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The tailbone, or coccyx, is the last bone in the spine. Symptoms of a tailbone fracture include a constant dull pain in the very low back,
pain that worsens when sitting, and swelling around the tailbone.
The tailbone is a triangle shaped bone is made up of three to five different sections, which can make it difficult to detect a broken tailbone. Tailbone breaks, or fractures, are fairly uncommon. It is more common for a person to bruise their tailbone or pull a ligament in that area.
The symptoms of a broken tailbone are similar to those of a bruised tailbone, so it can be difficult to diagnose. Treatment options for broken and bruised tailbones are also similar.
When the tailbone is broken, it may:
- be displaced, which occurs when the separated bone fragments are clear on an X-ray
- be a hairline fracture, wherein the broken pieces are not separated
- be comminuted, which occurs when the bone breaks into multiple pieces
This article discusses what can cause a broken tailbone and how to identify one, along with treatment options and recovery tips.
The symptoms of a broken tailbone include:
- an almost constant dull pain in the very low back, just above the buttocks
- pain that worsens when sitting and when standing up from a sitting position
- swelling around the tailbone
- pain that intensifies during a bowel movement
- pain that intensifies during sexual intercourse
- irregular bowel movements
- numbness or tingling in the leg
The most likely cause of a broken tailbone is trauma or direct injury.
In young people, a broken tailbone is most often due to a backward fall or a high energy accident. In some groups, including older adults, nutritional deficiencies can make broken bones more common.
Though rare, childbirth can also lead to fractures of the coccyx. This bone is particularly vulnerable to injury during difficult labor, or labor that requires the use of instruments, due to its location in the body. Tailbone bruises are more common than fractures.
Females are more likely than males to experience tailbone injuries. Obesity is also a risk factor for tailbone problems.
Because many factors and conditions can cause pain around the tailbone, diagnosing a broken tailbone requires a doctor taking the person’s medical history, conducting a physical exam, and ordering medical testing.
To take a thorough history, the doctor will explore:
- possible causes of the pain, including falls or sports injuries
- possible nontraumatic causes, such as age-related wear and tear
- pain that could be from other sources
A physical exam and a rectal exam will give the doctor more information about the site of the pain, as well as what may be causing or contributing to it.
Problems with the piriformis muscles and nearby joints, for example — such as the sacroiliac and lumbosacral facet joints — can contribute to pain in and around the tailbone.
Testing for a broken tailbone will include cancer screening and medical imaging.
X-rays can help a doctor locate and assess the damage to the tailbone. If the X-ray does not provide a clear image, or if there are other concerns about what is causing the pain, an MRI scan can provide more information.
Partly due to the structure of the coccyx and other conditions that might exist at the same time as the injury — such as obesity, gas, or constipation — it is not always easy to diagnose a broken tailbone.
Unlike other broken bones, it is not possible to put the tailbone in a cast and immobilize it. Instead, a doctor might recommend using techniques to reduce the pain.
For example, they may suggest using:
- Specially designed cushions: These can be very helpful for a person with a broken tailbone. These cushions have a hole cut out in the middle, allowing a person to sit without putting pressure directly on the coccyx. These cushions are available online.
- Hot and cold packs: These can help ease inflammation and pain around the injury. Some sources recommend using cold packs on and off for the first 2 days after the injury — placing a cloth between the skin and the pack so that it does not feel uncomfortable — and using warm soaks after 2 days.
- Nonsteroidal anti-inflammatory drugs and acetaminophen: These can also provide pain relief. If the pain is very severe, a doctor may instead prescribe opiates.
- A standing desk: For people who spend a lot of time at a computer or desk, using a standing desk can be helpful while recovering from a broken tailbone.
Doctors may recommend steroids or nerve blocks if the pain is very severe. Undergoing surgery for a broken tailbone is rare, and doctors usually recommend this only when all alternatives have not worked and the pain is interfering with the person’s quality of life.
Recovery from a broken tailbone can take some time. Most fractures take 6–12 weeks to heal.
Many people who experience a broken tailbone are athletes, and they are usually eager to return to play. Some experts say that the limiting factors are pain and the risk of pressure on the tailbone.
If there is any risk of re-injury, the person should delay returning to that activity.
Rest is very important when a bone is broken, and people need to give themselves time to heal when they have a fractured coccyx.
However, it is also important to strengthen the muscles around the tailbone, stretching them regularly to keep tightness and imbalances from developing.
A doctor may provide a list of exercises to strengthen the hips and core, as well as pelvic floor exercises and stretches to relieve pressure on the gluteal muscles, back, and hamstrings. They may also refer a person to a physical therapist for more extensive treatment.
Learning how to sit with good posture is a good way to promote and protect a healthy tailbone.
A broken tailbone is a rare and painful injury that can affect people of all ages, from young athletes to older adults.
Treatment generally consists of reducing pain and preventing further injury to the tailbone. Recovery can take up to 12 weeks, and people should rest during this time to encourage healing. Some light exercises can help strengthen the muscles in the area.