When most people think of rheumatoid arthritis (RA), they imagine joint pain affecting the wrists and knees. But back pain, including tailbone pain, can affect people with RA. One myRAteam member described that pain in their tailbone (coccyx), the lowest part of the lumbar spine, “makes it hard to sit or lie down a lot of the time.”

Managing chronic pain in the tailbone, also known as coccydynia, requires lifestyle modifications and possibly medical attention. Before you can find the best pain relief plan, it is essential to discover what is causing your symptoms in the first place.

Symptoms of Tailbone Pain

Coccydynia may cause low 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 identify fractures, torn ligaments, cysts, or other visible causes of your pain.

Common Causes of Tailbone Pain

Tailbone pain can have many origins. External trauma, such as a fall that causes fracture, dislocation, or bruising, is a common explanation for coccyx pain. Internal trauma can be caused by intense childbirth or sitting on a hard or narrow surface, like a bicycle seat, for a long time. Less commonly, tailbone pain can be caused by infection, abscess, and tumors, which are harder to pinpoint and diagnose, and can have very different treatment plans than tailbone pain from trauma to the body.

Different demographics of people face differing risks for lower back pain in the tailbone region. Those who are female, obese or underweight, pregnant, or older are considered the most likely to develop coccyxdynia.

Tailbone Pain in People With RA

RA is an inflammatory and autoimmune disease. The immune system attacks the body’s healthy cells, causing inflammation. Inflammatory symptoms can appear throughout the body, manifesting as pain and swelling, usually in the joints.

Autoimmune conditions are often associated with back pain because of the immune system’s attack on healthy cells, including cells that make up the vertebrae. Although the tailbone is not the most common location for RA pain, research has reported cases of coccydynia in individuals with RA. People with RA could have tailbone pain due to a fall or another common cause that’s unrelated to an inflammatory condition.

Tailbone pain in people with RA could be caused by a related autoimmune condition. The most common autoimmune cause of coccydynia is ankylosing spondylitis, an inflammatory disease that causes the fusion of bones in the body over time.

Tailbone pain may also be associated with other conditions, such as osteoarthritis of the spine, psoriatic arthritis, and systemic lupus. In such conditions, tailbone pain likely progresses over time, so it is important to seek medical advice from your rheumatologist to receive appropriate medical treatment.

Tips for Managing Tailbone Pain

People with RA may choose to manage tailbone pain just as they would manage the symptoms of an RA flare. This treatment plan may include pain management with over-the-counter pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, regular use of disease-modifying antirheumatic drugs, and heat and cold therapy.

Ways to reduce tailbone pain and other RA symptoms include:

• Resting
• Managing stress
• Sticking to a treatment plan prescribed by your health care team
• Using hot and cold therapy
• Following an anti-inflammatory diet may reduce tailbone pain, as well as other symptoms of RA

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 myRAteam members shared their experiences with different forms of tailbone pain management:

• “I am on Plaquenil and methotrexate injectable. These meds are to put my rheumatoid arthritis, ankylosing spondylitis, and Sjögren’s in remission, and they do help my pain.”
• “Steroids helped me. I had a high dose to start and weaned off them shortly after. I found that I didn’t have many side effects.”
• “When I’m in a lot of pain, I will run a hot bath.”
• “Aleve, heating pads, and hot baths are the only things that seem to dim the pain.”

If your pain doesn’t improve over time, medical interventions may include physical therapy targeting the pelvic floor muscles, medications such as antiepileptics and antidepressants, and — in extremely rare cases — surgical removal of the coccyx bone.

Remember to always speak to your health care team before starting any new treatments, including home remedies.

Talk With Others Who Understand

On myRAteam, the social network for people with rheumatoid arthritis and their loved ones, more than 190,000 members come together to ask questions, give advice, and share their stories with others who understand life with RA. Here, finding home remedies to alleviate pain is a commonly discussed topic.

Are you looking for ways to find relief from tailbone pain? Is chronic low back pain affecting your quality of life? Share your experience in the comments below, or start a conversation by posting on your Activities page.