Coccyx fracture

Causes of coccyx fracture can vary greatly, but are most commonly confined to falls into the seated position, or childbirth.

The following risk factors have been identified for coccyx fracture:

• Lack of/reduced muscle mass
• Advanced age
• Osteoporosis
• Being of the female sex (due to the wider pelvis typically found in females)
• Violence

Symptoms of coccyx fracture include:

• Pain that increases in severity when sitting or getting up from a chair, or when experiencing bowel movement
• Provoked pain over the tailbone
• Nausea
• Bruising or swelling in the tailbone area

The standard workup of a suspected coccyx fracture includes medical history and a physical examination including a rectal examination.[1]

X-ray has no quantifiable clinical impact,[2] and is regarded as a waste of resources and unnecessary exposure to ionizing radiation.[3]

If the coccyx fracture is severe enough, short-term hospitalisation may be required, although this is extremely rare. More often, self-care at home is administered.

Sitting on soft surfaces is recommended, as this reduces pressure on the coccyx. A 'donut' or 'wedge' cushion may be purchased – these are simply cushions with a hole in them to ensure that no weight is placed in the injured tailbone. Painkillers such as ibuprofen are also recommended, as is a diet high in fibre to soften stools and avoid constipation.

Doctors will not usually attempt to correct a bad alignment, as muscles in the area are powerful and can pull the bone back into the 'bad' position. The bone is also very difficult to immobilise simply due to the sheer number of muscles attached to it, as well as the position.

• Sacral fracture (rarer)