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Tailbone (Coccyx) Injuries

Tailbone / Coccyx Bone Injury Definition:
The coccyx, or tailbone, is found at the very end of your spine. It is not, in fact, one bone as the name would suggest, but 3-5 small, not fully-formed, vertebral bones, held together by joints and ligaments to form a triangular shape which has a limited range of motion. Because of these attachments, and the number of nerves in the area, damage to the coccyx can cause problems in the rest of the spine, the pelvic floor and perhaps even the intestines.

The coccyx is normally well protected as it curves inward toward the front of the body. However, in women, it curves less and is therefore more vulnerable to injury. A fall or some other trauma to the tailbone can be extremely painful. It even has its own name - coccydynia. There can be extensive bruising, ligaments can be stretched or torn, and the bones can be dislocated or perhaps even fractured.

Tailbone / Coccyx Bone Injury Causes:
The most common cause of an injury to the coccyx is a fall onto a hard surface. Slipping on ice and landing hard on your backside frequently results in a fractured or broken tailbone.
Other causes might be:
  • Trauma sustained during contact sports.
  • Childbirth. The anatomical position of the coccyx means that sometimes a tailbone fracture can occur during childbirth.
  • Bony growths (spurs), cancer or infection of the spine, although these are uncommon.
  • Repetitive action involving friction, for example bicycling or rowing.
  • Osteoporosis
  • Arthritis
  • Obesity
  • Poor nutrition, especially lack of sufficient calcium and vitamin D, needed for strong bones.

    Tailbone / Coccyx Bone Injury Symptoms:
  • Pain, worse when sitting for a long time, upon standing up, or when walking.
  • Increased pain when sitting leaning slightly backwards.
  • Increased pain when sitting on a soft surface due to the coccyx being subject to more pressure.
  • Increased pain during bowel movements.
  • There may be tenderness to the area, and bruising.
  • Constipation might become a problem.
  • For women, pain during sexual intercourse.
  • Low back pain, sciatica and headaches are all possible symptoms, but less common.

    Tailbone / Coccyx Bone Injury Diagnosis:
    See your health care provider to rule out any serious problems, but most injuries to the coccyx heal themselves in time. Definitely call 911 if you have sudden trouble breathing, moving your legs, or loss of feeling in your legs.

    Your doctor will take a medical history from you, followed by a physical examination. You might have a rectal examination if a tailbone fracture or dislocation is suspected.

    Although an x-ray might not show a coccyx bone injury, it could be useful to rule out any fracture of the tailbone. Further imaging tests such as a CT or MRI scan might be ordered if your doctor thinks it necessary.

    Tailbone / Coccyx Bone Injury Treatment:
    Self-help options:
  • Ice, applied to the tailbone area for 15 minutes at a time, four times a day for the first few days, will reduce inflammation. The ice should be crushed in a bag and covered with a towel before placing on the tender area.
  • Pain medication such as acetaminophen (Tylenol) will help, and if there is inflammation as well, you might try NSAIDs such as ibuprofen (Advil), aspirin or Aleve.
  • After any inflammation has reduced, heat can be applied, either via a hot compress or by taking a hot bath.
  • When sitting, try to sit on a hard surface and lean slightly forward to relieve pressure on the tailbone. Shifting from buttock to buttock might also help. One of the best solutions is to use a specially designed cushion. These can be doughnut-shaped, or wedge-shaped with a cut out for the coccyx area.
  • Sleep on your back with a pillow under the knees. This will lessen pressure on the spine.
  • Eat a diet high in fiber to avoid constipation.

    If these self-treatment measures do not provide relief, your doctor may prescribe stronger pain medication, stool softeners or a corticosteroid injection. Only very rarely is surgery required, and is not generally felt to be a satisfactory course to take. Occasionally the doctor might perform an intrarectal manipulation of a dislocated coccyx to realign it properly.

    A physiotherapist might use electrical stimulation on the spinal cord to numb the painful area but, as stated above, tailbone injuries of this sort usually heal themselves in time. It may, however, take several weeks for all tenderness to disappear.

    Osteopathy might be of some help if realignment of the spine is needed.

    What to look for in a cushion for an injured coccyx:
    Most coccyx cushions are now made in a wedge shape, although you can also find cushions in the shape of doughnuts. The important things to look for are:
  • Firm foam construction. Some of the best have memory foam.
  • A cut out for the tailbone area. This enables the tailbone to 'float' above the cushion, never coming into contact with any surface and so relieving pressure on the bones.
  • A useful feature might be a removable, washable cover.

    Tailbone / Coccyx Bone Injury Prevention:
    Most injuries to the coccyx are caused by an accidental fall, or slipping and landing hard on the tailbone, so sometimes nothing can prevent such a trauma. However, in day-to-day life there are some things that can be done to minimize the risk.
  • Wear slip-resistant soles on your shoes, especially when there is snow or ice on the ground.
  • Don't run on slippery surfaces, such as around a swimming pool.
  • Wear proper protection when taking part in contact sports.
  • Do weight-bearing exercises to build strong bones.
  • Do strengthening exercises to build strong muscles, which may help to prevent falls.
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