(Tailbone Fracture; Broken Tailbone)
Pronounced: cox-ixEn Español (Spanish Version)
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.
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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
Factors that increase your chance of a coccyx fracture include:
- 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. A physical exam will be done. 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.
The goal is to manage pain until the bone can heal. Doctors usually do not try to correct a bad alignment. Muscles in the area are powerful and can pull the coccyx back out of position. The location of the coccyx and the number of muscles attached to it make immobilization very difficult.
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. Steroid injections or surgery may be considered if severe pain persists. Surgery for a painful coccyx fracture is very rare and not very successful. Usually pain gradually disappears.
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 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.
American Academy of Orthopaedic Surgeons
American Orthopaedic Society for Sports Medicine
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
Juhl JH, Crummy AB, Kuhlman JE, et al. Paul and Juhl's Essentials of Radiologic Imaging . 7th ed. Philadelphia, PA:Lippincott, Williams, and Wilkins;1998.
Low back pain. American Academy of Orthopaedic Surgeons website. Available at: http://www.aaos.org/ . Accessed July 15, 2008.
Rosen P, Barkin RM, Braen GR, et al. Emergency Medicine: Concepts and Clinical Practice . 4th ed. St Louis, MO. Mosby-Year Book, Inc;1998.
Last reviewed October 2007 by Robert E. Leach, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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