Coccyx Injuries: Risks and Long-Term Effects After a Car Accident

The car accident impacted the last two segments of the coccyx?

Hello, doctor.
Last week, I fell and slid in a car accident, and my coccyx hit the wall.
I went to the emergency room, and the doctor examined me.
He said that as long as I can walk normally and it doesn't hurt too much when touched, there shouldn't be any major issues.
However, after I returned home, I noticed that whenever I sneeze, exert myself, or sit in a chair that puts pressure on my coccyx, I feel pain.
Later, I went to see an orthopedic doctor for reassurance, and they took X-rays.
The orthopedic doctor mentioned that the last two segments of my coccyx are displaced inward by about 2-3 centimeters (this is my own assessment based on the images).
At that time, the doctor advised against surgery or manipulation, suggesting that I could manage the pain with medication.
However, I am concerned that as I age, the displacement might lead to long-term complications, such as the development of bone spurs or similar issues.

Zhuang Xiansheng, 20~29 year old female. Ask Date: 2017/03/04

Dr. Li Yongheng reply Orthopedics

Generally, in cases of inward dislocation of the last two segments of the coccyx, if the displacement is minimal, medication for pain relief may suffice for recovery without any significant sequelae.
However, if the displacement is excessive, manual reduction can be performed through the rectum using fingers.
If you still have concerns, you may seek a second opinion from another physician.
Thank you.

Reply Date: 2017/03/04

More Info

Coccyx injuries, particularly those resulting from trauma such as a car accident, can lead to a variety of complications and long-term effects. The coccyx, or tailbone, is a small triangular bone at the base of the spine that can be quite sensitive to injury. When you experience trauma to this area, such as hitting a wall during a fall, it can result in pain, dislocation, or even fractures.

From your description, it seems that you have experienced a dislocation of the last two segments of your coccyx, which is not uncommon in such injuries. The fact that you can walk normally and that the pain is manageable is a positive sign, but the discomfort you feel when sneezing, sitting, or applying pressure to the area indicates that the injury is still affecting you.

Risks and Long-Term Effects
1. Chronic Pain: One of the most common long-term effects of coccyx injuries is chronic pain, known as coccydynia. This condition can persist for months or even years after the initial injury. The pain can be exacerbated by sitting for long periods, certain movements, or pressure on the coccyx.

2. Bone Spurs: As you mentioned, there is a possibility of developing bone spurs (osteophytes) around the coccyx over time. This can occur as a response to the injury and the body's attempt to stabilize the area. Bone spurs can lead to additional pain and discomfort, particularly if they impinge on surrounding tissues or nerves.

3. Increased Sensitivity: After an injury, the coccyx can become more sensitive to pressure and movement. This means that activities that were once comfortable may become painful, leading to lifestyle changes.

4. Potential for Further Dislocation: If the coccyx remains misaligned, there is a risk of further dislocation or complications in the future, especially if you engage in activities that put stress on the lower back and coccyx.

5. Impact on Mobility: Although you are currently able to walk without significant issues, some individuals may experience limitations in mobility or changes in posture due to pain or discomfort in the coccyx area.

Management and Treatment
Since your orthopedic doctor has advised against surgery and recommended pain management, it is essential to follow their guidance. Here are some strategies that may help manage your symptoms and reduce the risk of long-term complications:
- Pain Management: Over-the-counter pain relievers such as NSAIDs (e.g., ibuprofen) can help alleviate pain and reduce inflammation. Always consult with your healthcare provider before starting any medication.

- Physical Therapy: Engaging in physical therapy may help strengthen the muscles around the coccyx and improve flexibility, potentially reducing pain and discomfort.

- Cushions and Support: Using a coccyx cushion or a donut-shaped pillow when sitting can help relieve pressure on the coccyx and make sitting more comfortable.

- Activity Modification: Avoid activities that exacerbate your pain, such as prolonged sitting or heavy lifting. Gradually reintroduce activities as tolerated.

- Regular Follow-Up: Keep in touch with your healthcare provider to monitor your condition. If your symptoms worsen or new symptoms arise, further evaluation may be necessary.

Conclusion
While coccyx injuries can lead to long-term complications, many individuals find relief through conservative management strategies. It is crucial to listen to your body and seek medical advice when necessary. If you have ongoing concerns about your injury or its long-term effects, don't hesitate to discuss them with your healthcare provider for tailored advice and treatment options.

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