There is more than one possible cause of pain around the tailbone. Muscle tightness, sitting posture, pregnancy-related pelvic changes, spinal conditions, or injury may all contribute.

One common cause of tailbone pain is tightness in the muscles around the buttocks. When muscles such as the coccygeus, piriformis, and gluteus maximus become stiff, circulation may decrease and discomfort can develop around the coccyx.

Your sitting posture may also place unnecessary pressure on the tailbone. If you slide forward in your chair instead of sitting fully back on the seat, more of your body weight may be transferred directly onto the coccyx.

As the abdomen grows during pregnancy, the pelvis tends to tilt forward. This may change the position of the tailbone and increase strain around the area.

After childbirth, the pelvis gradually returns toward its previous position. If that process leaves the pelvis misaligned, tension may develop around the sides of the coccyx and may eventually lead to pain.

Compression of the nerves caused by lumbar spinal stenosis or a herniated disc may also cause pain around the tailbone. These conditions can produce sciatica, with pain or numbness extending from the lower back and buttocks into the thighs, legs, or feet.

Because it can be difficult to identify the cause of persistent tailbone pain on your own, medical imaging such as an X-ray or MRI may be needed when symptoms continue.

Some sleeping positions can increase pressure on the coccyx or tighten the muscles around the lower back and buttocks. If your tailbone hurts at night, avoiding these positions may help.

Sleeping on your stomach may place extra stress on the lower back and increase discomfort around the tailbone. In this position, one or both legs may rotate inward or outward, which can twist the hips and pull on the muscles around the buttocks.

For people with lumbar spinal stenosis or other lower back problems, prolonged stomach sleeping may also increase lower back discomfort.

If you have an excessive lower-back arch, spinal stenosis, or sciatica, lying completely flat on your back may make symptoms worse. Back sleeping can extend the hips and increase the arch in the lower back while also placing direct pressure on the buttocks.

If the muscles around the buttocks are already tight, this additional pressure may increase pain.

When sleeping on your side, bringing the upper leg too far forward can stretch the muscles around the buttocks and increase pain. If the discomfort is related to spinal stenosis or a herniated disc, this position may also contribute to pain or numbness in the lower back or legs.

If tailbone pain is making it difficult to sleep, adjusting your position and using cushions to reduce pressure may make you more comfortable.

If lying on your back causes the tailbone to press into the mattress, place a cushion beneath the lower thighs or knees.

When the legs are completely straight, the lower back may arch more, increasing pressure around the coccyx. Supporting the legs with a cushion can help reduce that strain.

When sleeping on your side, keep your legs slightly bent and place a cushion between your thighs. Keep your upper body straight or gently rounded rather than twisting forward.

If the upper leg moves too far forward or the knees are bent too deeply, the muscles around the buttocks may be pulled or shortened and become more painful.

The source article recommends a cushion approximately one to two fist-widths thick between the thighs.

Changing your sleeping position is not the only way to reduce discomfort. Depending on the cause, the following self-care approaches may also help.

If muscle tightness is contributing to the pain, warming the area in a bath may help improve circulation. If the discomfort feels better after warming, muscle stiffness may be involved.

When tight muscles around the buttocks are contributing to tailbone pain, gentle stretching may help keep the area more flexible and reduce stress on the coccyx.

When sitting, avoid sliding forward in your chair. Try to keep your pelvis upright and support your body through the sitting bones rather than placing your weight directly on the tailbone.

A cushion can also help reduce pressure on the coccyx.

Tailbone pain can have several different causes, and some sleeping positions may increase pressure on the coccyx or worsen lower back discomfort.

If your tailbone hurts at night, try adjusting your sleeping position and using cushions to support your legs or pelvis. If the pain is strong or continues, seek medical evaluation rather than relying only on self-care.

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