Coccyx Fracture
En Español (Spanish Version)

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:

  • Increased age
  • Osteoporosis
  • Certain diseases or conditions that result in bone or mineral loss, such as abnormal or absent menstrual cycles or 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
You will be asked 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 drugs (NSAIDs), such as ibuprofen
  • Analgesics, such as acetaminophen
  • Prescription pain medications
  • Local anesthetic injections
  • Rarely, local steroid injections
You may also need stool softeners to help prevent constipation or pain during bowel movements.

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.

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.



RESOURCES:
American Academy of Orthopaedic Surgeons

American Orthopaedic Society for Sports Medicine

CANADIAN RESOURCES:
Canadian Orthopaedic Association

Canadian Orthopaedic Foundation

References:
Acute low back pain. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 8, 2014. Accessed September 12, 2014.

Coccydynia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 28, 2010. Accessed September 12, 2014

Fractured coccyx. Cure Back Pain website. Available at: http://www.cure-back-pain.org/fractured-coccyx.html. Accessed September 12, 2014.

Low back pain. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00311. Updated December 2013. Accessed September 12, 2014.

Spinal cord injury—acute management. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.ebscohost.com/about/about-us. Updated December 10, 2013. Accessed September 12, 2014.

Last Reviewed August 2014



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