Tailbone trauma - aftercare

Most tailbone injuries lead to bruising and pain. Only in rare cases is there a fracture or broken bone.

Tailbone injuries are often caused by backward falls onto a hard surface, such as a slippery floor or ice.

Symptoms of a tailbone injury include:

• Pain or tenderness in the lower back
• Pain on top of the buttocks area
• Pain or numbness with sitting
• Bruising and swelling around the base of the spine

A tailbone injury can be very painful and slow to heal. Healing time for an injured tailbone depends on the severity of the injury.

• If you have a fracture, healing can take 8 to 12 weeks.
• If your tailbone injury is a bruise, healing takes about 4 weeks.

In rare cases, symptoms do not improve. Injection of a steroid medicine may be tried. Surgery to remove part of the tailbone may be discussed at some point, but not until 6 months or more after the injury.

Follow your provider's instructions on how to relieve your symptoms. These steps may be recommended for the first few days or weeks after your injury:

• Rest and stop any physical activity that causes pain. The more you rest, the quicker the injury can heal.
• Ice your tailbone for about 20 minutes every hour while awake for the first 48 hours, then 2 to 3 times a day. Do not apply ice directly to the skin.
• Use a cushion or gel donut when sitting. The hole in the center will take pressure off your tailbone. You can buy the cushion at a drugstore.
• Avoid sitting a lot. When sleeping, lie on your belly to take pressure off the tailbone.

For pain, you can use ibuprofen (Advil, Motrin, and others) or naproxen (Aleve, Naprosyn, and others). You can buy these medicines without a prescription.

• Talk with your provider before using these drugs if you have heart disease, high blood pressure, kidney disease, liver disease, or have had stomach ulcers or internal bleeding in the past.
• Do not take more than the amount recommended on the bottle or more than your provider advises you to take.

It may be painful to urinate or have a bowel movement. Eat plenty of fiber and drink plenty of fluids to avoid constipation. Use stool softener medicine if needed. You can buy stool softeners at the drugstore.

As your pain goes away, you can begin light physical activity. Slowly increase your activities, such as walking and sitting. You should:

• Continue to avoid sitting for long periods.
• Not sit on a hard surface.
• Keep using the cushion or gel donut when sitting.
• When sitting, alternate between each of your buttocks.
• Ice after activity if there is any discomfort.

Your provider may not need to follow-up if the injury is healing as expected. If the injury is more severe, you will likely need to see the provider.

Contact the provider if you have any of the following:

• Sudden numbness, tingling or weakness in one or both legs
• Sudden increase in pain or swelling
• Injury does not seem to be healing as expected
• Prolonged constipation
• Problems controlling your bowel or bladder

Coccyx injury; Coccyx fracture; Coccydynia - aftercare

Bond MC, Abraham MK. Pelvic injuries. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 46.

Cusack S. Pelvic injuries. In: Cameron P, Little M, Mitra B, Deasy C, eds. Textbook of Adult Emergency Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 4.6.

Updated by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.