The coccyx, or tailbone, consists of three to five fused rudimentary vertebrae at the base of the sacrum, providing attachment for muscles of the pelvic floor and gluteus maximus and serving as a weight-bearing surface during sitting.
| Articulations |
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| Landmarks |
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| Ossification | Each segment ossifies from its own primary centre, the first around birth and the others during childhood and adolescence. The segments fuse progressively with age, and the first segment may fuse to the sacrum in later life. |
The coccyx is the vestigial tail consisting of 3 to 5 coccygeal vertebrae. Coccydynia (tailbone pain) from a fall or childbirth injury is a common and often underappreciated source of significant disability, producing pain with sitting and rising from a seat. Dynamic lateral radiographs taken sitting and standing show whether the coccyx is hypermobile or dislocated. The anococcygeal ligament attaches here and the levator ani and coccygeus muscles form the pelvic floor around it. Most cases are managed conservatively with padded seating, analgesia and coccygeal injections, with coccygectomy reserved for truly refractory cases.
With the person lying on their side and with consent, place a fingertip at the top of the gluteal cleft (natal cleft) and follow the sacrum downward to the small, slightly mobile tip of the coccyx, which lies a few centimetres behind the anus. Gentle pressure here reproduces the pain of coccydynia.
Pain at the tailbone, often after a fall onto the buttocks or childbirth, worsened by sitting and by rising from a seat.
A backward fall can fracture or dislocate the coccyx at the sacrococcygeal joint; treatment is usually cushions, analgesia, and time.
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