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When Does Tailbone Pain Start During Pregnancy?

“When Does Tailbone Pain Start During Pregnancy?”

That’s a question A LOT of people are asking Google.

It made us wonder: Do many people just assume tailbone pain is an inevitable part of pregnancy, something they will have to “suffer through” at some point?

We are here to assure you that’s not the case!

While common, there are many things you can do to prevent or relieve tailbone pain, or coccydynia. First, let’s cover some background information on your tailbone, and what tailbone pain feels like. Then, we’ll discuss the common causes of tailbone pain during pregnancy and what you can do to prevent or relieve the pain.

Where is the Tailbone and What Does it Do?

The tailbone, or coccyx, is located at the very base of the spine and serves as an attachment site for tendons, ligaments, and muscles. It supports and stabilizes a person while sitting, especially when leaning back in a chair.

What Does Tailbone Pain Feel Like?

Tailbone pain primarily manifests as pain and tenderness at the base of your spine (near the top of your bottom). The pain can range from dull and achy to sharp. This pain can be exacerbated by sitting for prolonged periods, especially on hard or minimally-cushioned surfaces, or during certain movements such as standing up from a seated position. The sensation may also radiate towards the lower back or buttocks, making daily tasks very uncomfortable.

What Causes Tailbone Pain?

During pregnancy, the following changes can lead to tailbone pain:

  • Hormonal Changes: Pregnancy triggers the release of hormones such as relaxin, which relaxes the ligaments in the pelvis to prepare the body for childbirth. While this is a necessary adjustment, it can also lead to increased mobility in the coccyx area, resulting in discomfort or pain.
  • Increased Weight and Pressure (especially from sitting): As pregnancy progresses, the added weight of the growing fetus increases the load on the spine and pelvis. This can put extra pressure on the tailbone, especially when leaning backward in a chair, or slouching. Both of these positions can increase the pressure on the tailbone.

  • Postural Changes: The center of gravity shifts forward and up as the uterus expands, often causing pregnant individuals to adjust their posture unconsciously by leaning backward to counterbalance (as you can see below). These adjustments can add stress to the lower back and coccyx, contributing to discomfort.

  • Direct Pressure from the Baby: In later stages of pregnancy, the baby’s position can exert direct pressure on the tailbone, especially if the baby is in a breech (feet or bottom first) position. This pressure can be uncomfortable and cause pain in the tailbone area.
  • Childbirth: During vaginal delivery, the coccyx is pushed backward as the baby moves through the birth canal, which can lead to bruising, dislocation, or fracture of the coccyx. Although this is more directly related to postpartum coccydynia, the strain on the coccyx during childbirth can also exacerbate existing pain during pregnancy.
  • Previous Injuries: Individuals with a history of tailbone pain prior to pregnancy may find that their symptoms worsen during pregnancy due to the increased strain and hormonal changes.
  • Sedentary Lifestyle: Prolonged sitting, especially on hard or poorly cushioned surfaces, can exacerbate tailbone pain. Individuals who limit their physical activity during pregnancy, and spend more time sitting, could feel increased discomfort.

When Does Tailbone Pain Start During Pregnancy?

As mentioned upfront, tailbone pain does not necessarily need to start at all during pregnancy. For those who do experience tailbone pain, there is no universal timeline for its onset, though it is most commonly reported in the second and third trimesters. This variation is due to the body’s individual responses to pregnancy-related changes in weight, posture, and hormone levels.

How to Help Prevent Tailbone Pain

Preventing tailbone pain during pregnancy involves a combination of exercises, postural adjustments, and lifestyle modifications aimed at minimizing stress on the tailbone. Here are some strategies:

  • Maintain Neutral (Pelvic) Alignment: Practice sitting in neutral alignment (with the weight on your “sits” bones rather than on your tailbone) and distributing your weight evenly on both hips.

  • Improve Deep Core Function: Improving deep core function is the most significant thing you can do to help prevent nearly all pregnancy pains and injuries because of the systemic effect that deep core function has across the entire body. With tailbone pain specifically, the core muscles help to support the pelvis and tailbone. Begin with 360° Breathing (a.k.a. the #1 most effective core exercise) and practice incorporating it into your movements. Then, master Pelvic Floor Activations and practice them a few times per day.
  • Focus on Strength Training (especially glutes): With your body in neutral alignment and your deep core muscles activating well, the next most important strategy is to focus on strength training. The physiological changes of pregnancy place a great deal of added stress on the body, which is why there are so many “common” pregnancy pains. The stronger you are, the better your body will be at managing the increased stresses placed upon it. In the case of tailbone pain, strengthening the glutes (with exercises like squats and bridges) is especially important because they work with the core to support the pelvis and tailbone. For safe and effective strength training programs at all stages of pregnancy, explore our self-guided training programs.
  • Mobility Work: Stretch regularly, emphasizing gentle stretches for the lower back, hips, and pelvic area to relieve tension. Try these mobility exercises to prepare for birth for some extra bang for your buck to prep your body for an easier delivery.
  • Avoid Prolonged Sitting: Take frequent breaks to stand up and move around if your job or daily activities involve long periods of sitting. When sitting, alternate between different sitting positions to relieve pressure on your tailbone.
  • Mindful Movement: Be cautious when transitioning from sitting to standing or when lifting objects. Try bending your knees and move in neutral alignment to minimize unnecessary stress on your tailbone.

How to Help Relieve Tailbone Pain

All the above strategies are also helpful in alleviating pain. In addition to those, you can incorporate the following tips to manage pain.

  • Use a Donut Cushion or Wedge Pillow: Sitting on a donut cushion or a specially designed wedge pillow can relieve pressure on the tailbone.
  • Consult with a Specialist: A physical therapist can provide tailored exercises, manual therapies, and advice on posture and movement to alleviate pain and improve pelvic alignment. If pain is severe or persistent, consult with a specialist, such as a physiatrist or pain management doctor.
  • Consider Acupuncture or Massage Therapy: Some people find relief from acupuncture or massage therapy focusing on the pelvic area. Ensure the practitioner is experienced in treating pregnant clients.

Want Additional Resources?

As mentioned above, safe and effective strength training can be the key to mitigating most pregnancy pains & injuries because it prepares the body to be able to more successfully manage these stresses. For safe and effective total-body workouts throughout all stages of pregnancy, explore our Pre & Postnatal Self-Guided Training Programs. 

To learn how to design safe and highly effective strength training programs for pre & postnatal clients, check out our industry-leading Pre/Postnatal Fitness Specialist Certification