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What Is Coccygectomy?

Coccygectomy is surgery that removes part or all of the coccyx, commonly called the tailbone. It is used for chronic coccyx pain, or coccygodynia, that remains severe despite an extended course of nonsurgical treatment. The operation can be a partial coccygectomy, which removes only the painful or unstable segments, or a total coccygectomy, which removes the entire coccyx. Because most people improve without surgery, coccygectomy is generally reserved for carefully selected refractory cases.

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What Is Coccygectomy?

Coccygectomy is surgery that removes part or all of the coccyx, commonly called the tailbone. It is used for chronic coccyx pain, or coccygodynia, that remains severe despite an extended course of nonsurgical treatment. The operation can be a partial coccygectomy, which removes only the painful or unstable segments, or a total coccygectomy, which removes the entire coccyx. Because most people improve without surgery, coccygectomy is generally reserved for carefully selected refractory cases.

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Why Is Coccygectomy Performed?

The procedure is considered when persistent coccygodynia causes substantial pain with sitting or daily activity and conservative treatment has failed. Common underlying problems include prior trauma, abnormal coccygeal mobility, degenerative changes, or a painful bony prominence. Examination and imaging can help identify a focal coccygeal source of pain and exclude other causes such as pelvic, spinal, or rectal disease. Surgery is generally considered only after treatments such as activity modification, cushions, physical therapy, medications, and injections have not provided adequate relief.

How Is Coccygectomy Performed?

The surgeon makes a small incision over the coccyx near the top of the gluteal cleft. The coccyx is carefully separated from surrounding muscles and soft tissues while the rectum, which lies immediately in front of the bone, is protected. The painful segments or the entire coccyx are removed according to the operative plan. The wound is irrigated and closed carefully because the location near the perineum increases the risk of postoperative contamination and infection.

What Is Recovery Like After Coccygectomy?

Recovery focuses on wound care, pain control, bowel regularity, and reducing direct pressure on the incision. Sitting can be uncomfortable initially, so patients often use positioning changes or a pressure-relieving cushion during healing. Walking is encouraged as tolerated, while strenuous activity and prolonged sitting are gradually reintroduced. Pain relief can continue to improve over several months as the wound and deep tissues heal.

What Are the Risks and Complications?

Wound infection and wound separation are among the best-recognized complications after coccygectomy because of the incision location. Other risks include bleeding, hematoma, persistent pain, numbness, painful scarring, and delayed wound healing. Rectal injury is uncommon but potentially serious because the rectum lies directly in front of the coccyx. Some patients continue to have coccygeal-region pain even after technically successful removal.

Frequently Asked Questions About Coccygectomy

Is the entire tailbone always removed during coccygectomy?

No. Some operations remove only the painful or unstable coccygeal segments, while others remove the entire coccyx.

When is coccygectomy considered for coccyx pain?

It is generally reserved for chronic, disabling coccygodynia that has not improved with a substantial course of nonsurgical treatment.

What is the most common complication after coccygectomy?

Published reviews identify surgical-site infection and wound-healing problems as the most common complications.

Can coccygectomy relieve chronic tailbone pain?

Yes. Systematic reviews report meaningful pain improvement in many carefully selected patients with refractory coccygodynia, although results are not guaranteed.

References

Advances in Coccygectomy: A Comprehensive Review Evaluating Surgical Techniques for Coccygodynia. PubMed. https://pubmed.ncbi.nlm.nih.gov/40002545/. Date Accessed September 11, 2026.

Coccygectomy for refractory coccygodynia: a systematic review and meta-analysis. PubMed. https://pubmed.ncbi.nlm.nih.gov/34694498/. Date Accessed September 11, 2026.

Clinical Outcome of Coccygectomy Using a Paramedian Curvilinear Skin Incision in Adults and Children With Meta-Analysis of the Literature Focusing on Postoperative Wound Infection. PubMed. https://pubmed.ncbi.nlm.nih.gov/34875185/. Date Accessed September 11, 2026.

Coccygectomy in the Treatment of Chronic Coccydynia. PubMed. https://pubmed.ncbi.nlm.nih.gov/34468434/. Date Accessed September 11, 2026.

An evaluation of two different methods of coccygectomy in patients with traumatic coccydynia. PubMed. https://pubmed.ncbi.nlm.nih.gov/28442929/. Date Accessed September 11, 2026.