Patient education: Coccyx injury (The Basics)

What is the coccyx? — The coccyx, or "tailbone," is a triangle-shaped group of small bones located at the end of the spine (figure 1). Cartilage covers the ends of the bones. Ligaments hold all of these bones together. In most cases, the tailbone curves in a little bit, and it does not move very much.

What causes a coccyx injury? — The coccyx can be bruised, dislocated, or broken in different ways. Examples of things that can cause injury include:

●A fall, or a direct hit to the coccyx

●Poor posture

●Repeated strain to the area from sitting on a hard or narrow surface (like a bicycle seat)

●Arthritis

●Having a vaginal birth

What are the symptoms of a coccyx injury? — Symptoms depend on the type of injury. Common symptoms can include pain, swelling, or bruising over the area.

A coccyx injury can also cause pain or other symptoms in nearby areas. Some people have pain in their back, buttocks, or belly. Others have pain in their pelvis or rectum. For some people, the pain is worse when they change positions, lean back, have a bowel movement, or have sex.

Is there a test for a coccyx injury? — It depends. Your doctor or nurse will ask about your symptoms and do an exam. This might include a rectal exam. This involves putting a finger into your rectum to feel the front side of your tailbone.

In some cases, you might need an X-ray or other imaging test. Imaging tests create pictures of the inside of the body.

How are coccyx injuries treated? — Treatment depends, in part, on the type of injury you have and how serious it is. Many coccyx injuries only need treatment to help relieve symptoms.

Your doctor or nurse might suggest the following:

●If you have pain, sit leaning forward slightly. This takes the pressure off of your coccyx. You can also use a cushion with a hole in the middle or a wedge cut out of the back. Try not to sit for long periods of time.

●Take medicine like ibuprofen (sample brand name: Advil, Motrin) or naproxen (sample brand name: Aleve). These are nonsteroidal antiinflammatory drugs ("NSAIDs"). They can help with swelling and pain. You might also have gotten a prescription for stronger pain medicines to take for a short time. If so, follow the instructions for taking them.

●For the first few days after an injury, ice can help with pain and swelling:

•Put a cold gel pack, bag of ice, or bag of frozen vegetables wrapped in a towel over the painful part. Never put ice right on the skin. Do not leave the ice on more than 10 to 15 minutes at a time. Use for the first 24 to 48 hours after an injury.

●After the first few days, heat might also help with pain:

•Place a hot water bottle, covered heating pad, or hot compress over the painful part. Never go to sleep while using a heating pad. Use heat for 10 to 20 minutes at a time. Soaking in a hot bath might also help with pain.

●If straining to have a bowel movement makes your pain worse, you can take a stool softener.

If the pain lasts for a while, the doctor or nurse might suggest an injection of medicine in the area. This can help with the pain.

How long do coccyx injuries take to heal? — Most coccyx injuries take weeks to a few months to heal.

You might have to limit your activity or movement until your injury is healed. Your doctor or nurse will tell you what activities are safe for you to do.

When should I call the doctor? — Call for advice if:

●Your legs become numb, weak, or tingly.

●You have problems controlling your bowels or bladder.

●You are not able to sit because of the pain, even after trying ice, heat, medicine, and a cushion.

More on this topic

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Patient education: Low back pain in adults (Beyond the Basics)
Patient education: Back pain in children and adolescents (Beyond the Basics)