Hard, Painful Bump on Your Tailbone? Symptoms of a Pilonidal Cyst

Updated on June 24, 2019
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I had the unfortunate experience of developing a pilonidal cyst—it was a literal pain in the butt.

Pilonidal cysts are painful when left untreated. Find out what to look for.
Pilonidal cysts are painful when left untreated. Find out what to look for. | Source

A pilonidal cyst can be a dreadfully painful affliction. I had the unfortunate experience of developing one, and at the time, I had absolutely no idea what it was. I brushed it aside as a minor inconvenience and left it untreated until one day I found I could barely walk. Soon I couldn’t sit, stand, or lay down either—I was experiencing constant agony on my backside. This literal "pain in the butt" may seem funny to some (myself included), but it feels horrible when you’ve actually got one.

If you believe you may be developing a pilonidal cyst, the absolute best course of action is to recognize the symptoms early and get treatment before it begins to cause you excruciating pain. Early treatment of a pilonidal cyst, whether at home or at the hospital from your doctor, can save you a great deal of anguish.

Pilonidal Cyst Signs and Symptoms

When fully developed, a pilonidal cyst is an extremely painful lump that may contain pus, dead skin, and hair. Generally, the surrounding area will be red or pink, warm to the touch, tender, and inflamed.

If you suspect you may be starting to develop a pilonidal cyst, or if you think you may already have one, review the two main symptoms below. Thankfully, the signs are easily recognizable, so you shouldn’t have too much trouble working out whether or not they apply to you. If you are experiencing any of the symptoms below, visiting a medical professional is advisable.

1. A Lump on or Near the Tailbone

The first and most obvious symptom is the presence of a small lump, bump, or protuberance on or close to your tailbone. Beginning as a tiny lump, a pilonidal cyst will gradually increase in size. Even when noticed early, cysts can be easy to forget about when they are still small and relatively painless.

2. Pain in or Around the Tailbone When Sitting Down

Some cysts lie underneath the skin, making them difficult to detect until they reach a noticeable size. Even when not yet visible, however, these cysts can cause significant pain when you are seated due to the extra pressure put on the tailbone area.

Additional Symptoms

  • Tenderness and swelling at the base of the spine
  • Redness and heat
  • Foul odor
  • Fever
  • Draining pus
  • Discomfort when sitting

Almost all pilonidal cysts are located near the tailbone, or coccyx.
Almost all pilonidal cysts are located near the tailbone, or coccyx. | Source

Early Diagnosis and Treatment

Most people who develop these cysts don't pay them much mind until they suddenly transform into a large and painful lump. If you think you may have one developing, be sure to check on it every day. If the lump persists and increases in size, see your doctor immediately—treatment of a cyst in its early stages may be easier and less painful than waiting.

Jeep Seat: Pilonidal Cysts Caused by Prolonged Sitting

If you do have a lump developing, think back to whether you sat on something hard or uncomfortable for a prolonged period of time. During the Second World War, pilonidal cysts were known as "jeep seat", as soldiers frequently developed them by sitting in hard truck seats for hours on end. Mine was actually caused by repeatedly sitting on a hard, beaten-up, wooden couch in an awkward position (it was too small for me).

Many WWII soldiers developed pilonidal cysts from enduring long, bumpy rides on uncomfortable jeep seats.
Many WWII soldiers developed pilonidal cysts from enduring long, bumpy rides on uncomfortable jeep seats. | Source

Quick Pilonidal Cyst Facts

  • They occur most often in men, although women may be affected as well.
  • They are almost always located on or around the tailbone or coccyx, which is located at the crest of the buttocks.
  • Since they can be caused by ingrown hairs, pilonidal cysts are thought to affect those with darker, coarser hair more frequently.
  • They may occur after long periods of sitting on hard, uncomfortable, or bumpy surfaces.

Care, Treatment, and Medication

If you are experiencing the above-mentioned symptoms in addition to fever or lethargy, contact your doctor immediately. Should your cyst require excision and drainage, be sure to follow your doctor’s post-procedure instructions for at-home treatment and care, which may include keeping the excision site clean and using a broad-spectrum antibiotic to combat infection.

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

Questions & Answers

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      • profile image

        Deb 

        3 years ago

        I had one as a teenager, had it lanced. Was ok for about 20 years and it came back like a roaring lion... Omg. Horrible! Ended up getting it removed surgically and honestly the most painful thing ever! Took several weeks to heal and because of cutting through nerve tissue, I had no feeling in that tailbone area for nearly 10 years

      • SieberSounds profile image

        Ellie Shields 

        3 years ago from USA

        I played tough with mine until it developed to breakage point. I can attest, these are terribly painful experiences. As unfortunate as it is to have, I'm glad I'm not the only one who tried to 'sit it out'.

      • profile image

        Kevin Gambit 

        3 years ago

        I developed one of these Cst while I was stationed overseas. I think it came from doing sits on my dunks dirty floor. Few People know there are organism that are harder to kill in other parts of the world than in the states, but that is another story. I had what I thought was an ant bite rite at the top of my butt. I complained for a week or two until I could barely walk or do my job. Finally one of my Officers ordered me to get it checked out in the morning. When I when to the doctor they told me it was a cyst and it was as big as a baseball. They TRIED to operate rite there. Because it was so infected nothing would numb the area. So The doctor cut me open with NO numbing agents. Worst, most painful experience of my life. After he squeezed out all the puss, I had to get the gauss changed for a few weeks which was even worse if you can believe. I spent every second of every day thinking about having to get my gauss changed until finally it healed to the point were it wasn't that painful.

        Imagine someone taking a scalpel to your naked flesh. It was excruciating. I wish I would have went to get it checked out sooner instead of playing tough.

      • Ivory Morgan profile image

        Healthy Habits 

        3 years ago

        have you looked into essential oils and how they have helped heal cysts in some people's experiences? I am curious of your thoughts on using those to avoid a painful experience at the doctor.

      • DreamerMeg profile image

        DreamerMeg 

        5 years ago from Northern Ireland

        O my goodness! That looks like a terrible experience. Thank you for this interesting hub. I will file that information away inside my brain, in case I get any symptoms like that - I certainly hope not. Very useful info.

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