The lowest part of the spine, which represents a relic from our animal past, is called the coccyx. It is a bony structure composed of fused vertebrae, which arose through the involution of the tail in the course of evolution. A coccyx fracture can be very painful and take a long time to heal.
What is a coccyx fracture?
The spine is divided into five areas. From top to bottom these are the cervical, thoracic and lumbar spine, sacrum and coccyx. While the vertebrae in the upper three sections are clearly separated from one another and protected from impact by the intervertebral discs, the sacrum and coccyx consist of vertebrae that have grown together. For comprehensive guide to keratoconjunctivitis sicca, please visit growtheology.com.
The coccyx, where several muscles and ligaments of the musculoskeletal system attach, can be easily felt with the fingers. It is often also visible externally as a small bump through the skin. A coccyx fracture can occur as a result of an accident or a fall. This means nothing more than a fracture of the Os Coccygis, the coccyx.
Causes
A coccyx fracture occurs as a result of external mechanical influences. This means that a certain force must be applied to the coccyx to cause a fracture. In people with low bone density, such as women with osteoporosis, this force can be very small. It is enough, for example, to slip and fall on a chair or violently bump against a door frame or the edge of a wall.
However, it usually takes greater forces sufficient to evoke the fraction of the coccyx. The fracture almost always occurs as a result of a fall from a standing position onto the buttocks, for example while showering or getting out of the bathtub – i.e. from a certain height. Falling onto the hard surface of ice when skating or slipping on the steps is also a classic.
If the landing occurs on an edge (the edge of a shower tray, bathtub, step edge), the fracture happens particularly quickly and is even more painful. Heavy kicks in the buttocks can also result in a coccyx fracture.
Symptoms, Ailments & Signs
A coccyx fracture is a very painful injury. Not only does the fracture itself cause extreme pain, it is primarily the activities and movements that have to be carried out despite the injury that cause long-term complaints.
Movements such as sitting or lying down, which always involve some kind of pressure on the broken coccyx, can never be completely avoided and put a strain on those affected. Squeezing out of the anus and with the pelvic floor, such as when having a bowel movement, can also be very difficult and painful. Swelling and bruising are often visible from the outside in the first few days after the fracture.
Diagnosis & course of disease
The doctor usually tries to determine whether there is a likelihood of a coccyx fracture by having the patient describe how the accident happened. The fracture can then be easily identified with an x-ray. If neither the doctor nor the patient sees the need for an X-ray, a fracture can be felt through the anus.
However, this can be quite painful for those affected, as the doctor tries to move the coccyx when palpating. If you have a coccyx fracture, you can expect symptoms lasting several weeks. Rarely does it lead to chronic pain sensations that can last for years.
Complications
A coccyx fracture is associated with very severe pain, but usually heals without serious complications or long-term damage. In some patients, the pain can become so severe that oral analgesics are not sufficient and injections or IV fluids are needed.
Some patients also develop severe constipation or gastrointestinal problems because the stretching of the anus during defecation causes such pain that patients no longer defecate. In some patients, the pain subsides after the fracture has healed, but recurs sporadically when the coccyx is loaded. The pain then makes itself felt without a specific trigger during everyday activities such as lying, sitting, bending or standing, as well as when going to the toilet.
Women who want to have children in particular have to reckon with such complications. During pregnancy, the volume of the body increases significantly, which also increases the pressure on the coccyx. This can cause severe pain, especially if the fracture is recent or has not healed properly at the end.
Complications are also possible during childbirth. Since the flexibility of the coccyx is usually impaired due to the fracture, it is often no longer able to bend outwards during childbirth, which greatly increases the risk of injuries for the woman giving birth, up to and including another fracture of the coccyx. Injuries to the child are also possible.
When should you go to the doctor?
If severe pain occurs in the buttocks area after a fall, an accident or a violent impact, a doctor should be consulted. If you can no longer move or sit without symptoms, you have a problem that needs to be examined and treated. A coccyx fracture causes unusually intense pain. With every movement or external influence, the affected person suffers from the symptoms.
Since no spontaneous healing is to be expected, a doctor should be consulted as soon as possible. No pain medication should be taken without consulting a doctor. The risks and side effects of the preparations are high and must be discussed with a doctor. Otherwise, there is a risk of sequelae and further deterioration in health. If you experience pain at rest or tenderness in the abdomen, consult a doctor. If there are disorders of the gastrointestinal tract, diarrhea or constipation, medical help is also required. In the case of bleeding from the intestines, swelling or changes in the appearance of the skin, further examinations to clarify the cause are indicated.
If children experience sudden crying or changes in behavior, they should be seen by a doctor immediately. If there is spontaneous incontinence, this is an indication of an existing health disorder. It should be examined and treated by a specialist.
Treatment & Therapy
In the body region of the coccyx there are no possibilities of plastering or immobilization. As a result, more time must be expected before the patient is completely free of symptoms. As with all fractures, it is necessary not to put any strain on the body and to have periods of rest. In the first few days after the fracture, most patients will need painkillers ( analgesics ) and anti-inflammatory drugs (e.g. cortisone ).
In the case of very severe pain, infusions or injections are administered because of the faster and more intensive effect. Cold compresses also help reduce the swelling and bruising that cause additional pain. In order to prevent further problems, the patient’s stool must be kept soft – this saves those affected from uncomfortable pressing during a bowel movement and thus pressure pain.
A change in diet with a lot of fiber and liquid can be supportive. In some cases, enemas are needed initially when patients are unable to push due to excessive pain. Very rarely, the fracture must be repaired surgically (surgical resection). However, this measure is only taken if conservative therapy, as described above, does not help. The problem is that the operation in which the coccyx is removed can also result in scarring that causes pain.
As with most fractures, it normally takes about ten weeks before those affected are able to work normally again. Only then will everyday movements and activities be possible, i.e. being able to sit, lie or walk normally again without feeling any significant pain.
A seat ring can be of great service to the patient because it relieves the pelvic floor, ligaments and muscles associated with the broken coccyx.
Prevention
Those who keep their musculoskeletal system healthy and stable are less likely to suffer a fracture of any kind. This includes a protein and calcium-rich diet, lots of exercise and sports. Women going through the menopause and after should have their bone density checked regularly and – if necessary – take appropriate medication. A coccyx fracture can only be prevented by avoiding accidents wherever possible.
Because with a fracture of the coccyx, unlike other fractures, it is not possible to immobilize the fracture, therapy and aftercare require a lot of patience. So the healing process takes more time. The body should not be stressed in the first few days. Therefore, the patient must adhere to regular rest periods. Appropriate medication is administered to treat the pain.
Aftercare
The healing of a coccyx fracture takes several weeks, sometimes even months. An exact delimitation of the healing process cannot be made. Various different factors such as the fracture position, the physical constitution and the age of the patient play an important role. In extreme cases, it sometimes even takes years to achieve complete freedom from pain. A chronic course of coccyx pain is also possible.
When you can resume sporting activities after a coccyx fracture depends on the pain sensitivity of the person affected. Before that, however, the fracture must have healed completely so that the fracture site can be fully loaded again. Regular follow-up examinations by the doctor are necessary to determine the ability to exercise.
Until the doctor gives the green light for sporting activities, the patient is only allowed to move slightly and should rest as much as possible. Movements that maintain general fitness are considered sensible, as otherwise there is a risk of greater loss of muscle mass. The moderate movement promotes the healing process of the coccyx fracture. Pain-relieving and anti-inflammatory ointments or creams can be administered to support this.
You can do that yourself
If you have pain in the tailbone area, you should first consult a doctor. The medical professional has the necessary diagnostic tools available to diagnose a possible coccyx fracture. If a fracture has been identified, further measures can be taken.
Physical rest is important. Injury-related pain can be relatively intense and occurs in different situations. It is all the more important to avoid prolonged stress on the coccyx, for example by placing an orthopedic cushion underneath. Ring cushions or special heat cushions are also useful for relieving acute pain and avoiding the development of tension. Cooling pads are used to relieve pain and help especially with acute pain and swelling in the coccyx area.
Short walks and relaxation exercises are indicated after the first few days. They help to relax muscles and release tension. Older patients should also do physiotherapy in order not to lose full mobility of the coccyx. In the case of larger fractures, the gentle phase lasts two to three months. During this phase, it is necessary to take the necessary measures for recovery and to consult the specialist doctor.
