Coccyx Fractures or Pelvic Floor Dysfunction

April 15, 2017

Coccyx Fractures can occur more frequently in females then males (up to 4 times) because the Coccyx is out of the pelvis as a benefit for childbirth. This makes it more prominent in females and thus is more easily injured. The bruising or fracture of a tailbone can occur by landing hard on the buttocks or for example landing on a corner of a desk.

Generally it heals in 6-8 weeks. In a small subset of patients, the muscles are sore in the back and the pelvic floor and it becomes a chronic problem. What needs to be determined is if their is pelvic floor dysfunction or the pain is generated and coming from the coccyx itself. This is not common. Pelvic floor dysfunction however is common.

We see many women and some men walk around with lower back pain. As a result they stiffen their spine and tighten up their pelvic floor which can cause the muscles to spasm. Many people perceive this to be bladder incontinece when they feel they have trouble voiding. The problems the urethra spasms and one cannot urinate unless they push harder. They also have perceived consitpation because they have difficulty relaxing to have a bowel movement because of pelvic floor dysfunction. There are physical therapists locally that I work with constantly who are excellent at relaxing and relieving these muscle spasms. Many times this is the cause of the perceived coccyx problem.

In a rare instance, the coccyx can be the source of the pain and should be evaluated through an internal examination or with an injection. At times, back pain can cause pelvic floor dysfunction. The bottom line is if back pain can be diagnosed correctly it can be fixed.

The perception of coccyx pain can be confusing. Pelvic floor dysfunction is from spastic muscles in the pelvic floor causing perceived tailbone pain. Coccyx pain results from a fracture or an inflammatory response within the coccyx. Another cause of this problem is degenerative disc disease. The L5 and S1 degenerative disc can cause a scleratomal referral pattern to the tail bone which cause tail bone pain. If this not diagnosed correctly, the wrong surgery can be performed.

Clarification of the pain generator is necessary through historical and clinical evaluation and possible expert physical therapy evaluation before anything is tried.

Dr. John C. Nordt is a respected orthopedic surgeon with over 40 years of experience and is well known locally and internationally for his specialization in the care and surgery of the spine. His focus on back problems, spine disorders, fractures and surgical revisions places him in a unique league of surgeons who thrive on treating the most challenging cases and returning his patients to a pain free life.