Managing Coccyx Fractures and Osteoporosis in Seniors: Key Insights

Coccygeal fracture, osteoporosis?

My grandmother is 78 years old.
During the 228 holiday last year, she fell while walking to collect something and landed on her buttocks.
After going to the hospital, the doctor diagnosed her with a coccyx fracture and ordered a bone density test, which revealed severe osteoporosis.
She is scheduled to receive an injection of Prolia every six months.
I would like to know if Prolia can help slow down the progression of osteoporosis.
What are the effects of Prolia? My grandmother still occasionally experiences significant discomfort and pain in her coccyx, and sitting for too long on a chair also causes soreness.
When she feels very uncomfortable, she relies on pain medication for relief.
What recommendations do you have for us? Thank you for your response.

ru8 u4, 20~29 year old female. Ask Date: 2019/04/07

Dr. Shi Guozheng reply Orthopedics

Coccydynia, or pain in the coccyx, is typically caused by trauma and is not necessarily related to osteoporosis.
Fractures resulting from osteoporosis usually occur in the thoracic and lumbar vertebrae, often leading to compression fractures from minor falls.
Caltrate seems to help delay osteoporosis, but it is also important to supplement with calcium and vitamin D, along with engaging in moderate exercise.

Reply Date: 2019/04/07

More Info

Managing coccyx fractures and osteoporosis in seniors is a critical aspect of geriatric care, especially considering the increased risk of falls and fractures in this population. Your grandmother's situation, having sustained a coccyx fracture and being diagnosed with severe osteoporosis, highlights the need for a comprehensive approach to treatment and management.

Firstly, let’s discuss the role of medications like Boniva (ibandronate), which is commonly prescribed to help manage osteoporosis. Boniva is a bisphosphonate that works by inhibiting bone resorption, which is the process where bone is broken down and its minerals released into the bloodstream. By slowing down this process, Boniva helps to increase bone density and reduce the risk of fractures. Regular administration of Boniva, typically every three months, can indeed help in delaying the progression of osteoporosis and potentially prevent further fractures. However, it is essential to combine medication with lifestyle changes and other supportive measures for optimal results.

In terms of pain management for the coccyx fracture, it is not uncommon for seniors to experience persistent discomfort in the coccyx area, especially when sitting for prolonged periods. The coccyx, or tailbone, is a small bone at the base of the spine, and fractures in this area can lead to significant pain due to its location and the pressure exerted on it during sitting. Here are some strategies that may help alleviate your grandmother's discomfort:
1. Cushions and Seating Adjustments: Using a coccyx cushion or a donut-shaped pillow can help relieve pressure on the tailbone while sitting. These cushions are designed to provide support while reducing discomfort.

2. Pain Management: Over-the-counter pain relievers such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) can be effective in managing pain. However, it’s crucial to consult with her healthcare provider before starting any new medication, especially considering her age and any other health conditions she may have.

3. Physical Therapy: Engaging in physical therapy can be beneficial. A physical therapist can provide exercises that strengthen the pelvic floor and core muscles, which may help support the coccyx and reduce pain. They can also teach proper body mechanics to avoid further injury.

4. Activity Modification: Encourage your grandmother to avoid sitting for long periods. Frequent breaks to stand or walk can help alleviate pressure on the coccyx. Gentle stretching and mobility exercises may also be beneficial.

5. Heat and Cold Therapy: Applying heat or cold packs to the affected area can provide temporary relief from pain. Heat can help relax muscles, while cold can reduce inflammation.

6. Follow-Up Care: Regular follow-ups with her healthcare provider are essential to monitor her osteoporosis and manage her pain effectively. If her pain persists or worsens, further imaging studies or interventions may be necessary to rule out any complications.

In conclusion, managing coccyx fractures in seniors, particularly those with osteoporosis, requires a multifaceted approach that includes medication, lifestyle modifications, pain management strategies, and possibly physical therapy. It is essential to maintain open communication with her healthcare provider to ensure that her treatment plan is tailored to her specific needs and circumstances. By addressing both the fracture and the underlying osteoporosis, you can help improve her quality of life and reduce the risk of future injuries.

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