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Individuals with persistent coccydynia may be treated with physical therapy including modalities such as ultrasound and heat. Osteopathic manipulation and mobilization techniques are sometimes performed if the physician determines that mobility of the sacrococcygeal segments is decreased. Three sessions of coccygeal manipulation via the rectum have been found to be twice as effective in reducing pain as external physical therapy for those with traumatic onset of pain and a stable coccyx (Maigne). Active exercises and a home exercise program to improve pelvic strength may be incorporated in the treatment regimen. Individuals may be advised to increase fiber intake or to take stool softeners to prevent painful constipation.

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