A coccyx fracture is a fracture of the coccyx, commonly called a ‘broken tailbone’. Although they may be slow to heal, the majority of coccyx injuries can be managed with cautious treatment. The coccyx is the endmost part of the vertebral column. This is a minute structure which assumes a triangular shape and is also called, the tailbone. The coccyx itself is composed of three to five mingled vertebrae. You may find the coccyx to be slightly curved towards the pelvis. Because of the coccyx’s anatomical location, this is vulnerable to certain types of injuries. There can be quite a lot of circumstances that would lead to the fracture of the coccyx. However, the number one reason for sustaining coccyx fracture is believed to be a direct blow to the coccyx. Fracture to the coccyx is a serious thing and must be given attention because it takes some time for the fracture to heal. Learn something more about coccyx fracture in the next few paragraphs.
There are actually two types of coccyx fracture. The classification of coccyx fracture is based on the location of the fracture. Tuchis was the first person to classify coccyx fracture circa 1848. The first type of coccyx fracture involves the olecranon and the second one affects the radial head. The latter is believed to be a misnomer because the radius is not part of the coccyx but the elbow rather.
The principal causes of coccyx fracture include the following:
Fall – One may easily fracture his coccyx when accidentally falling and landing on the buttocks first. Engaging in sports like basketball and skating increase ones risk of sustain coccyx fracture.
Childbirth – Another speculated reason for coccyx fracture is during childbirth wherein the fetus puts forth pressure on the coccyx and resulting to fracture.
The remaining causes of coccyx fracture are believed to be idiopathic. This means that the coccyx just gets fractured without any known cause. However, there are several factors which increase ones risk of developing coccyx fracture and these include the following:
Old age – As a person goes through the normal process of aging his bones are likely to become brittle which makes it vulnerable to fractures especially at the coccygeal area.
Being a woman – The females practically have wider pelvis which increases their risk of sustaining coccyx fracture.
Nutritional Deficiency – Lacking the essential vitamins and other nutrients, especially vitamin D which is necessary for the formation of sturdy bones, one’s risk of developing coccyx fracture also heightens.
Bone anomalies – Having bone anomalies such as osteoporosis also make an individual predisposed to coccyx fracture.
Sports – At times, fracture to the coccyx can be associated with rigid sports.
Vehicular Accidents – Any form of vehicular accident which creates a sudden blow directly to the coccyx can cause fracture to the area.
The primary symptom immediately following a fracture to the coccyx would be pain. The pain especially becomes more prominent when one assumes a sitting position. Bearing down during defecation also triggers a painful sensation and the affected individual may find relief by lying down because pressure on the fractured coccyx will be lessened. When you have noted any of these symptoms, it is imperative that you consult your doctor the soonest so as to confirm the possibility of a coccyx fracture.
Thorough physical examination is highly necessary in diagnosing the presence of coccyx fracture. Modes of diagnosing coccyx fracture typically consist of digital rectal exam. Imaging studies like x-ray may or may not be indicated because there’s a high tendency of getting false negative or false positive results. Minute fractures have the tendency of getting missed during the x-ray examination and fractures caused by congenital anomalies may be mistaken as coccyx fracture. Thus, a rectal exam is the preferred mode of diagnosing fracture. Normally, during the rectal exam, there will be no pain upon palpation. However, when one has fractured coccyx, the area may feel tender upon palpation. To further confirm the presence of coccyx fracture, a local anesthetic may be injected to the buttocks to determine whether or not the pain is coming from the bone.
Treatment of Coccyx Fracture
Coccyx fracture is usually left to heal on its own. Surgery and manipulation of fractured coccyx aren’t all the time necessary. Thus, the primary goal of treatment for coccyx fracture is usually controlling the pain while the fractured coccyx is allowed to heal. One of the reasons why surgery is not indicated to repair coccyx fracture is that it would be very difficult to immobilize the area following the procedure. Another reason is that success rate of coccyx surgery is often meager. Doctors would usually recommend a complete bed rest following a coccyx fracture. Pain medications and steroid injections may be indicated to control pain and provide comfort to the patient while the coccyx is undergoing the healing process. The coccyx fracture would just eventually heal in time, along with the help of the muscles around it which helps push the coccyx back to its normal position. One should be patient enough to give the coccyx ample time to repair. With proper care and treatment, the condition would eventually resolve. However, if it doesn’t resolve within 12 to 15 months, you should consult your doctor because there might be other underlying pathology causing the condition.
If the condition is pervasive despite all the modes of treating it, certain forms of complication are to be expected. One of the common complications of coccyx fracture is failure to realign. This condition leads to impaired mobility because pain will surely accompany one wrong movement. Sophisticated modes of treatment are essentially required for this matter.
Coccyx fracture is an entirely preventable condition though. There are some precautionary ways that one may observe so as to veer away from this condition. Some of the ways in preventing coccyx fracture are the following:
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The Physicians mostly advised patients to use a coccyx cushion to reduce pressure on the spinal column and avoid tailbone pain. The coccyx is located at the end portion of the vertebral column. Any assault to the coccyx such as fractures, cracks and dislocations would surely trigger pain over the coccygeal area which is better known as coccydynia. Coccydynia is immensely debilitating for an individual, especially in terms of performing mundane tasks. The worse part is that sitting would absolutely send an individual in pain. So as to relieve coccydynia, coccyx cushions have been designed. These are created to enable the affected individual to perform his or her activities of daily living. Even if you have coccydynia, you can still sit for long hours working at the office or simply watching your favorite show at home, without being bothered by the agonizing pain on the coccyx. A coccyx cushion helps control coccydynia by relieving the pressure over the coccyx especially when an individual is in a sitting position. These coccyx cushions are made up of different types of materials and designed in different cuts to fit your condition and bring forth maximum amount of comfort.
The common types of coccyx cushions out in the market nowadays include the following:
Ring Coccyx Cushion :- These cushions are oftentimes shaped like a doughnut. This type of cushion is especially effective in dealing with coccydynia associated with hemorrhoids, bruising and prostate enlargement. Ring cushions can either be made of gel or air and these can be inflated. You have the option to choose whatever size of ring cushion which you think would bring utmost comfort for you. The bane of using this type of coccyx cushion is that this cannot be used for over a long period of time.
Gel Coccyx Cushion :- As the name suggests, this type of cushion is a mixture of gel and foam. Gel coccyx cushions are reputed for the great stability they provide. The gel coccyx cushion provides maximum comfort by relieving and evenly distributing the pressure that is building up around the coccygeal area. It also features a cut out portion especially designed to prevent the coccyx from touching a hard surface. Your weight is also ideally distributed over a gel coccyx cushion. This effectively deals with coccydynia but this is considerably pricey over the other types of coccyx cushions.
Memory Foam Coccyx Cushion :- Another type of coccyx cushion is called the memory foam coccyx cushion. The National Aeronautics and Space Administration (NASA) was the one which innovate visco-elastic foams that were to be originally used for aeronautics purposes. However, specialists from the medical field, specifically orthopedics, have accidentally discovered the excellent use of this type of material as a coccyx cushion. The memory foam coccyx cushion is created from these visco-elastic foams and this is considerably denser compared to other types of coccyx cushion. Since this is a memory type of foam, this can easily assume the contour of your own built thus preventing the accumulation of pressure especially around the coccyx. You don’t have to worry about warped memory foam coccyx cushion because this is considered temperature-sensitive which allows it to recover its original shape. Memory foam coccyx cushion is also highly durable so you may use this for a longer duration. There also other types of coccyx cushion which are considerably less dense than that of the memory foam because they are entirely built from firm, sturdy and less dense material yet they still provide optimum comfort especially when used along with padded seats. Nowadays, visco-elastic foams are being used in nearly every aspect of daily living.
Air/Inflatable Coccyx Cushion :- You may also make use of an air or an inflatable coccyx cushion. You have the option to inflate or deflate the coccyx cushion in any size that you want. The greatest advantage of using this type of coccyx cushion is that this is pretty handy and you can carry it with you anywhere you go. The firmness of the inflatable coccyx cushion would depend on the amount of air in it. When you find it more comfortable with little air inside the cushion, you may opt to deflate it. The pitfall of using this type of coccyx cushion is that this may not entirely be that durable and this is only intended for short term use.
Sloping Coccyx Cushion :- The sloping coccyx cushion is also ideal for those who sit for long periods of hours, especially those who are working over time at their offices. Not only is this good for office use but this can as well be placed on car seats. This is excellently made of polyurethane foam which is considered to be highly resilient and its cover is made of velour camel that is entirely washable. The sloping coccyx cushion works by tilting the pelvis thereby retaining the normal lumbar alignment and preventing coccydynia. This also has a cut-out feature which prevents the pelvis from touching on a hard surface. This is also a good choice for relieving coccydynia.
Wedge Coccyx Cushion :- The wedge coccyx cushion works in the same fashion as the sloping coccyx cushion does. This one is also made of durable polyurethane material and is machine washable. With the wedge coccyx cushion, the coccyx area will be suspended on the cut-out portion which leads to relief from pressure thence resolving coccydynia.
Apart from above-mentioned coccyx cushions, there are several other types of coccyx cushion. You have the freedom to choose which one brings forth maximum amount of comfort. With ample amount of knowledge on your condition and as well as on choosing various types of coccyx cushion, you are spared from suffering from coccydynia and you can breathe through life much easily.
Coccydynia is actually a medical term for tailbone pain or pain in the coccyx. The term is also otherwise known as coccygodynia. You’ll further understand this condition by first acquainting yourself with the anatomy of the coccyx. The coccyx is actually the terminal portion of the vertebral column. This originally comes from a Greek word which when translated would mean “cuckoo” because this looks like the beak of a bird. This is composed of 4-5 fused vertebrae and superior to it is the sacrum. The coccyx is triangular in shape and is slightly curved towards the pelvis. A number of people used to suffer from coccydynia. This can actually become a chronic problem especially when just being left untreated. Women are slightly at risk for developing this condition due to the anatomy of their pelvis which makes the coccyx more exposed to injuries.
The primary causes of coccydynia are linked to error in mobility and some inflammatory conditions which affect the coccyx. However, a study conducted by Maigne suggested that people who complain of coccydynia often suffer from a traumatic accident which immensely injures the coccyx; thereby resulting to a phenomenon called coccydynia. Tailbone pain especially becomes more prominent when one is sitting or suddenly stands up. This is primarily due to the pressure exerted to the coccyx. Since this condition has the tendency to affect us all, let us then acquaint ourselves about the true nature of coccydynia.
Coccydynia Causes :-
There may be a number of factors which lead to the development of tailbone pain. Despite a hodgepodge of possible causes of tailbone pain, there are also certain cases in which the exact cause remains unknown and thus termed idiopathic coccydynia. Some of the common causes of coccydynia include the following:
1. Accidental fall
2. Extra pressure exerted by the fetus’ head during delivery
3. Sitting for long hours especially on hard surfaces
4. Presence of tumor near the coccyx
5. Dislocation and fracture to the coccyx
6. Repetitive movements which strain the lower back especially the coccygeal region
Pain at the buttocks area is the defining characteristics of coccydynia. The pain would especially be aggravated when one sits for prolonged periods or when one shifts from sitting position to a standing position and then vice versa. Redness, swelling and warmth may also be noted over the coccygeal region.
Risk factors :-
People who have the following conditions have significantly higher risk of developing coccydynia:
1. The female population has a higher tendency of developing such condition because of the anatomy of their pelvis.
2. Osteoporosis and other degenerative bone diseases
3. Engaging in strenuous activities and contact sports
4. Inflammatory diseases like arthritis
5. Bone Infections such as osteomylitis
6. Obesity- Sometimes the coccyx cannot anymore tolerate the extra weight which oftentimes causes strain to the back then coccydynia.
How to Diagnosis Coccydynia :-
Early diagnosis may contribute to a better prognosis. Your doctor may typically have to obtain a comprehensive medical history of yours then conduct a thorough physical examination. To confirm the condition, further tests may be conducted which include imaging studies like CT scan and x-rays. These tests would help confirm bone fracture if there’s any.
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Varying modes of treatment may be involved in the management of coccydynia. Coccydynia treatment would usually vary depending on the severity of pain. However, ample amount of rest is usually required to relieve your self from the condition. Lying down would help control coccydynia because this relieves the pressure building up within the area. Other treatment modalities for coccydynia include the following:-
Ice application – This is effective in dealing with pain related to coccydynia. Ice can be applied over the affected area several times daily. This should be done within the first 48 hours starting from the onset of pain.
Coccyx cushion – There are also special types of padded cushions designed for people who used to suffer from coccydynia. The coccyx cushion is actually made of special materials and is engineered in such a way that would relieve the build up of pressure within the coccyx. There are different types of coccyx cushion designed for a specific condition. This is perfect for those who spend extra hours sitting down, especially those who work overtime at their offices.
Anti-inflammatory medications – For tailbone pain that does not seem to be relieved with the previously mentioned remedies, anti-inflammatory medications such as corticosteroids may be prescribed by your physician to give you relief. This may be given intravenously or injected directly to the coccyx. Cortisone injection is usually given at the doctor’s clinic.
Painkillers – Non-steroidal anti-inflammatory drugs (NSAIDs) are also preferred to control the pain associated with coccydynia. Paracetamol may also be indicated for coccydynia. Though tramadol is often powerful, its use is limited because of its side effects which include headaches, dizziness, nausea and vomiting, and abdominal pain.
Ganglion Impar Nerve Block – This is another effective management of coccydynia. The ganglion is actually is a nerve situated near the coccyx. Ganglion impar nerve block is performed by injecting local anesthetics directly towards the ganglion impar nerve. Signals are impeded from travelling to the brain. This has been found to provide temporary relief for those who suffer from chronic coccydynia. However, there are also some cases in which permanent relief can be achieved through this.
Coccygectomy – For tailbone that seems to be resistant to the conventional modes of treatment, surgery in the form of coccygectomy is usually indicated. Coccygectomy involves the removal of the coccyx. Doing so would provide lifetime relief from coccydynia. Nonetheless, there have been repercussions of the procedure. Coccyx surgeries oftentimes have poor success rate. Thus, this mode of treatment is not commonly indicated. Aside from the pitfalls of coccygectomy, it is better to leave the condition as is because coccydynia would eventually resolve on its own without any treatment.
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The coccyx originates from a Greek word that when translated into English would mean cuckoo. This is actually likened to that of the cuckoo’s curved beak especially on a side view. The coccyx is otherwise known as the tailbone and this is anatomically located at the end portion of the vertebral column, inferior to the sacrum to be exact. The coccyx comprises around 3 to 5 fused or detached coccygeal vertebrae. This is being joined to the sacrum through the sacrococcygeal symphysis. This is a type of fibrocartilaginous material which allows limited range of motion of the sacrococcygeal joint.
Without you paying much attention to it, the coccyx is actually a very important part of the body. The theory of evolution believes that the coccyx is actually the relic of the tail that earlier human forms used to have. All humans and primate forms do have the coccyx. One cannot just be nonchalant about the coccyx because this maintains specific functions in the body. In fact, the coccyx is the location of some attachments of muscles, tendons and ligaments. Having your coccyx removed would bring about certain changes in the way you function or move. One important function of the coccyx is that it is the structure that supports especially when an individual assumes a sitting position. The ischial tuberosities and its other parts serve as a support structure when a person is sitting and happens to lean forward. However, the coccyx assumes much of the weight when a person sits and leans backward. So, you can just imagine sitting without your coccyx supporting at the very base of the vertebral column. The different portions of the coccyx actually assume different functions. For instance, the anterior part is entirely responsible for the functions of the pelvic floor such as micturition and defecation because the coccygeus, iliococcygeus and pubococcygeus muscles are attached herein. On the other hand, the posterior part of the coccyx serves as the support structure of the anus and it’s also where the gluteal muscles attach into. Aside from these essential functions of the coccyx, this is also where we can find the attachments of ligaments such as the anterior and posterior ligaments. Their ends are located at the sacrococcygeal ligaments. The coccyx also serves as an extension to the pia mater.
Since the coccyx is the location of several attaching ligaments, this appears to be slightly concave out in the front with transverse grooves which makes it ideal for the attachment of the sacrococcygeal ligament. Portion of the anterior coccyx also provide some support to the rectum. Just like the anterior side, the posterior aspect of the coccyx also has some transverse grooves.
The coccyx is also vulnerable to certain types of injuries. Often, a bruised tailbone or coccyx develops. When pain is felt at some point on the coccyx, this is referred to as coccydynia. Sports, car accidents, falls and other mishaps have a huge tendency of injuring the coccyx. Other than that, tumors may also grow within the coccyx itself. The most common type of tumor that can be found over the coccyx is called sacrococcygeal teratoma. Coccydynia without serious pathology may be managed through conventional pain medications. However, more severe ones would often require surgery so as to correct the existing condition. The commonly performed surgical procedure involving the coccyx is coccygectomy or the removal of the coccyx. Often, before allowing the patient to undergo this type of surgery, the doctor has to carefully do some assessment first owing to the fact that the important functions of the coccyx will be lost following the surgery. This is also considered to be a critical procedure and must be done with utmost dexterity. The good thing is that, problems involving the coccyx are oftentimes dealt with effectively even without resorting to surgery.
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