Bruised coccyx bone after bad fall - question

by Sarah Jane

Hi, your article is very informative, thanks for sharing!
I had a bad fall on the edge of tiled stairs and bruised my coxxyc bone. At first my G.P. was convinced I had fractured it however after the results came back from an x-ray it appears there is no fracture. This happened 5 weeks ago now and I am still in a lot of discomfort and still on medication etc.

But worst of all, since I fell I have an almighty constant urge to urinate. It started off mild but now (it's 2.30am) it has got so bad it keeps me awake at night with a feeling of pressure in my lower tummy. There is no burning sensation when i do pee and although my body is telling me I need to pee when I get up to go, either a tiny drop comes or nothing at all but the pressure (almost tickley) sensation is still here?! Please can you shed some light on whether you've heard of this before associated with a bad fall causing a badly bruised coccyx bone?

I'm only 28 and have never ever suffered with anything like this extremely annoying condition. Iv one child and even at my full term of pregnancy I never had this pressure sensation or urge to urinate so strongly.

It's so bad tonight that if my G.P. was open I'd get in my car and drive to the surgery now!! I feel like screaming it's that irritating!
Can't see any other reason or cause for this condition, other than the fall I had and the trauma it's caused.

Please help, appreciate any advice.

Hello Sarah Jane
Firstly, a question, then two suggestions.

When you do pee, do you have a normal stream? Can you empty your bladder? Or is it ALWAYS a trickle? If not the nerve supply to the sphincter that enables the bladder to open has been damaged. Then you will get an infection, if you can't void the bladder. Start the Kegel exercises at this site.

I recommend you go off all the meds, and hope this is just a side-effect of the painkillers. Instead use ice (see our newsletter #24), it's more effective anyway.

Immediately get one of those rings, or make one for yourself, or a kid's swimtube. You must get the pressure off the coccyx for at least a month, perhaps three.

Can you get a copy of the X-ray? Take a picture with your digi camera and attach it to this page. If it's been displaced forwards, it needs to be repositioned.

I would see a chiropractor to evaluate your pelvis. You probably upset the sacroiliac joint at the same time. A fall on the sacrum/coccyx does that, and that hopefully is the cause of your nerve troubles.

If you can't void your bladder, you should see a urologist.

I hope this has contributed.

Go off all the medication, it's just possible that it's just a side effect of the medication.

Dr Barrie Lewis

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Apr 06, 2019
Butt bone
by: Anonymous

Hi last year I fell down the carpet stair when I missed a step. My butt hurted really bad after the fall. Whenever I lay on my back I always feel something on my butt bone. I urinate well no problem. I went to work but ever time I sit on a chair my butt hurt or when I get up. I’ve been like that for 2 weeks or so. I didn’t go see a doctor or got my X-ray done. Didn’t take any pain medicine. I’m writing this if I should get it checked up?

Jun 21, 2018
Bad fall on a wet tarp causing inability to push to urinate
by: Anonymous

Is it normal to have lower abdominal pain after falling and hurting your tailbone and lower back? It also feels like I cannot push to urinate when I do go. The x Ray shows no fracture but I can hardly walk/sit/lay down. I have never had this much pain plus my neck is sore from the fall when I hit my head.

Frankly, I'm not sure. A fall like that is really quite traumatic and can effect multiple systems.

Is that simply cannot push, in other words weakness of the deep pelvic muscles, or pain when you push? It's an important distinction.

If you are unable to urinate it's a clinical emergency, and you need to be catheterized; otherwise your bladder will burst.

In the initial stages, I'd stay with the medical community, and once the crisis is over, see a local chiropractor who is experienced in treating sacral and coccygeal injuries; ask before making an appointment.

Meantime start some very gentle lower back exercises, pulling your knees to the chest, and doing some pelvic tilts in the painfree zone.

T12/L1 is the common fracture site. Any pain there?

It's very hard for me to be specific without more information about which movements actually hurt, and where. Did this happen days, or months ago?

Dr Barrie Lewis

Apr 22, 2018
Healing time?
by: Kathryn

39 year old female. I fell directly onto the tip of my coccyx while ice skating a month or so ago. It can still be quite sore at times after sitting for my job. Will this ever completely go away? It hurt a lot initially but painkillers and not over exerting helped. I felt like I did hurt it more at one point about two weeks post injury when I climbed awkwardly up into a bigger truck. It twanged it a bit and then instant pain. It is not sore to touch regularly, just after sitting.

Hello Kathryn,
There are unfortunately a lot of ifs and maybes.

Firstly, I take you have had it x-rayed and there's no fracture. Then dependent on the degree of displacement and tearing of ligaments you can hope for close to complete relief in another few months.

Then, the problem with a fall of this nature, very often the sacroiliac joints, and those in the lumbar spine, are affected. Only a careful clinical exam can determine whether this has happened.

In the short term, I'd assume the worst if I was you. Use a ring cushion of sorts to keep the pressure off the coccyx whilst sitting, including in the car. You can make one at home; find the directions at our coccyx page. There are various orthopaedic appliances available that may be more or less successful.

And do our basic sacroiliac and lumbar spine exercises every morning before getting out of bed every morning. It takes less than a minute. In fact, I recommend that everyone should do them; so little effort is required and there such great benefit for one minute of exercise. I do them myself.

Chiropractic management of the condition would also include mobilisation of the coccyx, done externally initially. Unpleasant though it is, internal mobilisation via the anus is more effective in severe cases.

The trick is not to allow it to become chronic. Follow the above rules, be careful with bending and avoid sitting on hard surfaces. If in another few weeks you are not certain that everything is improving, then see a professional of your choice.

I hope this helps.

Dr Barrie Lewis

Mar 04, 2018
Slipped on ice
by: Heather

Hi, I was out walking dogs earlier today, I slipped on ice and came down very hard on my bottom, sort of thankfully I had the two dogs leads so did not put hands out to save me, I felt the judder right up to my neck.

I’m now left with pain in buttocks, and all I can describe is a feel of pressure like in childbirth. And a sharpish pain going up right side of spine and neck, I’ve taken brufen and had heat on it, any other suggestions? Thank you. Heather

Hello Heather,
Run your index finger down the crease between the buttocks. Just before the anus you'll find the coccyx. Is it very tender?

Be careful for a few weeks now; a fall of this nature can do a lot of damage not only to the coccyx but sacrum and the spine.

Cold is generally better for acute conditions, but I expect you have an adverse opinion on ice right now!

If the pain continues more than a week, or doesn't get better, or is severe, you'd better get a professional opinion. Don't let it become chronic.

Dr Barrie Lewis

Feb 14, 2018
Fell on my butt on a stair and hurt my coccyx
by: Anonymous

I was getting ready this morning and as I was ready to go downstairs, I put one foot on my carpeted stairs and did not take one step yet and I slipped forward and fell down on that stair straight on my butt. In the morning it hurt to go down the stairs after, it even hurt to sit on my comfortable couch. As the day is going by, it's starting to hurt more and I more to the point I could cry. It hurts to walk, move my legs upward, get up from sitting, laugh, etc. I don't know what I did and I don't know what to do about it. I just don't want it to hurt anymore.

Start by trying to figure out exactly where it hurts. Do you have a bruise? Slide your finger down the crease between the buttocks; just before the anus is it very tender? That's the coccyx.

But it could be in the sacroiliac joint, and also your back, so prod about and see if you can work where it hurts and what provokes the pain. Just sitting, or bending too? Could it be just a bruise, or something more?

Coccyx pain can be extreme and go on for months; start with alternating ice and heat; it can be subluxated forwards, and even fractured.

If it is the coccyx then you need a doughnut cushion.

Dr Barrie Lewis

Feb 02, 2018
Flew down stairs onto brick lint
by: Anonymous

One month ago I flew down 6 wooden stairs onto a brick floor. I landed on my butt an lower back. I am 74 years old and had back surgery for spinal stenosis 10 years ago. The edema and dark black bruises were all over my left buttocks and lower back. No bruising or pain on right. The sacrem is still very swollen after a month. I could walk fine with a little pain. I had X-ray and Cat. I was getting all better! Nothing broken! After a month I started to feel extreme pain on the RIGHT EDGE OF THE SACRUM but more importantly PAIN DOWN THE FRONT OF MY RIGHT LEG before the knee. I am limping with excruciating pain when I walk. This developed, with great surprise when it wasn’t there at all after my fall. WHAT DO YOU THINK . Will the inclination and pain go away? Thank you so much! Sasha

Hello again, Sasha, this adds more light to your other post.

Even more than before, I think this is spine related, though SI issues can refer to the groin and upper thigh.

Sitting, if you raise your knee off the chair, is it painful? Where? Or just weak and not painful? And now straighten the lower leg parallel to the ground; what happens?
Have the knee jerk reflex tested and prick your upper thigh and compare with the other leg.
Start by doing our lower back exercises, ice your back and sacrum, and generally stay at home and be careful for a few weeks; sit as little as possible, no housework; it's boring but better than another back operation.

Dr Barrie Lewis

Nov 24, 2017
HELP for an old coccyx injury
by: Anonymous

I fell on my tailbone almost 10 years ago and broke it. Now the past 8 months or so it really hurts 24/7; there is always a sharp pain. There is no relief. I don't know what to do about it.

Apologies for the delay, I've been on leave.

Start by getting a doughnut cushion, or making one yourself. Getting the pressure off the coccyx whilst sitting is the first step. Alternating ice and heat might help.

You almost certainly bumped it a few months ago, and may have simultaneously affected the sacroiliac joint.

Usually a chiropractor will use an external manipulative technique, but in stubborn cases an internal adjustment via the anus is often much more effective; it's awkward and embarrassing though, but quick and relatively painless. Take someone with you.

I hope this helps.

Dr Barrie Lewis

Nov 19, 2017
I fell on my tailbone 4 days sgo
by: Anonymous

Hi dr.b.
I fell on my tailbone when my friend tried pulling me down. It has been 4 days now. And whenever I squat or sit or even bending or moving my leg or try to press the area hard my tailbone it hurts. A small bruising can be seen.

But my right side of my butt is swollen and it hurts whenever I lift my leg up and I feel like the pain is spreading to my thighs. And on the 3 day i felt like a weird feeling in my right leg too, its like its about to have cramps but its not. What injury do u think I have?

In a fall of this nature, very often there are multiple injuries; a bruise and occasionally a fracture of the sacrum or coccyx; more often it is subluxated forwards.

Then because the sacrum attaches to the ilium in the SI joint, this is also injured; bruises of the surrounding tissue is common.

And not uncommonly the lumbar spine is injured too; fractures of the elderly at the thoraco-lumbar junction are to be considered.

That swelling and the weird feeling in your leg needs to be evaluated. It's impossible for me to make a diagnosis but if your sense is within a few days that this is not spontaneously getting better - bruises will generally heal of their own - then I would recommend a professional examination.

Dr Barrie Lewis

Oct 16, 2017
by: ARH27

Regarding my fall back in early September, I tried the things you suggested and none of them brought me pain or discomfort. The pain is if I sit for too long or if anything even barely bumps my tailbone. It’s most likely just sensitive because I am very thin but it does concern me since I fell so bad.

Including running your finger over the tailbone? It's not tender?

Dr Barrie Lewis

Oct 12, 2017
Bruised coccyx bone
by: Anonymous

I was sitting on the floor and I slid back really fast and ended up hitting my lower back really hard on the corner of a step. I have been to my doctor and he said that I had bruised my coccyx.

He gave me medication for the pain but at night I wake up a lot due to the pain. I have resorted to sleeping on my side because as soon as I lay on my back, the pain is really bad. Because I lay on my side the entire night, my hip has started to ache as well. Is there another way I can sleep comfortably? I tried taking pain killers( the ones prescribed by my doctor) before going to sleep, but they don’t seem to help either.

What do YOU think? Is this your coccyx or your back. Is the pain in your spine or deep down between the buttocks towards the anus?

A bruised bone, be it in your back or coccyx can be tender for months, so if this has just happened, you probably just need to grin and bear it for a while. Use a combination of an icepack, followed by a hot shower or hot water bottle over the painful spot.

Make yourself a makeshift ring like kids use when learning to swim, to keep the coccyx off the deck; don't sit back.

I would start some gentle back exercises, pulling your knees to the chest and doing some pelvic tilts; see the navigation bar at Chiropractic Help.

Then, if it's still misery after a couple weeks, go back to your doctor.

I hope this helps.

Dr Barrie Lewis

Oct 10, 2017
Sore tailbone a month after a fall?
by: ARH27

Hi there, about a month ago I had a really bad fall against a wooden bookshelf and hit my tailbone right on the bone. For several days after it happened I couldn’t sit, bend over, or lay certain ways. Now it’s been a little over a month and it still hurts after sitting for more than 5 minutes or if something taps my lower back it hurts so bad that I have to stay still for a few minutes before the pain dissipates. I’m very very small and have fallen on my tailbone before and I’m scared of fracturing it. Is it still hurting because it’s just still healing or is it a bigger problem?

Hello ARH27,
The big question is whether you hurt anything else when you fell; what you describe suggests that may be the case.

If you bend slowly forwards, then backwards, and then to the side, what happens?

Sitting in a kitchen chair, flex your head onto your chest, and the slowly extend the knee so the lower leg is parallel to the ground, first right and then left. What happens?

Standing, if you slide your middle finger between the creases of the butt towards the anus, what do you feel?

Give me some answers, as accurately as you can.

Dr Barrie Lewis

Sep 25, 2017
Can't pee after a fall on my tailbone
by: Jody

I fell down about 6-7 concrete stairs 2 days ago on my bum and broke 2 bones in my wrist and had to get surgery. I also hurt my tailbone when I fell as I slid all way down on my bum. It hurts when I bend over or sit down or try rolling over on my side and I'm struggling to pee. I'm dying for the toilet but it just won't come out any advice would be great. I just had a C-section 8 weeks ago as we'll so I'm worried something is wrong. Please help!

Hello Jody,
You need to see your medical doctor, TODAY. Obviously I'm looking at the worst case scenario, being dramatic and what follows probably hasn't happened, but if has, you need immediate catheterisation or you'll cause serious damage to your bladder, and back up to the kidneys.

There is a suggestion that you may have slipped a disc, or fractured a bone in your spine, and if it sequesters and effects the cauda equina, then you can't pee. It's serious; see your GP today.

It could be a side effect of the anaesthetic too; he'll have tests done; it still may need catheterisation.

If he says I'm grossly exaggerating, which I probably am, then get back to me, and we'll continue with the coccyx story.

Meantime, be very careful with your back; no housework and get help with lifting baby.

I hope that the hoof beats that I'm hearing are not zebras, when it's really only those of a horse; better to be safe than sorry.

Dr Barrie Lewis

Sep 24, 2017
Fell down steps and landed on my coccyx
by: Anonymous

Six months ago, coming down steps, my feet flew out from under me. I tried not to hurt it where I previously had surgery.

I recently had back surgery for the third time. I have osteoporosis.

I ended up at the bottom of the steps of about 6 steps. My coccyx is hurting especially when I sit or lay. What should I do. Go to my surgeon next month for post-op.

Yours is a story I wish everyone would read; there's a common fallacious belief that if you just have surgery, your back problems will be over; fix it properly, once and for all.

It's a myth, surgeons can no more fix a back once and for all than chiropractors can; you now need a disciplined set of exercises that you will do every single morning before getting out of bed for the rest of your days. Ask the surgeon when you seen him if you are ready, and what you should do; and whether you can start swimming regularly.

After three surgeries you almost certainly have what's known as paresis - neurological weakness - in the muscles in your legs; that's why your feet took wings.

Concerning your coccyx, start with sitting on a doughnut cushion for say a month; the bone is very close to the surface and is easily bruised.

If that doesn't help, then you are going to need to start hunting for a very experienced chiropractor, in light of your surgeries. The sacroiliac joint is often also subluxated in a fall on the buttocks; we have some gentle treatment that won't disturb the surgery.

Ask the surgeon about it when you are there; an internal mobilisation of the coccyx, with cross friction of the coccygeal muscles, is what's needed. Not pleasant as it's done rectally, but takes only two minutes and not particularly painful.

Exercise or ache, take your pick, that's your lot for the rest of your days; and the threat of a fourth and fifth back surgery.

Dr Barrie Lewis

Feb 02, 2017
Tail bone injury
by: Anonymous

Can tailbone injury cause blood in urine? I fell on my tailbone with my 180lb son on top of me..I weigh 110.

I doubt, not directly anyway. If the coccyx fractured, may have damaged the urethra. I'd see your medical doctor sooner rather than later if it continues.

Dr Barrie Lewis

May 21, 2016
Your Advice
by: Nina

Dear Dr. B
Thank you very much indeed for your very helpful advice. I am continuing with the exercises but now note that I should not pull both legs up into a foetal position. I do not have any pain or other bad sensations in my legs and I can walk almost normally. I do think that it is improving but. I shall certainly seek help should it continue to cause problems.
Yes, there are chiropractors in France but just not locally, unfortunately.
Thank you for giving me the confidence that I was seeking.
My thanks again.

Good, you just don't want to end up with a chronic problem, and it can go on for years.

A small correction; you can pull both knees into the foetal position, unless you have a disc injury, but not both legs together when straightened out at the knees.

Dr Barrie Lewis

May 19, 2016
An injury above the coccyx
by: Nina

I have been reading the really helpful comments that have been posted about coccyx injuries. Seven days ago I fell backwards out of a lift and down eleven stairs. My main concern was my head which I cracked and I had bruised arms but my back was less painful at the time. I was x-rayed but not at the site of my back injury which seems to be above my coccyx. I fell heavily onto the edge of the stairs. It feels as though that part of my back is fixed.

It is painful to walk upstairs, sitting and everything else seems better now but not my back.

I live in France and cannot find a chiropractor but remembered exercises that I had been given for a lower back problem that I was successfully treated for in England. The exercise is to lie flat on the floor raising and bending each leg straight and then sideways and then both together. It has given me some relief but I wonder if this is correct for my current injury?

I would be most grateful for some advice I tend not to make a fuss and just keep gong but I do not want to cause more injury by carrying on. My thanks in anticipation and for this excellent site.

Hello Nina,
There are plenty of good chiropractors in France; they have one of the best colleges in the world.

Lifting both legs together is definitely not what I would recommend.

The area just above the coccyx is where the sacrum is found, and it has joints with the ilia and lower back which are very frequently injured. Of course, it may just be bruising of the bone.

I presume you have no pain down the leg; that changes everything.

You have hit on a good point; what is the current injury exactly? Exercises for one diagnosis are not necessarily pertinent to another.

I'm a great believer in gut feel; if after another week you are not sure that this is improving, then it's time to get professional help.

Dr Barrie Lewis

May 16, 2016
Broken coccyx from blow to kidney?
by: Anonymous

Hi, I had a fall from my motorbike at low speed and landing directly on a raised sort of solid ground, directly on my left kidney area, with significant instant pain around the kidney lower back area.
The pain was quite acute for the first day or two but then subsided a little. However after over a week I still had reasonably strong pain in my lower left back. I went to the doctor, had X-rays and they have said I have a fractured coccyx.

I have fractured my sacrum before from a skydiving accident but this pain feels totally different. I do have some severe bruising just at the top of the "bum crack" but don't have any pain here or lower - where I would have thought I would have a lot of pain with a broken coccyx?

I also have bruising around the left flank area, just above the hip bone.

I just don't feel like I could break my coccyx from a blow to the fleshy part of the kidney area, and also have no pain a round the coccyx area - sitting gives me no pain at all around that area.
Any suggestions please?

That fracture seen on xray of the coccyx is almost certainly what is known as an "incidental finding". True, an old ununited fracture, but quite irrelevant to this new injury. Just to be sure, run your finger down from the bum crack; just before the anus press fairly hard. Is it severely painful? If not, no new fracture.

Something else has obviously happened. Just bruising is the first probability, but has anything else occurred?

Does taking in a deep breath cause pain in that lower kidney area? If so, a cracked rib is a distinct possibility. Just needs to be taped for a month.

And then there's a distinct possibility of either a fracture or subluxation of one of the lumbar vertebrae. Did your doctor percuss on the spinous processes of the lower back? Wack those bumps with a reflex hammer? The lumbodorsal area is particularly prone to fracture after a fall of this nature. Ask if you can see the radiographs. Are T12 and L1 well visualised? Were they x-rayed?

Does forward bending, to the side and backwards hurt? Do you have pain on bearing down, as in going to the toilet? It's called a valsalva, and suggestive of a disc injury.

There are really very many possibilities; but I think you're right. That old fracture of the coccyx is probably a red herring.

Good luck; let me know what comes of it. If you do write again, please copy this and paste it into a new thread of your own.

Dr Barrie Lewis

Mar 11, 2016
Katie fell and hurt her coccyx
by: Anonymous

I fell real bad at my drug store in front also; they came out and help me up, and checked me out. I am sore and can't sleep.

Hello Katie,
What's needed is an examination to see what damage you may have done. It could be your coccyx bone has been displaced, or even fractured. Frequently there will also be a subluxation of one of the pelvic bones.
If it's disturbing your sleep then it warrants something further than just waiting a few weeks.

Dr Barrie Lewis

Nov 13, 2014
ladder fall
by: dee

I too fell off a ladder two days ago. At first just my tail bone here but now I feel like I need to pee all the time. I had a complete hysterectomy in 89 and even my cervix was removed. Could I have just jilted or bruised my bladder? Everything is sewed shut so what do I do?

Honest, Dee, I'm not sure. Give it a few days, and then if it continues see your GP. Some routine things need to be done, like a urine test.

If it's neurological, then it's a lot more complex and requires careful and thorough clinical evaluation.

Either way, I think the medical route is probably right for you, unless you have specific coccyx or sacroiliac joint pain.

Sometimes an internal coccyx treatment is needed, and I've no idea whether your chiropractors are licensed to do that. It's not really painful, just awkward. Take your husband along.

I hope this contributes.

Dr Barrie Lewis

Oct 26, 2011
Reply to Dr. B regarding bruised coccyx / lower abdomen pain
by: Sarah Jane

Hi Dr. B, you are so good for your valuable reply. I have an update, I was at my GP again today, he called me in after recieving the lab results back from my urine sample. There is NO signs of any infection and he has ruled out a kidney/bladder infection.
He has booked me in for a private ultrasound in the morning (?250!) as he wants to get to the bottom of it asap.
He feels it is my uterus and possibly it may be prolapsed?! I have to still continue taking the course of antibiotics as I have started them and can't stop mid course and my GP has given me a cocktail of strong painkillers. The pain I am in is unbearable.
I asked him could this be caused as a result of my accident / trauma injury when I fell and bruised my tailbone/coccyx however he says that is just a distraction and he wants to deal with it separately. I can't help but feel upset and slightly annoyed as this only came about after my fall and the impact of the fall. iv never had this discomfort or pain b4.
You asked me am I emptying my bladder, to be honest I don't know anymore.... Sometimes it's a trickle and sometimes a longer pee? But he says iv no infection which wipes that out.... Also, it doesn't sting or hurt at all when I pee.
I would appreciate any advice you have, what would your feeling be on the two illnesses being related?
I'm getting the ultrasound scan done on my Pelvis and Uterus tomorrow.
Thank you so much.

Certainly sounds like the two are connected, SJ. The advantage of the US scan is they can see whether your bladder is emptying or not. I didn't say this was because of infection. I said, if you can't void your bladder, you will get an infection. In the future.

I think an evaluation of your sacroiliac joint is important, though I can't tell you directly that it would affect the nerve to your bladder.

By the way, X-rays of the coccyx are very difficult, small thin bone in the middle of nowhere. If it remains very tender, sometimes only a CT scan can confirm, deny a fracture. But in fact, makes little difference. The fracture will heal in 6 weeks, but if the ligaments are torn, and it's been displaced, it will remain painful for months, even years. See if you can get a copy of the XR.

Go with your GP. He's ruling out something medical, and that needs to be done. Then see an experienced chiropractor to evaluate your pelvis.

Hard place you're in. Get that ring to sit on. Use ice on your coccyx.

Dr Barrie Lewis

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