Definition
The coccyx fracture is a fracture of the coccygeal bone. The Os coccygis is the lowest bone of the spine and consists of 3-5 vertebral body parts. However, these vertebral bodies have become bony together through a synostosis (= fusion of two bones). The coccyx is the starting point for some muscles and ligaments of the pelvic region.
Causes
Os coccygis can be palpated on the buttocks and is prone to fractures due to its location. A fall or a hard kick against the buttocks can therefore quickly lead to a coccygeal fracture. Less often, a coccygeal fracture occurs after continuous stress on the bone, such as after riding a long bicycle. In this case, the coccyx fracture is usually accompanied by osteoporosis. Osteoporosis describes the clinical picture of reduced bone density and strength, which leads to an increased susceptibility to fractures of the skeletal bones.
Symptoms
Affected persons complain of very severe pain in the buttocks region after a coccyx fracture. This type of pain is also known as coccygodynia. It is characterized by strong pain in the area of the coccygeal bone with radiation in the anal, lumbar and hip region, mostly caused by a coccyx fracture.
Coccygeal anomalies, bruises, severe constipation or injuries during birth can also trigger coccygodynia. After a coccyx fracture, swelling and hematomas (bruising) are the primary causes of pain and pain. A rectal examination by a doctor can reveal a painful shifting of the coccyx.
The fracture of the coccyx is often followed by complaints during bowel movements, sexual intercourse and even during normal quiet sitting. As soon as there is any kind of tension in the surrounding pelvic muscles, pain can be provoked, for example if you have to sneeze. A broken coccyx causes severe pain in the affected buttock region.
The pain is often described as dull and excruciating. Severe pain is also summarized under the technical term coccygodynia. This is an attack of severe pain in the area of the coccygeal bone, which can radiate into the anal, lumbar and hip regions.
The pain of coccygodynia is described as stabbing, pulling and burning. Despite the radiation, the coccygeal fracture results in relatively well localized pain in the back and buttocks. Since the Os coccygis is the starting point for some muscles and ligaments of the pelvic region, tension and pressure can be transferred to the bone.
This also triggers severe pain. General strain on the affected region caused by a lot of movement and long periods of sitting aggravates the intensity of the pain. The pain before treatment of the coccyx fracture must be distinguished from that after it.
As a rule, patients are free of pain after successful therapy. Pain only occurs if conservative treatment is not sufficient. Long-lasting pain should therefore always be the guiding principle when considering and adapting the choice of therapy.
After an operation, scars and general healing processes can cause pain. However, the intensity of pain should not be comparable to that immediately after the fracture. Drug therapy of pain is independent of the time of the disease process.
Painkillers (analgesics) are particularly suitable as they not only relieve the pain but also have an anti-inflammatory effect. If a coccyx fracture is suspected, the course of the injury is first discussed. If the patient describes a hard fall onto the coccyx with subsequent long lasting, strong pain, the diagnosis of a coccyx fracture becomes more difficult.
As a rule, a palpation (=examination by palpation) of the coccygeal bone is performed to test whether pain has been triggered. This palpation can be performed from the outside or transrectally. In a transrectal examination, the doctor inserts a finger into the anus and palpates the coccyx, which is located at the end of the spine.
If the coccyx is broken, slight movements of the os coccygis cause severe pain. However, this diagnostic measure alone is not sufficient to find a broken coccyx. Coccygeal luxations, bruises or tumors as well as injuries during birth can cause similar pain.
Therefore, it is important to additionally consult an imaging procedure. X-ray diagnostics is particularly suitable for this purpose. As a rule, 2 x-rays of the coccyx are taken perpendicular to each other in order to assess the bone well.Further diagnostic measures usually do not have to be taken in the case of a coccyx fracture.
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