A hard fall on the bottom and the pain, bruising, and swelling that accompany it could be symptoms of a fractured tailbone. The tailbone, or the coccyx, refers to the very last segment of the spinal column that ends just above the buttocks. A fracture occurring in this area means the tailbone has suffered a break or crack. In actuality, however, such breaks are somewhat rare. A careful examination of the symptoms experienced can be used to tell if the tailbone has been fractured or, more commonly, if the area has simply been injured.
An actual fracture usually occurs because of some form of trauma to the coccyx, such as a sharp kick to the area or rough contact during physical sports. A fall can also be responsible. Although various falls can occur, the types that cause a fractured coccyx usually involve a fall onto a seated position, such as when skating or falling onto icy pavement. Vaginal births can also break the coccyx — usually, such incidents occur with larger than normal babies who weigh 9 pounds (4 kg) and up. The larger size of these babies puts increased pressure on the bones of the coccyx as they push through the birth canal.
With a fractured tailbone, there are usually obvious symptoms that indicate a problem with the coccyx area. Severe pain and discomfort in the area is a chief complaint. Although the coccyx does not have a wide range of motion, it does have limited mobility that could mean some impairment and strain in other parts of the body. In some instances, pelvic pain and lower back pain are associated with a broken tailbone; pain will usually worsen when sitting, and sufferers are likely to notice increasing strain and pain during bowel movements. This pain, however, may also be eased somewhat by leaning forward.
Bruising is also likely to occur in a coccyx injury. If bruising does occur, it is usually visible at the base of the spine and may be purple or red in color. The skin may also be puffy or swollen looking and feels tender when touched. As the tailbone heals, the bruising and swelling typically fade away.
Even though a fractured tailbone can be extremely painful, a minor hairline break is not usually considered a medical emergency. If pain is so severe that it is hard to function or is accompanied by tingling in the legs, trouble moving the legs, and shortness of breath, it is generally best if immediate medical attention be sought. Should a tailbone injury occur and an injury to the neck or spine is suspected, the patient should not be moved. Instead, emergency dispatch services should usually be contacted.