What to expect from a cortisone injection for coccydynia

Coccydynia is pain around the coccyx, often worse when sitting, rising from a chair or leaning backward. Before injection, the clinician considers the location and pattern of pain and checks for other causes, including injury or problems nearby. The medicine is placed near the painful joint or surrounding tissues, sometimes with imaging guidance. Local anaesthetic may give short-lived numbness, while cortisone can take several days to reduce inflammation. The injection is a symptom treatment, not a way to change the shape of the tailbone.

Discuss diabetes, blood-thinning medicine, allergies, infection and previous procedures beforehand. For the first period after injection, avoid prolonged sitting and follow the clinician’s advice about driving and activity. A coccyx cushion with a suitable cut-out, frequent position changes and a gradual return to sitting may reduce pressure. Physiotherapy can address pelvic-floor coordination, hip mobility and sitting mechanics when appropriate. Keep a record of which positions provoke pain so the plan can be adjusted around real daily activities.

Contact the clinic promptly if pain at the injection site is worsening, or if there is increasing redness, warmth, swelling, drainage or fever. Seek urgent help for new leg weakness, loss of bladder or bowel control, numbness around the groin, breathing difficulty or facial swelling. Persistent tailbone pain, unexplained weight change, night pain or symptoms after a significant injury also deserve clinical assessment rather than repeated injections without review.

Which structure is causing my tailbone pain, and will imaging guide the injection? How should I sit and move afterward? Could pelvic-floor or hip treatment help? What symptoms mean I need an examination rather than another injection?