How many days of sick leave should a patient with a coccyx (tailbone) fracture be given?

Sick Leave Duration for Coccyx (Tailbone) Fracture

For a patient with a coccyx (tailbone) fracture, 3-5 days of sick leave is appropriate for most cases, with extension to 7-14 days for more severe cases or jobs requiring prolonged sitting. 1

Assessment of Severity and Work Requirements

• Coccyx fractures typically result from direct trauma such as falls or accidents, with pain being the primary symptom requiring management 2, 3
• Evaluate the patient's job requirements, particularly whether it involves prolonged sitting, which can significantly exacerbate coccydynia 2
• Assess pain severity using a numerical rating scale to help determine appropriate sick leave duration 2

Recommended Sick Leave Duration

• For mild cases with minimal displacement and moderate pain:

  • 3-5 days of sick leave is generally sufficient 1
  • This allows for initial pain management and adaptation to sitting modifications 3

• For moderate to severe cases with significant displacement or severe pain:

  • 7-14 days may be necessary, especially for patients whose jobs require prolonged sitting 1
  • Extended leave may be required for patients with jobs that involve physical labor or inability to use sitting modifications 3

Management During Sick Leave

• Prescribe appropriate analgesics for pain control during the initial acute phase 3
• Non-steroidal anti-inflammatory drugs (NSAIDs) are typically first-line treatment for pain management 2
• Recommend sitting modifications including donut cushions or wedge cushions to reduce direct pressure on the coccyx 2, 4
• Advise patients to avoid prolonged sitting and to take frequent standing breaks when returning to work 4

Return to Work Considerations

• Most patients with coccyx fractures can return to modified work duties within 1-2 weeks 1
• Provide clear instructions for workplace modifications such as specialized cushions and frequent position changes 4
• For patients with persistent pain beyond 2 weeks, consider referral for further evaluation and possible additional treatment modalities 3

Special Considerations

• Conservative treatment is successful in most cases of coccyx fracture 3
• Patients should be advised that while acute pain typically improves within days to weeks, complete resolution may take 2-3 months 2, 3
• If pain persists beyond 8 weeks despite conservative management, consider referral to pain management for evaluation of refractory coccydynia 2

Follow-up Recommendations

• Schedule follow-up at 1-2 weeks to reassess pain levels and functional status 2
• Consider extending sick leave if significant pain persists or if workplace accommodations cannot be implemented 3
• Document pain levels and functional limitations carefully to support sick leave recommendations 2