(Tailbone Fracture; Broken Tailbone)
A coccyx fracture is a broken tailbone. The coccyx is the lowest part of the backbone or spine. It is small, triangular in shape, and consists of four fused vertebra, or spine bones. Normally, it has a little bit of movement and curves gently from the end of the spine into the pelvis.
Causes of coccyx fracture include:
- Falling on the buttocks. Skating and other activities that lead to falls in the seated position often contribute.
- During birth, newborns can break their coccyx going through the birth canal.
A risk factor is something that increases your chance of getting a disease, condition, or injury.
- Sex: Female (A woman's broader pelvis leaves the coccyx more exposed to injury.)
- Advanced age
- Reduced muscle mass, which may lead to poor balance and increased risk of falls
- Poor nutrition, especially inadequate calcium and vitamin D
- Certain congenital bone conditions
- Participating in certain activities, such as skating
Symptoms may include:
- Pain that increases with sitting or getting up from a chair
- Pain that increases during a bowel movement
- Tenderness over the tailbone
The doctor will ask about your symptoms and how the injury occurred, and perform a physical exam. The exam may include a rectal exam. During a rectal exam, the doctor places a lubricated, gloved finger into the rectum and feels for any abnormalities. If the coccyx is fractured, your doctor may feel abnormal movement of the coccyx and you will experience pain. X-rays may or may not be required.
Treatment aims to manage pain until the bone can heal. Even if the coccyx has moved out of its normal position, doctors usually do not try to correct the malalignment. Muscles in the area are powerful and can pull the coccyx back out of position. Because of the location of the coccyx and the number of muscles attached to it, immobilization is very difficult. That muscle movement also delays healing.
The area may remain painful for an extended period of time, even after the fracture has healed. You may be advised to stay in bed initially for a day or two, or move only as comfort allows. After a reasonable healing time, steroid injections or surgery may be considered if severe pain persists. Surgery for a painful coccyx after fracture is very rare and not very successful. Usually pain gradually disappears, although not as quickly as patients would desire.
You may be given medication to ease the pain. To reduce discomfort during bowel movements:
- Drink plenty of fluids and eat a diet rich in fruits, vegetables, and whole grains.
- Stool softeners may help decrease straining during bowel movements.
- Sitz baths can help relieve muscle spasms. A sitz bath involves soaking the anal area in warm tap water for 10-20 minutes.
Sitting can be very uncomfortable after a coccyx fracture. Suggestions to make sitting less painful include:
- Sit on an air cushion or doughnut pad.
- Alternate between sitting on one side of the buttock or the other.
- Try sitting on a hard chair. Sinking into a soft chair sometimes increases the pressure on the coccyx.
- Slouch to move your weight forward and off the coccyx. Note: This advice holds only until you are well enough to sit properly again.
- Sit on a telephone book, with the area of the coccyx hanging off the posterior portion of the phone book.
If pain continues and causes persistent disability, a coccygectomy might be recommended. During this procedure, the doctor removes the coccyx. It is not a common procedure and the success rate is not what one would hope for.
To help prevent a coccyx fracture:
- Eat a diet rich in calcium and vitamin D.
- Do weight-bearing exercises to build strong bones.
- Build strong muscles to prevent falls.