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Tailbone Injury
A tailbone injury (a.k.a. coccyx injury) is an injury to the bony area at the base of the spine.Depending on its severity, the injury may involve bruising, dislocation or fracturing of that area.
Although this is a painful and unpleasant injury that can take time to heal, most of its occurrences are treatable.
In this article, we take a brief look at the nature of this injury, how it may be caused and its typical signs and symptoms. We will also briefly describe how it is typically treated, both at home and by a doctor.
How Are Tailbone Injuries Caused?
Almost all of these injuries are due to a severe blow to the coccyx (tailbone area). The coccyx actually contains 3 to 5 segments of bone held together by joints and ligaments. As a result, such a blow can weaken the ligaments holding the bones together or even possibly cause a fracture of one or more of them.
The coccyx is broader in women than in men. As a result, women are more susceptible to tailbone injuries than men. Apart from female sex, other risk factors for this type of injury include reduced muscle mass,high age, osteoporosis (thinning of the bones), certain activities like skating and violence.
Events that can lead to a coccyx injury are:
- Falling onto the base of the spine and hitting the ground in a seated position, especially against a hard surface. This type of injury typically occurs in contact sports that involve possible collisions between players. It is also the most common cause of a tailbone injury;
- A direct blow to the base of the spine. This, again, typically occurs in contact sports;
- Tailbone injuries can also occur during childbirth; and
- Activities that place sustained or repetitive strains on the coccyx can result in tailbone injuries over time. Cycling or rowing are typical examples.
In addition to the above, tailbone injuries can be due to spinal nerve root compression, bone spurs and even to tumors or infections.
In a few cases, the cause of a tailbone injury may be unknown.
Symptoms
Typical signs and symptoms of a fractured or bruised tailbone include:
- Tailbone pain and tenderness. There may also be bruising and swelling in this area;
- Increased pain after you have remained seated for a while, when sitting or rising from a chair; as well as
- Additional pain while defecating.
It is important to note that some of the symptoms of a tailbone injury may be indicative of a spinal injury. This is obviously a serious medical condition.
A spinal problem may be present if you observe partial paralysis or reduced bowel or bladder control. Weakness / numbness in the legs or arms can also indicate these problems. If you observe any of these signs, we suggest seeking immediate medical advice.
Diagnosis
To diagnose a possible coccyx injury, your doctor will likely rely mainly on a physical examination of the spine and tailbone area. The examination would usually include a rectal examination.He or she will probably also review your medical history.
The rectal examination involves insertion of a finger into the rectum to check for signs of a broken tailbone or dislocation. If a coccygeal fracture is present, it may be possible to palpate abnormal movement of the coccyx.
Some doctors may request an X-Ray of the tailbone area in order to check for a fracture or dislocation.
Treating A Tailbone Injury
In looking at possible treatments for tailbone injuries, we will consider treatments at home and those in a doctor’s office or hospital separately.
Treatment At Home
If there are no signs of spinal injury, treatment at home may be tried first. This may include doing the following:
- Avoid sitting down for extended periods. When you are seated, choose a soft surface and avoid sitting on the center of your behind. It may also help to maintain a forward leaning position while sitting;
- To further reduce pressure on the tailbone while seated, use a cushion such as a LumbAir to sit on. A special U-shaped cushion will help to reduce pressure on the coccyx when in a sitting position;
- Apply a cold pack to the tailbone area for a few days after the injury. Do this for around 15 minutes at a time and every one to two hours (about 4-6 times a day).
- Over the counter painkillers like tylenol (paracetamol) or non steroidal anti inflammatory drugs (NSAIDs) may also help;
- Try to avoid becoming constipated. Eat plenty of high fiber foods to reduce discomfort during bowel movements.
- A physical therapist can help you follow a course of exercise that will speed up recovery from your injury.
Treatment In A Doctor’s Office
If your tailbone injury is a serious one, or shows signs of a spinal injury, treatment at home may not be adequate. Stool softeners may be prescribed to improve bowel movements. More powerful (prescription) pain relief medications are another option that your doctor can offer.
In addition, the following may be necessary:
- Anesthetic injections into the coccyx area to reduce pain while healing takes place;
- In rare cases, the coccyx may have to be removed via surgery (coccygectomy). This is usually done if there is persistent coccygeal pain;
- Surgery is sometimes necessary for a displaced fracture of the coccyx.
Recovery
The recovery period varies from one individual to another. However, in most cases, you should expect to be back to normal within about 12 weeks.
Preventing Tailbone Injuries
It is difficult to completely eliminate the risk of this type of injury.
However, if you play contact sports or engage in activities in which falling is common (e.g. skiing), you should wear protective padding over the tailbone area.
