The coccyx, commonly known as the tailbone, is a small, triangular bone at the end of the vertebral column, just above the buttocks. Composed of three to five fused vertebrae, it forms the terminal point of the spine and contributes to the true pelvis. The coccyx serves as an attachment point for muscles, ligaments, and tendons, and provides weight-bearing support when seated.
Understanding Tailbone Injuries
While a complete tailbone dislocation, where it fully separates from the sacrum, is uncommon, partial dislocation (subluxation) occurs more frequently. Subluxation involves a misalignment or abnormal movement of the coccyx. Both can cause significant pain.
Tailbone injuries also include fractures (breaks in the bone) and bruises (damage to surrounding soft tissues). Fractures can range from hairline cracks to complete breaks, while bruises result from direct impact, causing swelling and tenderness. All these injuries are medically termed “coccydynia,” referring to pain in the tailbone region.
Common Causes and Indicators
Tailbone injuries often result from direct trauma, such as falling backward onto hard surfaces. Childbirth is another significant cause, as delivery pressure can strain or injure the tailbone and its surrounding structures.
Repetitive strain also contributes to tailbone pain, often from prolonged sitting on hard surfaces or activities like cycling. Poor posture can similarly stress the coccyx. Indicators of injury include localized pain and tenderness at the base of the spine.
Pain typically worsens when sitting, especially for extended periods, or when transitioning from sitting to standing. Discomfort may also increase during bowel movements or sexual activity. Swelling or bruising around the coccyx can sometimes be visible after an injury.
Seeking Medical Attention and Care
If a tailbone injury is suspected, consult a healthcare professional for diagnosis and management. A physical examination, possibly including palpation or a rectal exam, helps determine the injury’s nature. Imaging tests like X-rays can identify fractures or significant dislocations, though subtle injuries may not always appear.
If X-rays are inconclusive or soft tissue involvement is suspected, an MRI or CT scan may be recommended. Non-surgical treatments are typically the first line of care. Pain management often involves over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation.
Specialized cushions, such as donut or wedge-shaped pillows, can alleviate sitting pressure. Applying ice packs initially, followed by heat therapy, helps manage discomfort. Activity modification, including avoiding prolonged sitting or pain-exacerbating activities, is also advised. Physical therapy may be recommended to strengthen pelvic floor muscles and improve posture.
Living with a Tailbone Injury
Recovery from a tailbone injury requires patience, with healing times varying by severity. A bruised tailbone may heal in about four weeks, while a fracture can take eight to twelve weeks. Some individuals may experience persistent pain even after initial healing.
Managing pain during recovery involves practical strategies. Maintain proper sitting posture by leaning slightly forward to reduce direct pressure. Avoid prolonged sitting and take frequent breaks to stand and move. Specialized cushions remain helpful for daily comfort.
In rare cases where conservative treatments fail, surgical intervention (coccygectomy) may be considered. This procedure involves removing all or part of the coccyx. Coccygectomy is a last resort, as recovery can be lengthy, often several months, with no guarantee of complete pain resolution.