Johns Hopkins Health Alerts |

Back Pain - Osteoporosis | Trauma to the Tailbone

In older adults, falling is the most common cause of tailbone injury.

The technical name for your tailbone (which is actually made up of several bony segments at the base of your spine) is the coccyx, and pain in that area is called coccydynia. Tailbone pain is usually caused by falling and landing on the coccyx. Older adults, who often have balance problems, are particularly at risk for this type of fall, especially when walking on ice or a wet floor. Women are at higher risk than men because a woman’s coccyx is rotated and faces backward, leaving it more exposed. Other risk factors for coccyx injury include arthritis, osteoporosis, and medications (such as corticosteroids, which can cause osteoporosis). Also, activities that involve repetitive straining against the tailbone and friction (such as cycling or rowing) can cause injury to the coccyx.

An actual coccyx fracture is rare; instead, the injury usually bruises the bone or stretches ligaments in the area. The main symptom of coccyx injury is severe pain and tenderness in the tailbone area, particularly when sitting. Bowel movements can be painful, as can sexual intercourse for women. Most cases of coccyx injury are treated with self-care techniques, but these symptoms require a visit to the doctor to rule out other possible causes.

Treating coccyx pain -- In most cases, injuries to the coccyx heal on their own, although pain can linger for several weeks or months. The following measures can be helpful in reducing pain after a coccyx injury:

• Apply ice to the coccyx for 15 to 20 minutes at a time, four times a day, during the first few days after the injury.
• Use a pain reliever such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) as needed.
• Sit on a donut-shaped pillow, which keeps the injured area away from the hard surface of a chair. These pillows can be purchased at a medical-supply store.
• Avoid sitting for long periods of time, if possible.
• Constipation can make bowel movements painful, so prevent it by eating a diet high in fiber and drinking plenty of fluids. Your doctor may also prescribe a stool softener to achieve the same result.
• Spend some time in a hot tub or whirlpool, if possible, which will reduce pain and swelling. For severe pain, your doctor may prescribe a stronger pain reliever, administer anesthetic and steroid injections, or refer you to a physical therapist. Surgical treatment usually is not required.

Click here to download illustrations and a handy tip sheet on treating Tailbone Trauma

For more Alerts and Special Reports, please visit the Back Pain and Osteoporosis Topic page.