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Definition

A coccyx fracture is a broken tailbone. The coccyx is the lowest part of the backbone or spine. It is small and shaped like a triangle. The bone curves gently from the end of the spine into the pelvis.

The Coccyx
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Causes

Coccyx fracture is caused by trauma. Trauma may be caused by:

  • Falls
  • Childbirth, which may result in a newborn breaking the mother's coccyx

Fractures may may also occur during straining or friction, such as with rowing or bike riding.

Risk Factors

Coccyx fractures are more common in women. Other risk factors that may increase your chance of a coccyx fracture include:

  • Advancing age
  • Osteoporosis
  • Certain diseases or conditions that result in bone or mineral loss, such as abnormal or absent menstrual cycles, or post- menopause
  • Decreased muscle mass
  • Certain congenital bone conditions
  • Participating in certain activities, such as skating or contact sports that may lead to falls in a seated position
  • Violence

Symptoms

A coccyx fracture may cause:

  • Pain that increases with sitting or getting up from a chair
  • Pain that increases during a bowel movement
  • Tenderness over the tailbone

Diagnosis

The doctor will ask about your symptoms and how the injury occurred. A physical exam will be done. The exam may include a rectal exam. If the coccyx is fractured, your doctor may feel abnormal movement of the coccyx. You will experience pain. X-rays may or may not be needed.

Treatment

The goal is to manage pain until the bone can heal. The location of the coccyx and the number of muscles attached to it makes it difficult to prevent it from moving while it is healing. Generally, pain will go away on its own.

The area may remain painful for a long period of time, even after the fracture has healed. You may be advised to stay in bed for a day or two, or move only as comfort allows.

Medications

Medications may be given to help manage pain. These include:

  • Nonsteroidal anti-inflammatory medications (NSAIDs), such as ibuprofen
  • Analgesics, such as acetaminophen
  • Prescription medications
  • Local anesthetic injections
  • Rarely, local steroid injections

You may also need stool softeners to help prevent constipation or pain during bowel movements.

Home Care

In addition to medications, home care is important for your recovery.

Some pain medications may cause constipation. To help prevent this drink plenty of fluids throughout the day, and eat a diet rich in fruits, vegetables, and whole grains.

Sitting can be uncomfortable after a coccyx fracture. Some suggestions to help manage discomfort include:

  • Massage the tailbone area in a circular motion. Use a styrofoam cup filled with ice. Do this for 15-20 minutes at at time.
  • Sitz baths can help relieve muscle spasms. A sitz bath involves soaking the anal area in warm water for 10-20 minutes.
  • Sit on an air cushion or doughnut pad.
  • Alternate between sitting on one side of the buttock or the other.
  • Avoid sitting on soft surfaces. Sinking into a soft chair sometimes increases the pressure on the coccyx.
  • Slouch to move your weight forward and off the coccyx. (This only helps until you are well enough to sit properly again.)
  • Sit on a large book, with the area of the coccyx hanging off the posterior portion of the book.

Surgery

Surgery for a painful coccyx fracture is rare and not very successful. If pain continues and causes disability, a coccygectomy might be recommended. During this procedure, the doctor removes the coccyx.

If you are diagnosed with a coccyx fracture, follow your doctor's instructions .

If you are diagnosed with a coccyx fracture, follow your doctor's instructions .

Prevention

To help reduce your chance of a coccyx fracture, take these steps:

  • Do not put yourself at risk for trauma to the bone.
  • Build strong muscles to prevent falls.
  • Wear proper padding and safety equipment when participating in sports or activities.

To help reduce falling hazards at work and home, take these steps:

  • Clean spills and slippery areas right away
  • Remove tripping hazards such as loose cords, rugs, and clutter
  • Use non-slip mats in the bathtub and shower
  • Install grab bars next to the toilet and in the shower or tub
  • Put in handrails on both sides of stairways
  • Walk only in well-lit rooms, stairs, and halls
  • Keep flashlights on hand in case of a power outage

Revision Information

  • American Academy of Orthopaedic Surgeons

    http://www.orthoinfo.org

  • American Orthopaedic Society for Sports Medicine

    http://www.sportsmed.org

  • Canadian Orthopaedic Association

    http://www.coa-aco.org

  • Canadian Orthopaedic Foundation

    http://www.canorth.org

  • Acute low back pain. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.ebscohost.com/about/about-us . Updated June 26, 2013. Accessed September16, 2013.

  • Coccydynia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.ebscohost.com/about/about-us . Updated June 28, 2010. Accessed September 16, 2013.

  • Fractured coccyx. Cure Back Pain website. Available at: http://www.cure-back-pain.org/fractured-coccyx.html . Updated June 21, 2013. Accessed September 16, 2013.

  • Low back pain. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00311 . Updated May 2009. Accessed September 16, 2013.

  • Spinal cord injury—acute management. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.ebscohost.com/about/about-us . Updated January 23, 2013. Accessed September16, 2013.