Home care for a sacrococcygeal injury includes:

• Avoid pressure on the sacrum and coccyx:
• Coccyx cushion
• Donut pillow
• Apply cold compresses:
• Apply for 20-30 minutes, 4-6 times a day, for the first few days.
• Return to walking as soon as possible.
• Avoid constipation:
• Eat a high fiber diet.
• Acetaminophen for pain
• Nonsteroidal anti-inflammatory medications for pain:
• Ibuprofen (Motrin, Advil, Nuprin, NeoProfen)
• Ketoprofen (Actron, Orudis, Oruvail)
• Naproxen (Anaprox, Naprosyn, Aleve)
• Take prescribed medications as directed:
• Don't skip doses of your medication. This makes them less effective.
• Be aware of the common side effects that may be caused by your medication.

Medications commonly used to control pain and inflammation in adults with a sacrococcygeal injury include:

• Acetaminophen
• Controls pain, but has no anti-inflammatory properties
• Nonsteroidal anti-inflammatory drugs:
• Aspirin
• Ibuprofen
• Naproxen
• Ketoprofen
• Narcotic pain medications:
• Require a doctor's prescription
• Generally reserved for moderate to severe pain or severe pain

• Acetaminophen decreases fever and pain, but does not help inflammation.
• Adult dosing is 2 regular strength (325 mg) every 4 hours or 2 extra-strength (500 mg) every 6 hours.
• Maximum dose is 4,000 mg per day.
• Avoid this drug if you have alcoholism, liver disease or an allergy to the drug. See the package instructions.
• Common brand names include Tylenol, Panadol, and many others.

• Aspirin decreases pain, fever and inflammation.
• It is a nonsteroidal anti-inflammatory medication (NSAID).
• Adult dosing is two regular strength (325 mg) every 4 hours with food.
• There are numerous products that contain aspirin.
• Follow the package instructions and NSAID precautions (below).

• Ibuprofen decreases pain, fever and inflammation.
• It is a nonsteroidal anti-inflammatory medication (NSAID).
• Adult dosing is 200-400 mg every 4-6 hours.
• Do not exceed 1,200 mg per day without a doctor's recommendation.
• Brand names include Advil, Motrin and Nuprin.
• Follow the package instructions and NSAID precautions (below).

• Naproxen decreases pain, fever and inflammation.
• It is a nonsteroidal anti-inflammatory medication (NSAID).
• Adult dosing is 200 or 220 mg twice a day with food.
• Do not exceed 500 mg per day.
• Its brand name is Aleve.
• Follow the package instructions and NSAID precautions (below).

• Ketoprofen decreases pain, fever and inflammation.
• It is a nonsteroidal anti-inflammatory medication (NSAID).
• Adult dosing is 12.5 mg every 4-6 hours with food.
• Do not exceed 75 mg per day.
• Its brand name is Orudis KT.
• Follow the package instructions and NSAID precautions (below).

• Avoid using alcohol when taking any of these medications.
• Do not mix prescription and non-prescription NSAIDS unless directed to do so by your doctor.
• NSAIDS can interact with other blood thinners, such as Coumadin, and cause bleeding complications.
• Ask your doctor before using an NSAID if you are pregnant or breastfeeding.
• Ask your doctor before using an NSAID if you have a history of:
• Allergy to aspirin
• Asthma
• Peptic ulcer disease
• Stomach ulcers
• Esophageal ulcers
• Bleeding problems
• Liver disease
• Kidney disease

Common medications used at home for pain in children with a sacrococcygeal injury include:

• Acetaminophen
• Ibuprofen
• Naproxen

• Acetaminophen decreases fever and pain, but does not help inflammation.
• Dosing is 10-15 mg per kilogram (5-7 mg per pound) of body weight every 4-6 hours, up to the adult dose.
• Do not exceed the maximum daily dose.
• Acetaminophen products come in various strengths. Always follow the package instructions.
• Avoid this drug in children with liver disease or an allergy to acetaminophen.
• Common acetaminophen products include Tylenol, Panadol and many others.

• Ibuprofen decreases pain, fever and inflammation.
• It is a nonsteroidal anti-inflammatory medication (NSAID).
• Dosing for children over 6 months of age is 7-10 mg per kilogram (4-5 mg per pound) of body weight every 6 hours, up to the adult dose.
• Do not exceed the maximum daily dose.
• Always follow the package instructions.
• Avoid this drug in children with liver, kidney, stomach or bleeding problems.
• Brand names include Advil, Motrin and Nuprin.

• Naproxen decreases pain, fever and inflammation.
• It is a nonsteroidal anti-inflammatory medication (NSAID).
• Dosing for 13 and older is 200 mg twice a day with food.
• Do not exceed 500 mg per day.
• Always follow the package instructions.
• Avoid this drug in children with liver, kidney, stomach or bleeding problems.
• The brand name for naproxen is Aleve.

Notify your doctor if you have a sacrococcygeal injury and any of the following:

• Bladder incontinence
• Difficulty urinating:
• Inability to urinate
• Groin numbness
• Difficulty walking:
• Inability to walk
• Leg numbness (unilateral)
• Leg weakness (unilateral)
• Rectal bleeding
• Fever over 101 degrees F (38.3 C)
• Worsening back pain
• Worsening back swelling

Last Updated: Jan 4, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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