Broken tailbone

The tailbone, or coccyx, is the end of the spine. Its exact function is unknown; it is a vestige of what was once a tail.

How does a broken tailbone occur?

In most cases, there is a clear moment when the tailbone breaks. A fall flat onto the buttocks on a hard surface, such as slipping while ice-skating, falling down the stairs, or on the street. A hard collision or kick directly to the tailbone can also lead to a fracture.

Another possible cause occurs during childbirth. The pressure of pushing and delivery can bend the tailbone and, in some cases, break it. People with osteoporosis (bone demineralization) can also fracture the tailbone because the bone is more brittle (weaker). In such cases, even a minor bump or fall may be enough to cause a fracture.

Characteristics of a broken tailbone

Symptoms vary from person to person. The pain may be a mild, nagging ache, but sharp pain attacks can also occur. This pain can radiate toward the buttocks, groin, and legs. Depending on the pain, one person may be unable to sit on the buttocks at all, while another may still be able to ride a horse or bicycle.

In more severe fractures, complications can occur. This means the fracture also causes other (serious) problems. Examples include difficulty urinating or having a bowel movement, or compression of the nearby nerves. When compressed, these nerves can cause paralysis and sensory disturbances in a leg. These are reasons to seek immediate medical help.

How is a broken tailbone diagnosed?

The patient's account is very important to pinpoint the exact injury. Even a hard fall or collision in the past is important information. It is possible that the tailbone was then broken or bruised and is now causing new symptoms. To further investigate a possible fracture, an X-ray will be taken—two, to be precise: one from the front and one from the side.

If there is doubt, a CT scan will also be performed. After these tests, it can be determined with near certainty whether there is a broken tailbone. An MRI scan is also possible; it provides even more information about the ligaments, muscles, and nerves near the tailbone.

Treatment of a broken tailbone

If the tailbone is indeed broken, the treatment options mainly depend on whether complications have occurred. If not, bed rest is usually chosen, and the fracture typically heals on its own.

If the fracture does not heal (sufficiently), or in the case of complications, surgery may be considered. One option is removal of the tailbone. Much research is being done on the outcomes of this surgery, which remain very variable so far.

Even without surgery, there are ways to reduce symptoms. What works best varies by person. In any case, it is advisable to consult a pelvic physical therapist for symptoms around the tailbone. In some cases, a special cushion with a hole (donut cushion or seat ring) relieves pain.

A magnesium deficiency increases the risk of fractures. In some cases, dietary supplements such as calcium and magnesium seem to have a positive effect on recovery. Always ensure that your treating physician is aware of any supplement use.