Symptoms, consequences and treatment of tailbone fracture
First, let's go a little deeper into human anatomy. What is the tailbone? This is a small bone, in an adult it consists of 4-5 fused vertebrae. It is connected with the sacrum by a peculiar joint, reinforced with ligaments. The junction of the tailbone and sacrum has low mobility, but in women it is more pronounced. During childbirth, the tailbone deviates backward, increasing the birth canal.
At a young age, the coccyx vertebrae are interconnected by layers of cartilage tissue.
The tailbone is well protected from external influences by an array of gluteal muscles and is surrounded by a large number of highly sensitive nerve fibers.
The muscles and ligaments involved in the activity of the genitourinary organs are attached to the tailbone. In its front part there is a nerve plexus, from which nerve canals and endings branch in the anus and pelvic organs.
The tailbone is an important fulcrum that is involved in the distribution of physical activity on the small pelvis. For example, when a person bends forward in a sitting position, the load is transferred to the lower part of the ischial bones, when he tilts backward, then the tailbone takes on a partial role of the fulcrum.
A tailbone fracture can result from:
- falls on the buttocks (the traumatic force is directed to the upper part of the tailbone);
- direct blow with a blunt and narrow object (the outer surface is damaged);
- childbirth (the inner surface of the coccyx is injured), when a large fetus passes through the birth canal, tears and significant displacements of the coccyx-sacral joint are possible;
- road traffic accidents;
- long driving and shaking in the vehicle.
Content:
- Symptoms of a tailbone fracture
- How to identify a tailbone fracture?
- Consequences of a tailbone fracture
- What to do with a tailbone fracture?
- Coccyx fracture treatment
Symptoms of a tailbone fracture
Experienced traumatologists argue that in most cases of coccyx injury, we are not talking about a true fracture, but about damage to the ligaments of the joint connecting the coccyx with the sacrum, displacement of the coccygeal vertebrae relative to each other, ruptures of the connections between them.
It is possible to speak of a fracture only when fractures of small bone processes of the tailbone become a consequence of the injury. A true closed fracture, caused by congenital degeneration or acquired with age, occurs in practice in isolated cases.
It is generally accepted that tailbone fractures most often occur in the elderly and children. However, traumatologists report that the overwhelming number of cases of fracture-dislocation of the coccyx occur among young women. In children, only dislocations are observed.
For tailbone fractures, both radiographic findings and clinical evaluation are equally important.
The main symptoms of a fracture are:
- piercing pain in the area of injury;
- difficulties in movement;
- inability to sit and a sharp increase in pain when trying to get up;
- difficulty with defecation due to acute pain.
How to identify a tailbone fracture?
It is impossible to independently determine the features of the tailbone injury. The final diagnosis can only be made by a doctor after carrying out diagnostic measures:
- Direct examination of the patient. In the area of injury, swelling is clearly visible, a hematoma is possible. When loading the upper part of the tailbone, the patient experiences acute pain.
- Coccyx radiography. The standard examination is performed in a straight line (in the supine position with straight legs) and lateral (on the side with bent legs) projection. The fracture can not always be seen on the radiograph, since the small bones of the coccyx are hidden by an array of soft tissues.
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Computed tomography of the spine. The most informative method for making dense structure detail available.
- Magnetic resonance imaging. In addition to determining the state of bone tissue, this study checks the integrity of nerve fibers and blood vessels, muscles and skin.
- Vaginal and rectal examination. Sometimes it allows you to feel crepitus (a characteristic crunch that occurs when bone fragments rub). It is not prescribed unless absolutely necessary, since the information content of the study is small, and the patient experiences discomfort during the procedure.
Consequences of a tailbone fracture
A fracture of the coccygeal spine can be without displacement and with displacement of bone fragments.
The last type of fracture is the reason for the development of various pathologies:
- Chronic headache (migraine).
- Spinal cord injury. A condition in which the pain syndrome accompanies the patient constantly (especially felt when doing squats), significantly impairing the quality of life.
- Complicated labor. Women who have had a tailbone fracture have increased pain during childbirth.
- Salt deposition or callus formation. This condition is also accompanied by constant pain when sitting and getting worse when standing up.
- Anacopchial pain (coccygodynia). Pain syndrome localized in the coccyx region. In most cases, it is observed in women. The pain is worse while sitting, walking and stool. Coccygodynia occurs with neuralgia of the nerve fibers surrounding the coccyx and with damage to its nadosnat. Usually appears on the background of other neuralgic disorders.
Since the coccyx zone itself is hypersensitive and reacts extremely painfully to the lightest bruises, it is very uncomfortable for a person to live, experiencing constant pains that increase with movement.
Displaced tailbone fracture
This type of fracture is the most painful and certainly causes difficulty in moving a person, since the displacement of bone fragments leads to injury to the neurovascular bundle and soft tissues.
Since the bones are displaced, the process of their fusion becomes more complicated and, at the same time, pain syndrome is far from the most unpleasant consequence. Surgical removal of bone fragments can cause a tailbone abscess, accompanied by defecation disorders and fistula formation.
A displaced tailbone fracture is a big problem for women planning a pregnancy. This diagnosis is an indication for a cesarean section, but not all expectant mothers agree to this kind of operation.
In order to understand whether natural childbirth is available with such an injury, it is necessary, even before pregnancy, to conduct an X-ray and present the results to an experienced gynecologist. Having the size of the pelvis and taking into account the reduced mobility of the broken tailbone, the specialist will be able to determine whether natural childbirth is possible or whether surgery is necessary.
What to do with a tailbone fracture?
So, there was an unpleasant fall, you hit your coccyx hard and it hurts, what should you do? Before the arrival of an ambulance and a professional examination by a traumatologist, pain relief must be made. First, try to lie down and apply a cold compress to the affected area.
It is usually recommended to lie down so that the injured area does not touch the surface. However, the human body is its own best healer, it will tell (by increasing or decreasing pain) what position to take.
Pain medications can be taken. In this case, baralgin or kethanol is suitable, two tablets will be enough, you can use diclofenac.
Coccyx fracture treatment
In the acute and subacute stages, patients are prescribed conservative treatment. The main task of doctors is to urgently stop pain and relieve swelling.
- While the pain syndrome is pronounced, the patient is shown bed rest. In order to ensure rest, a special orthopedic device is used, we will describe it below.
- Your doctor may prescribe a local pain reliever as needed. In some cases, the use of ointments may be indicated, provided that the integrity of the skin is not compromised. It is possible to use rectal suppositories based on Voltaren (diclofenac). To prevent constipation and displacement of the coccyx vertebrae, rectification enemas are prescribed.
- A special splint is applied to the patient, which is a gauze circle with cotton wool inside.
As a rule, severe pain goes away within a week, after which the patient is allowed to get up.
Surgery
Surgical treatment is indicated if it is necessary to correct the deformity and significant displacement of the fragment. The task of the surgeon is to remove the damaged fragment of the coccyx.
Surgical intervention can be prescribed for compression of the pelvic organs and, as a consequence, disruption of their natural functioning, improper passion of the coccyx segments. The operation is quite complicated - the manipulations should not lead to damage to the rectum.
To maintain the correction of coccyx deformity after surgical treatment, the doctor prescribes adherence to bed rest and rest for up to 10 days and an appropriate diet.
If pain syndrome persists for a long time (coccygodynia), it is necessary to remove the tailbone. The consequences of such an operation can be suppuration, fistulas and hematomas.
Proper nutrition
When treating an injury, you need to take care of the correct diet. You need to eat foods high in calcium: dairy products (cottage cheese, milk), cabbage, herbs, fish, persimmons, sesame seeds and hazelnuts.
In order for the calcium entering the body to be absorbed, silicon must be present in the diet. This element is found in currants, olives, radishes and cauliflower.
When treating the consequences of a tailbone fracture, it is possible to use narrowly targeted methods:
- hirudotherapy;
- Paravertebral chipping;
- Electroanalgesia.
Learn more: Do's and don'ts for a fracture?
ethnoscience
As an adjunct therapy for recovery after a fracture of the coccygeal spine, you can also use folk remedies, such as mummy. For the preparation of the ointment, 0.5 gram mixed with rose oil is enough.
Raw potatoes, grated on a fine grater, relieve pain well. The gruel is simply applied to the affected area.
Comfrey ointment is widely used. A glass of plant leaves is crushed and diluted with a glass of vegetable oil. The mixture must be boiled over very low heat, strain and add beeswax to it (a quarter of a glass). Allow the ointment to cool and apply to the injury site twice a day for about 60 minutes.
On the subject: 12 popular ways for home treatment
Orthopedic pillow for tailbone fracture
Above, we mentioned that when treating a spinal fracture, the patient is prescribed to comply with the pastel regimen. In order to prevent pressure on the damaged area and prevent the formation of pressure ulcers, an orthopedic pillow is used.
This device is specially shaped to provide the greatest comfort in a sitting position. Thanks to the hole in the pillow, the load is removed from the sacrococcygeal region, the patient does not feel pressure on the damaged area, and therefore does not feel pain.
As rehabilitation measures, it is recommended:
- physiotherapy;
- phytotherapy;
- acupuncture;
- massage.
Provided that the treatment and rehabilitation course is correctly structured, doctors manage to improve the patient's condition within 14 days. On average, the process takes four weeks. In some cases, it takes several months to recover, it all depends on the characteristics and severity of the injury.
If you suspect a tailbone fracture "for later", you should not postpone contacting a traumatologist. The rate of recovery after injury and the quality of later life depend on the speed of receiving professional help.
Author of the article: Kaplan Alexander Sergeevich | Orthopedist
Education: diploma in the specialty "General Medicine" received in 2009 at the Medical Academy. I. M. Sechenov. In 2012 completed postgraduate studies in Traumatology and Orthopedics at the City Clinical Hospital named after Botkin at the Department of Traumatology, Orthopedics and Disaster Surgery.
