Coccyx fracture

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Lateral radiograph showing a fracture of the coccyx, as well as a lower lumbar fracture.

A coccyx fracture is a fracture of the coccyx, commonly called a 'broken tailbone' or ‘puzzle fracture.’

The coccyx is located at the base of the spine, under the sacrum. It is the last section of the ape vertebral column. Most commonly in humans it comprises 3 to 5 fused (or, more rarely, separate) vertebrae, and is approximately 4 to 10 cm in length. The coccyx is attached to the sacrum by a fibrocartilaginous joint, called the sacrococcygeal symphysis, allowing for some (but little) movement.

Anatomical diagram of a healthy coccyx


Causes of coccyx fracture can vary greatly, but are most commonly confined to falls into the seated position, or childbirth.

Risk factors[edit]

The following risk factors have been identified for coccyx fracture:

Symptoms of coccyx fracture include:


X-rays are usually necessary, but this is not always the case. A physical examination will be carried out, which sometimes involves a rectal examination and/or neurologic examination.


If the coccyx fracture is severe enough, short-term hospitalisation may be required, although this is extremely rare. More often, self-care at home is administered.

Sitting on soft surfaces is recommended, as this reduces pressure on the coccyx. A 'donut' or 'wedge' cushion may be purchased – these are simply cushions with a hole in them to ensure that no weight is placed in the injured tailbone. Painkillers such as ibuprofen are also recommended, as is a diet high in fibre to soften stools and avoid constipation.

Doctors will not usually attempt to correct a bad alignment, as muscles in the area are powerful and can pull the bone back into the 'bad' position. The bone is also very difficult to immobilise simply due to the sheer number of muscles attached to it, as well as the position.


Following a coccyx fracture, surgery is not usually required; however, if the pain continues even after the fracture has healed, and is severe enough to cause disability, a coccygectomy may be required. Coccygectomy is the surgical removal of the coccyx.

External links[edit]