Can Hemorrhoids Cause Tailbone Pain? (Coccyx Pain)

Medically reviewed by: Gary H. Hoffman, MD

Hemorrhoids and Tailbone Pain. A Real Pain in the...

Everyone has heard that hemorrhoids can bleed, itch, and burn. They may even protrude out of your anus. But what about tailbone pain? Tailbone pain is that sharp or dull discomfort you might feel during prolonged sitting, walking, or sleeping.

As it turns out, tailbone pain is one of the most common complaints amongst patients in our proctology practice. And other colon and rectal surgeons report that their patients often suffer tailbone pain, as well.

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So, in short, yes, hemorrhoids can make your tailbone hurt. Let’s find out why this happens and what you can do about it.

Hemorrhoids may bring unexpected symptoms

Hemorrhoids have many symptoms. There are some well-known, classic symptoms of hemorrhoids that are almost unavoidable and universally understood as a part of suffering through the condition. These symptoms include:

  • Painless rectal bleeding, especially if you have internal hemorrhoids
  • Burning and pain around the anus
  • A protrusion sometimes called prolapse
  • Itching
  • Swelling

What many people do not realize, however, is there are also many other symptoms of the condition. And our patients commonly report tailbone pain along with the classic symptoms.

Still, it seems unbelievable to many people that a small irritated and engorged blood vessel could cause major discomfort in a nearby but unrelated part of the body. But a quick anatomy lesson is all it takes to understand why it happens.

Anatomy 101: the key lies in the muscles

In order to prevent the untimely, accidental discharge of feces, liquid, or gas out of the anus, our bodies have special muscles called the levator muscles.

The levator muscles work in concert with our anal sphincters to give us our full control of our bowels under normal circumstances. They elevate the abdominal contents out of the pelvic cavity — think “elevator” — and also contract around the rectum to hold in the contents and aid in peristalsis. Peristalsis is the pulsing of rectal muscles to help to push the content of the colon and rectum forward.

Now, each of the group of levator muscles has an origin (a beginning attachment) and an insertion (an ending attachment). These attachments are the key to the strong muscle contractions necessary for peristalsis.

As such, the levators begin in the front of the pelvic cavity and end in the back of the pelvis. And one of the points of termination for some of these muscles is the coccyx or tailbone.

Because of this connection and the strength of the levator muscles, the tailbone flexes slightly with each muscle contraction. This connection and movement explain why an issue that seems only to affect the anus can cause tailbone pain.

Understanding hemorrhoids

Many people do not understand what hemorrhoids are, leading to confusion and misunderstanding.

These structures are one of the most common causes of anal pathology, and if you have a problem with them, you unwillingly think about them a lot. But we find that many of our patients do not understand what hemorrhoid

s are and what happens when things go wrong.

First and foremost, hemorrhoids are normal tissue. Everyone has them from birth. They serve to cushion and protect the anal opening during bowel movements.

What people generally think of as “hemorrhoids” are inflamed and enlarged hemorrhoidal tissues. It is this inflammation and swelling that turn these normal tissues into the dreaded condition no one wants to talk about.

Hemorrhoids are a collection of veins, arteries, nerves, and connective tissue that are located inside, and sometimes outside, of the anal canal. Blood flows into the area, delivering oxygen and nutrients to the tissues. The blood then returns to the heart via the hemorrhoidal veins. Problems begin when the hemorrhoidal veins begin to dilate.

When these veins dilate, they become larger and closer to the surface. The irritation caused by inflammation and swelling leads to classic hemorrhoid symptoms.

Hemorrhoids and tailbone pain

When the hemorrhoidal tissues become inflamed or enlarged — especially when they prolapse — they cause the levator muscles to pull harder. This moves the coccyx more than normal, causing tailbone pain.

Like other bones, the coccyx has pain nerves, which cause pain when stretched. When the levator muscles pull on the tailbone too hard, it stretches the bone ever so slightly, triggering the pain nerves and making your tailbone hurt.

The tailbone pain often associated with hemorrhoids may be acute and occur suddenly without warning. In other cases, it may be chronic and long-lasting.

Many of our patients describe acute pain from hemorrhoids disrupting their sleep at night, followed by persistent tailbone discomfort that accompanies them throughout the day. Understandably — and possibly from personal experience — both types of pain can significantly distract or even lead to missing work due to hemorrhoids.

The good news is that this type of tailbone pain is not related to cancer or any other serious, life-threatening problems. Of course, any unexplained pain that does not go away on its own should be evaluated by your doctor to be sure that nothing else is causing the pain.

Clinical management of inflamed hemorrhoids should stop the tailbone pain, and it should not occur again unless the hemorrhoids recur. When inflamed hemorrhoids are treated, and the swelling in these tissues goes down, the symptoms of the hemorrhoids should also disappear.

Without swelling or inflammation, the levator muscles no longer have to work as hard and should not put extra stress on the tailbone. Your pain should stop within a few days after your hemorrhoid symptoms’ disappearance.

If it persists, there might be another cause for the pain, like a tailbone injury or rheumatoid arthritis. You may need treatments like physical therapy or rheumatological drugs to get rid of it.

Hemorrhoid treatment to stop tailbone pain

In most cases, hemorrhoids only require conservative treatment. Once you see a doctor and have a diagnosis, you can begin making the small lifestyle changes likely recommended by your healthcare provider.

You can also use sitz baths and over-the-counter medications recommended by your doctor to manage pain and symptoms until you heal.

In addition, eating a diet higher in fiber and with increased water intake can help keep your bowel movements regular and prevent a recurrence.

If a recurrence occurs or your case is serious, your doctor may recommend an in-office procedure to treat your hemorrhoids. In some cases, surgery or other alternatives may be necessary.

How to relieve tailbone pain from hemorrhoids?

To relieve tailbone pain from hemorrhoids, it’s important to treat your hemorrhoids first. However, if you have severe pain, you can ask your doctor for nonsteroidal anti-inflammatory drugs like Tylenol or Ibuprofen and see if they’re effective. But it’s important to continue hemorrhoid treatment and any other over-the-counter medication you get for tailbone pain.

Can coccyx pain cause rectal pressure?

Coccyx pain does not cause rectal pressure. Instead, it results from rectal pressure. When levator muscles get inflamed due to any pathology, they cause a build-up of rectal pressure and coccyx pain.

Can bowel problems cause tailbone pain?

Yes, bowel problems can cause tailbone pain. The levator muscles are closely related to the bowel and can go into spasms as a result of bowel problems. This can lead to pain, as discussed above.

Can constipation cause tailbone pain?

Yes, constipation can cause tailbone pain. When constipated, you are more likely to sit on the toilet for long periods during bowel movements. Prolonged sitting — especially if you have a bad posture — can hurt your tailbone.

Can hemorrhoids cause low back pain?

No, hemorrhoids don’t classically cause low back pain. However, they can cause tailbone pain, which may be perceived as low back pain by some patients. Although, some patients have stated that their hemorrhoids have caused aching down the backs of their legs.

If you have hemorrhoids and tailbone pain, call us

If you do not have a doctor, the team from Los Angeles Colon and Rectal Surgical Associates can help. We are trained to diagnose and treat hemorrhoids, including tailbone pain or any other unusual symptoms you may have. Make an appointment and confidential consultation by calling our Los Angeles hemorrhoid treatment team today at (310) 273-2310.

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