risks of lower back pain in the tailbone region. Individuals considered the most likely to develop coccydynia are:

• Female
• At a higher body weight (excess weight can place additional pressure on the coccyx)
• At a lower body weight (lower weight means less fatty cushioning around the tailbone)
• Pregnant

Can Lupus Cause Coccyx Pain?

Lupus is an inflammatory and autoimmune disease where the immune system attacks the body’s healthy cells, causing inflammation. Inflammatory symptoms can appear throughout the body, causing symptoms like joint pain and swelling, fatigue, fever, and facial rash.

The tailbone is not a common area for lupus symptoms to occur. Joint pain in people with lupus is most likely to affect the joints in the arms and legs, like the fingers, toes, elbows, wrists, and ankles. However, lupus-induced inflammation in other joints might cause secondary posture or movement changes that place pressure on the coccyx. Coccydynia itself is more likely a secondary issue from the condition rather than a primary symptom.

Osteoporosis

People with lupus are more likely to develop osteoporosis, a condition that weakens bones. Osteoporosis increases your risk of developing bone fractures anywhere in your body, including your tailbone. This can lead to tailbone pain if a fracture occurs in the lower spine or coccyx. Long-term use of corticosteroids, which are commonly prescribed to manage lupus flares, also contributes to bone loss and makes osteoporosis more likely.

If you’re experiencing persistent tailbone pain and have lupus, it’s important to talk to your doctor about whether bone loss or a fracture could be the cause. They may recommend a bone density test or imaging studies to check for signs of osteoporosis or fractures.

To help protect your bones, your doctor might suggest taking calcium and vitamin D supplements, doing weight-bearing exercises, and possibly taking medications to strengthen your bones.

Sitting for Long Periods of Time Due to Fatigue

Lupus-related fatigue can be overwhelming and often leads to long periods of rest or inactivity. During a flare, people with lupus may find themselves sitting or lying down more than usual, especially if joint pain, weakness, or brain fog makes movement difficult.

Unfortunately, prolonged sitting — particularly on hard or unsupportive surfaces — places increased pressure on the tailbone. This can lead to inflammation of the tissues surrounding the coccyx, resulting in discomfort. People with lupus who are underweight due to appetite loss or medication side effects may have even less natural cushioning in the buttocks area, making them more vulnerable to tailbone irritation when sitting for extended periods.

Changes in Posture Due to Muscle Changes

Though not a direct symptom of lupus, repetitive strain from activities like biking, rowing, or even poor posture can contribute to tailbone pain, and people with lupus may be more susceptible to these types of strain.

Lupus can affect muscle tone and coordination, sometimes leading to altered movement patterns or posture as the body compensates for pain or joint stiffness. For instance, someone with hip or lower back pain from lupus arthritis might sit unevenly or lean back more often, which could shift pressure onto the tailbone. Over time, these movements can cause repetitive strain on the soft tissues in the coccyx area, resulting in pain.

Pregnancy and Pelvic Changes With Lupus

People with lupus who become pregnant may experience tailbone pain due to hormonal and structural changes that occur during late pregnancy and childbirth. During the third trimester, hormones cause the pelvis and tailbone to loosen, allowing for flexibility during labor. While this is a normal part of pregnancy, those with lupus may have additional risk factors for pain due to joint inflammation or past musculoskeletal issues.

If the pelvic floor muscles or ligaments are overstretched or strained during delivery, it can affect the alignment and support of the tailbone. This may lead to lingering coccyx pain in the postpartum period, especially when sitting or engaging in physical activity.

Fibromyalgia

People with lupus have a higher risk of developing fibromyalgia, a chronic pain condition that causes widespread sensitivity, including in the lower back and tailbone area. Although fibromyalgia does not cause inflammation or joint damage, it heightens the nervous system’s pain response. This can make even minor pressure on the coccyx feel intense.

As a result, a person with both lupus and fibromyalgia may feel tailbone pain more severely, even without a specific injury. This overlap can complicate diagnosis and treatment, making it important to work with a rheumatologist who understands both conditions.

Tips for Managing Tailbone Pain

People with lupus may choose to manage tailbone pain just as they would manage the symptoms of a lupus flare.

To increase the chances of success, people with lupus-related tailbone pain should use a combination of different approaches, like physical therapy, ergonomic adaptation (making things more comfortable and efficient), and taking medications. This treatment plan may include pain management with over-the-counter pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids (steroids), regular use of disease-modifying antirheumatic drugs (DMARDs), and heat and cold therapy.

Lifestyle Changes

Ways to reduce tailbone pain and other lupus symptoms include:

• Resting
• Managing stress
• Sticking to a treatment plan prescribed by your healthcare team
• Using hot and cold therapy
• Stretching the affected area gently
• Participating in a physical therapy plan

Additional lifestyle recommendations for tailbone pain include leaning forward while sitting down and sitting on a doughnut- or wedge-shaped cushion to help ease tailbone discomfort.

Some MyLupusTeam members have shared their experiences with different forms of tailbone pain management:

• “Have you tried ice? Or you could try one of those packs that get cold when you snap them.”
• “I have a good pillow that takes the pressure off my tailbone when I’m seated for a long time at work.”
• “I sleep on my side with a pillow on the small of my back. It seems to help.”

Make sure to ask your doctor for medical advice before starting any new treatments, including home remedies. They can provide valuable guidance and tailor the treatment approach based on your specific condition. You’ll want to discuss any symptoms, pain severity, and how it affects your daily life to ensure an accurate diagnosis and appropriate management.

Find Your Team

On MyLupusTeam, the social network for people with lupus and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Are you looking for ways to find relief from tailbone pain? Do you have any tips to offer? Share your experience in the comments below, or start a conversation by posting on your Activities page.