Tailbone (Coccyx) Injury

Tailbone Injury Overview

A coccyx injury results in pain and discomfort in the tailbone area (the condition is called coccydynia). These injuries may result in a bruise, dislocation, or fracture (break) of the coccyx. Although they may be slow to heal, the majority of coccyx injuries can be managed with cautious treatment.

The coccyx is the triangular bony structure located at the bottom of the vertebral column. It is composed of 3-5 bony segments held in place by joints and ligaments.

The majority of coccyx injuries occur in women because the female pelvis is broader and the coccyx is more exposed.

Tailbone Injury Causes

Most coccyx injuries are caused by trauma to the tailbone area.

• A fall onto the tailbone in the seated position, usually against a hard surface, is the most common cause of coccyx injuries.
  
  
• A direct blow to the tailbone, such as those that occur during contact sports, can injure the coccyx.
  
  
• The coccyx can be injured or fractured during childbirth.
  
  
• Repetitive straining or friction against the coccyx (as happens in bicycling or rowing) can injure the coccyx.
  
  
• Sometimes, the cause of coccyx injuries is unknown.
  
  
• Less common causes of coccyx injuries include bone spurs, compression of nerve roots or injuries to other parts of the spine, local infections, and tumors.

Tailbone Injury Symptoms

• Severe localized pain and tenderness may be felt in the tailbone area.
  
  
• If the injury is traumatic, a bruise may be visible in this area.
  
  
• The pain is generally worse when sitting for prolonged periods of time, or with direct pressure to the tailbone area.
  
  
• Bowel movements and straining are often painful.
  
  
• Some women may experience pain during sexual intercourse.

When to Seek Medical Care

If you have the signs and symptoms of a coccyx injury or unexplained discomfort in the coccyx area, contact your doctor. It may be necessary for the doctor to decide if the injury is traumatic or if the pain is caused by other, more serious, coccyx problems.

Injuries to the region of the coccyx rarely require a visit to the emergency department. However, if you are unable to reach your physician, have no physician, or are otherwise concerned about your symptoms, it is wise to visit your nearest hospital's emergency department.

Exams and Tests

The cause of a coccyx injury is largely determined based on a medical history and a physical examination. Occasionally, x-rays are taken.

• The entire vertebral column (spine) may be examined. A neurologic examination may be performed. A rectal examination may also be performed. For this exam, the physician inserts a finger into your rectum to feel the area of the coccyx and determine if there is a dislocation or a fracture that can be felt and if direct pressure against the coccyx reproduces your pain.
  
  
• Rarely, if the cause of discomfort is unknown, a local anesthetic may be injected into the coccyx to determine whether the origin of the pain is from the coccyx or another part of the vertebral column.
  
  
• X-rays may be taken to determine whether there is a fracture or dislocation. However, x-rays occasionally may not reveal these injuries. Some physicians recommend x-rays in both the standing and seated positions to better determine the presence of a fracture or dislocation.