Tailbone (Coccyx) Pain Care in St. Thomas, U.S. Virgin Islands

Tradewinds Chiropractic & Wellness sees tailbone pain in Charlotte Amalie, St. Thomas. Dr. Bradley Keys, Doctor of Chiropractic, treats residents, new mothers, boaters, cruise passengers and visitors at the VI Medical Foundation Building in Estate Thomas, a short drive from Havensight. This page covers what it is, what we do for it, and when it needs a physician.

What tailbone pain feels like

The medical word is coccydynia. The pain sits at the very bottom of the spine, between the buttocks. It is sharp when you sit down, worse when you lean back in a chair, and often worst in the moment you stand up from sitting. Lying down and walking usually feel fine.

Three stories bring it in the door. A fall, straight down onto the tailbone off a wet swim platform, down companionway stairs, or off a paddleboard into shallow water. Sitting, a long flight from the mainland followed by a week of hard dinghy benches, or months in an office chair. And childbirth, where the coccyx gets pushed back hard during delivery and stays sore, sometimes at a new angle.

What is usually going on

The coccyx is three to five small bones at the tip of the sacrum, joined by small joints and ligaments, with the pelvic floor muscles and gluteus maximus attaching to it. It bears weight when you sit leaning back. After a fall it can be bruised, sprained where it meets the sacrum, bent into too much or too little curve, or occasionally fractured or dislocated. With long sitting the joint gets irritated and the pelvic floor muscles around it tighten and stay tight. Childbirth does the same in reverse, forcing the bone backward.

Tailbone pain sometimes comes from the SI joint or low back instead, and a sore tailbone can leave you sitting so crooked that SI pain develops on top of it. The exam sorts out which is which.

How we treat tailbone pain at Tradewinds

We take a history, then press on the sacrum, the coccyx and the muscles around them to find what is tender and whether the coccyx moves normally. After a fall, or when the pain is severe, we take digital x-rays on site to check for fracture or dislocation and see the angle of the bone. Most tailbone pain does not need an x-ray.

Treatment:

• Gentle external techniques to the sacrum and coccyx, using light pressure and drop-table methods. The tailbone does not need much force.
• Soft tissue work, from the outside, to the gluteus maximus and the muscles alongside the coccyx.
• Adjustment of the sacrum and SI joints where they have stiffened from sitting crooked.
• Cushion advice. A wedge cushion with the back corner cut out, or a U-shaped cushion, takes the weight off the bone. Donut cushions are usually the wrong shape. Lean slightly forward when you sit.
• Activity advice: shorter sits, getting up often, and a short course of ice for a fresh injury.

Some chiropractors and physical therapists also adjust the coccyx internally, through the rectum, for cases that do not respond to external work. Tailbone work here is external only. If internal adjustment is needed, we refer you to someone who does it.

Services are listed on the services page, and a first visit is described on what to expect. New mothers with tailbone pain after delivery can read our pregnancy care page for how soon we see patients postpartum.

Dr. Keys is the Chair of the Virgin Islands Board of Chiropractic Examiners, a member of the Virgin Islands Chiropractic Society, and the International Chiropractors Association representative for the U.S. Virgin Islands.

A bruised tailbone from a fall generally settles over several weeks with care and a cushion. Pain that has been there for months, or that started with childbirth, takes longer. We set a plan with a re-check date, and if it is not moving we talk about imaging and a referral for an injection.

When you should see someone else

Tailbone pain that is positional, worse sitting and fine otherwise, is almost always mechanical. See your physician, or the emergency room for the more urgent items, if you have:

• Rectal bleeding, or blood in the stool
• Fever with the pain
• A lump or mass you can feel near the tailbone
• Numbness in the saddle area, or numbness or weakness in a leg
• Any change in bowel or bladder control
• Pain that is constant, not affected by sitting or standing, or that wakes you at night
• Unexplained weight loss or a history of cancer

Those can point to infection, a pilonidal cyst, a tumor or a nerve problem, and they need to be worked up before anyone treats the tailbone.

Visitors and crew

Falls on wet decks and swim platforms happen every charter season, and the flight home is a long sit on a sore tailbone. We can usually see visitors the same week, check the bone, and send you off with a cushion plan. See hurt your back on vacation.

Getting seen

Tradewinds Chiropractic & Wellness is at the VI Medical Foundation Building, Suite 202, 9150 Estate Thomas, St. Thomas, USVI 00802. Call (340) 690-4994 or email info@tradewindschiropractic.com.

Hours: Mon, Wed, Thu: 10:00 am to 1:00 pm and 3:00 pm to 7:00 pm. Tue, Fri: 7:00 am to 2:00 pm. Closed Sat and Sun.

We take walk-ins and same-day appointments. We have more than 180 five-star Google reviews.

Questions patients ask

I hurt my tailbone in a fall. Who do I see in St. Thomas?

If there is bleeding, numbness, weakness, or any bowel or bladder change, go to the emergency room. Otherwise Tradewinds Chiropractic & Wellness in Estate Thomas can examine the coccyx, x-ray it on site to rule out a fracture or dislocation, and treat it with gentle external techniques, soft tissue work and a cushion plan. Call (340) 690-4994.

Can a chiropractor in the USVI treat coccyx pain from sitting?

Yes. Tailbone pain from long sitting is usually an irritated coccyx joint with tight muscles around it. Dr. Bradley Keys treats it with light pressure and drop-table techniques to the sacrum and coccyx, soft tissue work, and advice on a wedge or U-shaped cushion and how to sit. Most cases improve over a few weeks.

My tailbone hurts after childbirth. Can I get help in the Virgin Islands?

Tailbone pain after delivery is common and often lingers because the coccyx was pushed back during birth and the muscles around it stayed tight. We treat it at Tradewinds with gentle external techniques, soft tissue work and a cushion for feeding and sitting. See our pregnancy care page for how soon after delivery we see patients.

Do I need an x-ray for tailbone pain?

Not usually. We take digital x-rays on site after a fall, when the pain is severe, or when it has not responded to care, to check for fracture or dislocation and to see the angle of the bone. For pain from sitting alone with no injury, the exam is generally enough to start.

What cushion is best for tailbone pain?

A wedge cushion with the back corner cut out, or a U-shaped cushion open at the back, so the tailbone floats and your thighs carry the weight. Donut cushions tend to push the tailbone down and are usually not the right shape. Lean slightly forward when you sit and get up every half hour.