Pudendal Nerve Pain versus Coccyx Pain, Tailbone Pain

I was recently asked how do physicians distinguish between pudendal nerve pain (also called “pudendal neuralgia”) and coccyx pain (also called tailbone pain, or coccydynia). Below is a very, very brief overview.

Genital involvement:
  • Pudendal nerve pain usually involves the genitalia region, whereas coccyx pain usually does not.
  • Genital symptoms may include pain, numbness or tingling. In males, these symptoms may occur at the scrotum and/or penis. In females, these symptoms may occur
Right, Left, or Midline:
  • Pudendal nerve pain is often unilateral, meaning that it often involves only one side of the pelvic. For example, it often involves only the right side or only the left side. (Still, some cases of pudendal nerve pain can be bilateral, meaning that both right and left are involved.
Tailbone tenderness on physical exam:
  • Pudendal nerve pain usually has no significant tenderness at the coccyx during coccyx palpation on physical exam, whereas coccyx pain usually does have focal tenderness at the coccyx during coccyx palpation on physical exam.
Location of the pain/symptoms compared with the location of the anus:
  • Tailbone pain is located slightly above/behind the anus.
  • Pudendal nerve pain is located in front of the anus. (Basically, pudendal nerve symptoms can involve the anus or forwards from there.)
Pain with sitting:
  • This is an area of similarity between coccyx pain and pudendal nerve pain. Both of these conditions are often worse with sitting, and especially they are usually worse with sitting on a bicycle seat. Both are usually less painful sitting on a toilet seat rather than on a bicycle seat.

 


GET THE BOOK: To get your copy of the book “Tailbone Pain Relief Now!” go to: www.TailboneBook.com  or go to Amazon.

COME FOR RELIEF: For more information on coccyx pain, or to be evaluated in-person at Dr. Foye’s Tailbone Pain Center in the United States, go to: www.TailboneDoctor.com

- Patrick Foye, M.D., Director of the Coccyx Pain Center, New Jersey, United States.

 

Tailbone Pain Questions and Answers for 1.5 Hours on Facebook Live, by Patrick Foye, MD

As part of Tailbone Pain Awareness Day, Patrick Foye, M.D., did more than one and a half hours live on Facebook answering questions about tailbone pain (coccyx pain, coccydynia).
The video is on the Facebook page for the Tailbone Pain Center:

https://www.facebook.com/TailbonePainCenter/

Here is the same video, uploaded to YouTube:


Screen capture:

Tailbone Pain Awareness Day, Patrick Foye MD answered Live Questions about Tailbone Pain, Coccyx Pain, on Facebook Live

Tailbone Pain Awareness Day, Patrick Foye MD answered Live Questions about Tailbone Pain, Coccyx Pain, on Facebook Live


GET THE BOOK: To get your copy of the book “Tailbone Pain Relief Now!” go to: www.TailboneBook.com  or go to Amazon.

COME FOR RELIEF: For more information on coccyx pain, or to be evaluated in-person at Dr. Foye’s Tailbone Pain Center in the United States, go to: www.TailboneDoctor.com

- Patrick Foye, M.D., Director of the Coccyx Pain Center, New Jersey, United States.

How to Get a FREE Book on Tailbone Pain

Act now to get your FREE copy of the book, “Tailbone Pain Relief Now!”
Today is Tailbone Pain Awareness Day, November 15, 2018.
So, worldwide, you can get my book for FREE through Amazon for the next day or so.
Follow These 3 Simple Steps: 
1) Go to Amazon for your country and search for: Tailbone Foye. (If you use a Kindle then you can also search for it directly from your Kindle. But you do not need a Kindle to receive or read the free book.) In the United States use this link: http://a.co/9ans5Vr


2) Select my book and above the price click on the line that says “see all versions”, to select the electronic version (the e-book, which is the version that is free).
FREE Book, Select it on Amazon, for Tailbone Pain Awareness Day

FREE Book, Select it on Amazon, for Tailbone Pain Awareness Day


3) Download the electronic version of the book for free. Read it to learn more about the best tests and treatments for tailbone pain (coccyx pain). Once you have downloaded it, it should remain on you computer or e-book reading device.


Tips:

  • If you don’t already have a copy, this is your chance to get it for FREE.
  • Even if you already have the printed, paper version, you should log in to Amazon now and also get the electronic version.
  •  If you want the paper/printed version, that is available for purchase.

Special Request from Dr. Foye: 
Please post a REVIEW of this book on Amazon. I appreciate your feedback and your review can help others who are also suffering from this condition, so that they can find the book and find answers/relief. CLICK HERE to post a Review on Amazon.

Free Book on Coccyx Pain for Tailbone Pain Awareness Day, Nov. 15, 2018

Learn about Tailbone Pain Awareness Day, which is Thursday, November 15, 2015.

For a very limited time, you can get a free copy of Dr. Foye’s book, Tailbone Pain Relief Now!

Tailbone Pain Awareness Day, Nov. 15, 2018, Free Book

Tailbone Pain Awareness Day, Nov. 15, 2018, Free Book

Free e-book, Tailbone Pain Relief Now, by Patrick Foye MD

Free e-book, Tailbone Pain Relief Now, by Patrick Foye MD


GET THE BOOK: To get your copy of the book “Tailbone Pain Relief Now!” go to: www.TailboneBook.com  or go to Amazon.

COME FOR RELIEF: For more information on coccyx pain, or to be evaluated in-person at Dr. Foye’s Tailbone Pain Center in the United States, go to: www.TailboneDoctor.com

- Patrick Foye, M.D., Director of the Coccyx Pain Center, New Jersey, United States.

Tailbone Pain Awareness Day: November 15

“Tailbone Pain Awareness Day” is November 15
Goals of Tailbone Pain Awareness Day:
  • The goal of Tailbone Pain Awareness Day is to draw attention to tailbone pain (also called coccyx pain), and to offer educational materials, support, understanding, and compassion for people suffering from tailbone pain.
  • Goals also include providing useful educational materials for people suffering from tailbone pain and for their treating clinicians (who, unfortunately, often do not have much expertise in treating tailbone problems).
History of Tailbone Pain Awareness Day:
  • Tailbone Pain Awareness Day is an internationally-recognized day, November 15, each year.
  • The first such day was started in 2018 by Patrick Foye, M.D., Director of the Tailbone Pain Center at Rutgers New Jersey Medical School in the United States. After evaluating and treating thousands of patients with tailbone pain over the prior 20 years, Dr. Foye initiated this campaign to shed light on this condition which is so commonly misunderstood, under-diagnosed, under-treated, and under-appreciated.
Tailbone Pain Awareness Day, Nov. 15, 2018, Free Book

Tailbone Pain Awareness Day, Nov. 15, 2018, Free Book

Dr. Foye choose November 15 based on math:

  • Dr. Foye choose November 15 based on mathematically calculating what percent of the spinal vertebral bones were represented by the coccyx at the end of the spine.
  • The human spine (vertebral column)  is made up of a series of vertebral bones stacked up one on top of the other. The number of vertebral bones varies based on each region of the spine. The cervical spine (neck) has 7 vertebral bones. The thoracic spine has 12. The lumbar spine has 5. The sacrum has 5. The coccyx has 3-to-5 (average is 4).
  • This means that there are typically 33 vertebral bones in the human spine: 29 above the coccyx and 4 at the coccyx. That makes 29 + 4 = 33 spinal bones in total.
  • Ignoring the coccyx (which, unfortunately, many clinicians do) means focusing only on 29 of the 33 spinal bones, which is about 87%.
  • So, ignoring the coccyx means ignoring the lowest 13% of the human spine.
  • Similarly, this would be like ignoring the last 13% of the calendar year. So…. that would be like ignoring the part of the year after November 15. Imagine all the holidays, festivities, gatherings, etc. that you would miss out on if your year ended on November 15!

 


 

GET THE BOOK: To get your copy of the book “Tailbone Pain Relief Now!” go to: www.TailboneBook.com  or go to Amazon.

COME FOR RELIEF: For more information on coccyx pain, or to be evaluated in-person at Dr. Foye’s Tailbone Pain Center in the United States, go to: www.TailboneDoctor.com

- Patrick Foye, M.D., Director of the Coccyx Pain Center, New Jersey, United States.

Ricardo Plancarte Sanchez, MD

It was great to once again see Ricardo Plancarte Sanchez, MD, at the Pain Symposium held by the New Jersey Society of Interventional Pain Physicians and New York Society of Interventional Pain Physicians. (NJSIPP and NYSIPP)

“Pain Medicine Symposium 2018″ was held in Jersey City, New Jersey, United States, in November 2018.

Dr. Plancarte has published and lectured extensively throughout his medical career, thus contributing to many pain physicians and the patients that we treat. Dr. Plancarte is based in Mexico, but lectures internationally. I am very very grateful for his contributions to the field of Pain Management.

Patrick Foye MD with Ricardo Plancarte Sanchez, MD, 2018. Dr. Plancarte originated Ganglion Impar Injections, which he first published in 1990. Dr. Foye has published 3 alternative techniques for performing these nerve blocks. Shown here at NYSIPP-NJSIPP, 2018.

Patrick Foye MD with Ricardo Plancarte Sanchez, MD, 2018. Dr. Plancarte originated Ganglion Impar Injections, which he first published in 1990. Dr. Foye has published 3 alternative techniques for performing these nerve blocks. Shown here together at NYSIPP-NJSIPP Pain Symposium, 2018.

Dr Plancarte Lectured on Celiac Plexus and Splanchnic Nerve Blocks

Dr. Plancarte Lectured on Celiac Plexus and Splanchnic Nerve Blocks

Dr Plancarte Lectured on Celiac Plexus blocks and Splanchnic Nerve Blocks

Dr. Plancarte Lectured on Celiac Plexus blocks and Splanchnic Nerve Blocks


 

NYSIPP and NJSIPP Pain Conference, 2018

Pain Medicine Symposium 2018 was held by the New Jersey Society of Interventional Pain Physicians and New York Society of Interventional Pain Physicians. (NJSIPP and NYSIPP)

This was a great conference, held in Jersey City, New Jersey, with a fantastic view of the New York City skyline.

Patrick Foye MD, at the NYSIPP and NJSIPP Pain Symposium, November 2018

Patrick Foye MD, at the NYSIPP and NJSIPP Pain Symposium, November 2018.

Patrick Foye MD, NYSIPP, NJSIPP, with matching NYC skyline in background, November 2018

Patrick Foye MD, NYSIPP, NJSIPP, with matching NYC skyline in background, November 2018.

Patrick Foye MD's name tag, NYSIPP, NJSIPP, with matching NYC skyline in background, 2018

Patrick Foye MD’s name tag, NYSIPP, NJSIPP, with matching NYC skyline in background, 2018


 

A Lecture on Pelvic Pain at Connect PT, Pelvic Floor Physical Therapy

On Nov. 8, 2018, I was very happy to attend a lecture titled, “Uncovering the Black Box of Chronic Pelvic Pain” at Connect Physical Therapy, in New Jersey.

Thank you to Michelle Dela Rosa, PT, DPT, at Connect Physical Therapy, for hosting a great event and thank you to Dr. Allyson Shrikhande for giving a great lecture.

Pelvic Floor Physical Therapists with Patrick Foye MD and Dr. Allyson Shrikande, Michelle Dela Rosa PT DPT

Pelvic Floor Physical Therapists with Patrick Foye MD and Dr. Allyson Shrikande, Michelle Dela Rosa PT DPT, at Connect PT.


 

Some of the Pelvic Floor Physical Therapists that Dr. Foye has met so far

I have been VERY fortunate to have met many great Pelvic Floor Physical Therapists in recent years.

Pelvic Floor Physical Therapy can be very helpful for a variety of conditions in the pelvis.

Here are a few photos…

Pelvic Floor Physical Therapists with Patrick Foye MD and Dr. Allyson Shrikande, Michelle Dela Rosa PT DPT

Pelvic Floor Physical Therapists with Patrick Foye MD and Dr. Allyson Shrikande, Michelle Dela Rosa PT DPT. November 8, 2018.

http://tailbonedoctor.com/wp-content/uploads/2018/07/Pelvic-Floor-Physical-Therapy-Coccyx-Pain-Tailbone-Pain.png

Rivki Chudnoff (from Hamakom PT), along with Stacey Futterman Tauriello & Kara (both from @5pointPT). In Newark, New Jersey, 2018.

Patrick Foye MD with Netherlands Pelvic Floor Physical Therapist Marijke Slieker. At the International Coccyx Pain Symposium, 2018, in Holland.

Patrick Foye MD with Netherlands Pelvic Floor Physical Therapist Marijke Slieker. At the International Coccyx Pain Symposium, 2018, in Holland.

Pelvic Floor Physical Therapy Coccyx Conference 2017. Herman and Wallace.

Pelvic Floor Physical Therapy Coccyx Conference 2017. Herman and Wallace. Tampa, Florida.

Dr Foye Gives a Lecture on Coccyx Pain (Tailbone Pain) to Pelvic Floor Physical Therapists

Dr Foye Gives a Lecture on Coccyx Pain (Tailbone Pain) to Pelvic Floor Physical Therapists. Tampa, Florida. 2017.

Pelvic Floor Physical Therapists with Patrick Foye MD, after his lecture on Tailbone Pain, for the American Physical Therapy Association's New Jersey Chapter, Women's Health Special Interest Group. 2016.

Pelvic Floor Physical Therapists with Patrick Foye MD, after his lecture on Tailbone Pain, for the American Physical Therapy Association’s New Jersey Chapter, Women’s Health Special Interest Group. 2016.

Patrick Foye MD,  gave a lecture on Tailbone Pain, for the American Physical Therapy Association's New Jersey Chapter, Women's Health Special Interest Group (Pelvic Floor Physical Therapists). 2016.

Patrick Foye MD, gave a lecture on Tailbone Pain, for the American Physical Therapy Association’s New Jersey Chapter, Women’s Health Special Interest Group (Pelvic Floor Physical Therapists). 2016.

Niva Herzig PT with Patrick Foye MD, after Dr. Foye's lecture on Tailbone Pain, for the American Physical Therapy Association's New Jersey Chapter, Women's Health Special Interest Group

Niva Herzig PT with Patrick Foye MD, after Dr. Foye’s lecture on Tailbone Pain, for the American Physical Therapy Association’s New Jersey Chapter, Women’s Health Special Interest Group. 2016.

At Beyond Basics Pelvic Floor Physical Therapy, NYC, Stephanie Stamas, Amy Stein, with Patrick Foye MD, October 2014

At Beyond Basics Pelvic Floor Physical Therapy, NYC, Stephanie Stamas, Amy Stein, with Patrick Foye MD, October 2014.

#PFPT

What Causes Fuzzy MRI images of the Coccyx (Tailbone) in Patients with Coccyx Pain (Tailbone Pain, Coccydynia)?

Someone recently told me online that their treating physician tried to look at the coccyx MRI, to try to find the cause of the person’s  coccyx pain (tailbone pain, coccydynia). But the physician  reportedly said that the MRI images of the coccyx looked  “fuzzy,” so they were not able to see very much detail.

What Causes “Fuzzy” MRI images of the Coccyx (Tailbone) in Patients with Coccyx Pain (Tailbone Pain, Coccydynia)?
  • Most common reason for “fuzzy” MRI images of the coccyx: Lack of T-1 sagittal images of the coccyx.
  • Second most common explanation for “fuzzy” MRI images of the coccyx: lower quality magnet in the MRI machine.
    • The quality of an MRI image depends upon  not only the  technique that is used (as discussed above) but also the  quality (strength)  of the magnet  within the MRI machine.
    • Magnet strength is measured in “Tesla.”
    • Most modern MRI machines  have a magnet strength of  1.0 Tesla or even 3.0 Tesla. Any machine with a 1.0 Tesla magnet strength or better will usually give a good quality image of the coccyx  as long as the  technique is done properly.  (Essentially,  a 1.0 Tesla magnet is strong enough to give a good image, but to get that could image the MRI technician needs to use the machine properly in order to get the  optimal views, such as the T-1 and T-2 sagittal images, as discussed above.)
    • Lower quality MRI images will usually be seen if the MRI has a weaker magnets strength, such as an MRI with only a 0.5 Tesla magnet.
    • “Open” MRI machines  cause less claustrophobia  for the patient while they are in the machine, but unfortunately  the trade-off is that the open MRI machines usually have a lower quality/strength magnet.

GET THE BOOK: To get your copy of the book “Tailbone Pain Relief Now!” go to: www.TailboneBook.com  or go to Amazon.

COME FOR RELIEF: For more information on coccyx pain, or to be evaluated in-person at Dr. Foye’s Tailbone Pain Center in the United States, go to: www.TailboneDoctor.com

- Patrick Foye, M.D., Director of the Coccyx Pain Center, New Jersey, United States.

Book Now Available! Click on the book to get it now:


Get the Book at www.TailbonePainBook.com