My coccyx pain was secondary to a sacroiliac ligament sprain that went untreated. My pelvis twisted slowly out of shape and because my low back and hips hurt so much, I would slink down in chairs when I sat, and eventually that made my tailbone sore. It took a long time to correct this (about a year with the help of a physiatrist (not psychiatrist) who specializes in rehabilitation medicine, and a chiropractor. Just as I was almost completely recovered, I made the mistake of allowing the rehab doctor to inject Prolo into the sacrum to help stabilize it. For anyone suffering coccyx pain, I would strongly suggest staying away from this kind of injection. It completely reversed my recovery for 9 months or so. My anger at the doctor who caused this was so great I believed it kept me from getting better. When I finally chewed her out, my coccyx pain cleared up in four days, and was just fine for 4 or 5 months. But I pushed it too far with a long road trip, so now I'm a mess again - sore sacrum, low back pain, hip pain, and of course coccyx pain.
I've tried most all therapies except coccyx removal because it was advised against since I have not actually broken this bone. (It is the muscles attached to it that get so tight and sore.) I find what helps most is a combination of things: a portable sitting chair insert called a Sacro-Eze makes almost any chair or car seat more comfortable, especially if you are short, and is much more comfortable than a Tush Cush or donut. Also, another insert is called an Obusforme but it is mostly meant for leaving in a particular chair or car, it is not as portable.( Both are expensive though, but worth it - about $200 each). Also, I take a regimen of Esgic Plus and Vicodan daily. The Esgic Plus will relax muscles and reduce pain while leaving you clear headed and alert, and the Vicodan assists with some of the pain. I can function on this regimen as long as the doses are low. Believe it or not, sitting on gel ice-packs under a towel has reduced butt pain for me. You can carry them in an insulated sandwich pack. They seem to prevent a lot of pain. Antidepressants not only help with depression (and let's face it - thoughts of suicide!), but reduce pain sensitivity. A pain-management program can be helpful too - that's worth a try. And prayer, prayer, prayer!
I've had acupuncture, hypnosis, cortisone epidurals, trigger point injections, manual massage (yes, on the inside as well as the outside!), and pelvic floor rehabilitation. I can't say any of these was especially helpful, but that doesn't mean you shouldn't give them a try - everyone's case is different.
This is one of the most difficult situations I have ever faced, and certainly my first protracted bout with chronic pain. I've had it so long it seems like a way of life now. Working with it is the only thing I know how to do. And I think deep repressed emotion (regarding enduring this problem or other life situations) can somehow exacerbate it, though I'm sure it is not the only factor. But don't overlook it. It really helps to read about others suffering through this. I understand them and I take comfort in knowing they understand me.
I would recommend a good pain management course to anyone who is suffering with chronic pain, of any kind. The one I'm in is run by a psychological practice that specializes in pain patients, but you can find them at hospitals or by a doctor's referral. A great book for learning to overcome pain is called MANAGING YOUR PAIN BEFORE IT MANAGES YOU by Margaret Caudill, MD, Ph.D. This book is used with the course I'm in. There really is a lot to learn about how the brain processes pain, and what you can do to affect that and cope better while waiting for "the cure"!
Best of luck to all.