Coccyx Fracture
A break in the tailbone at the very bottom of the spine
Quick Facts
- Type: Spinal fracture (tailbone)
- Common cause: Falling onto the buttocks
- Main symptom: Pain worsened by sitting
- Outlook: Usually heals with self-care
Overview
The coccyx, or tailbone, is the small, triangular group of bones at the very bottom of the spine. A coccyx fracture is a break in this bone, most often caused by a fall onto the buttocks or a direct blow. Because the coccyx supports some of your weight when sitting and anchors several muscles and ligaments, even a minor injury here can be quite painful.
The good news is that most coccyx fractures heal on their own with simple self-care over several weeks. Pain that lingers after a tailbone injury is sometimes called coccydynia, and it can usually be managed with conservative measures.
Symptoms
The main symptom is pain and tenderness at the very base of the spine, between the buttocks. Typical features include:
- Pain that worsens when sitting, especially on hard surfaces, or when leaning back
- Increased pain when standing up from sitting
- Tenderness, bruising, or swelling over the tailbone
- Discomfort during bowel movements
- Pain with sexual activity in some people
Most tailbone injuries cause local pain only. Numbness in the buttocks or groin, leg weakness, or new bladder or bowel problems are unusual and would suggest a more serious injury needing prompt evaluation.
Causes
Coccyx fractures usually result from direct force to the tailbone. Common causes include:
- Falls: Slipping and landing on the buttocks, such as on ice or stairs, is the most frequent cause.
- Direct blows: An impact during contact sports or an accident.
- Childbirth: The coccyx can be injured during a difficult or prolonged delivery.
- Repetitive strain: Prolonged sitting on hard or narrow surfaces, as in some sports, can irritate or injure the tailbone over time.
Thinner bone in older adults and a naturally more exposed tailbone shape in some people can make injury more likely.
Risk Factors
- Falls, especially on ice or stairs
- Contact and high-impact sports
- Childbirth, particularly difficult deliveries
- Older age and osteoporosis
- Prolonged sitting on hard surfaces
- Being underweight, which reduces cushioning over the tailbone
Diagnosis
A coccyx fracture is usually diagnosed from the history of injury and a physical exam. Tests may include:
- Physical examination: Pressing on the tailbone to locate tenderness; sometimes a gentle internal exam helps assess movement of the bone.
- X-rays: Can show a fracture, although the coccyx is small and breaks are not always clearly visible.
- Further imaging: CT or MRI is occasionally used for persistent or unclear pain.
Because the diagnosis often rests on symptoms and exam, treatment can begin even when imaging does not show an obvious break.
Treatment
Most coccyx fractures heal with simple, conservative care while the pain gradually settles.
- Pain relief: Over-the-counter pain medicines such as acetaminophen or anti-inflammatories, used as directed.
- Cushioning: Sitting on a wedge or doughnut-shaped cushion to take pressure off the tailbone.
- Activity changes: Avoiding prolonged sitting, leaning forward when seated, and applying ice early then heat later.
- Bowel care: Fiber and fluids to keep stools soft and reduce pain with bowel movements.
- Persistent pain: If pain continues for months, options include physical therapy, injections, or, rarely, surgery to remove the coccyx.
Healing usually takes several weeks, though some tenderness can linger longer.
Prevention
- Take care on slippery surfaces and stairs to avoid falls
- Wear protective padding for high-risk sports
- Use a supportive cushion if you sit for long periods
- Keep bones strong with adequate calcium and vitamin D
- Address balance problems that increase fall risk
When to See a Doctor
See a doctor if tailbone pain is severe, does not improve over a few weeks, or follows a significant fall. Seek prompt or emergency care if you have:
- Numbness or tingling in the buttocks, groin, or legs
- Leg weakness or difficulty walking
- New trouble controlling the bladder or bowel
- Severe pain after a high-impact accident, which may signal a more extensive injury
These less common symptoms suggest injury beyond the tailbone and need urgent evaluation.
Frequently Asked Questions
How do I know if my tailbone is broken or just bruised?
Both cause pain at the base of the spine that worsens with sitting, and they can be hard to tell apart without imaging. Treatment is similar for both, so a clear distinction is not always necessary to start care.
How long does a coccyx fracture take to heal?
Most tailbone fractures heal over several weeks with self-care, though some tenderness can persist for months. Using a cushion, avoiding prolonged sitting, and managing pain help recovery.
How can I relieve tailbone pain?
Use a wedge or doughnut cushion when sitting, take pain relievers as directed, apply ice early then heat, and keep stools soft with fiber and fluids. Avoiding long periods of sitting also helps.
When should I see a doctor for a tailbone injury?
See a doctor if the pain is severe, lasts more than a few weeks, or follows a major fall. Numbness in the buttocks or groin, leg weakness, or new bladder or bowel problems are warning signs that need urgent evaluation.
Is surgery ever needed for a broken tailbone?
Surgery is rarely needed. It is considered only for long-lasting, severe pain that does not respond to conservative care, and it may involve removing the coccyx.
References
- OrthoInfo, American Academy of Orthopaedic Surgeons. Coccydynia (Tailbone Pain).
- Mayo Clinic. Tailbone pain.
- MedlinePlus, U.S. National Library of Medicine. Tailbone (coccyx) injury.
- National Health Service (NHS). Tailbone (coccyx) pain.