4 Reasons why Tailbone Fractures and Dislocations Can NOT be Treated like Other Body Regions

Why can’t you just treat coccyx pain or injuries the same way you would treat other musculoskeletal injuries?
There are 4 main reasons:  
  • #1: You can NOT put a CAST on the tailbone.
    • Unlike an injury to your arm or leg, you can not put a CAST on your tailbone.
  • #2: You can NOT use a SLING for the tailbone.
    • Unlike an injury to your arm, you can not use a SLING for your tailbone.
  • #3: You can NOT use orthopedic hardware on the tailbone.
    • Unlike an injury to your arm, you can not use orthopedic hardware on the tailbone.
    • For arm or leg injuries, orthopedic hardware includes using plates and screws to hold the bones in place. But the bones that the tailbone are very small and fragile, and do not have the sturdiness or “bone stock” for the screws, plates, or rods to be held in place. The small bones of the coccyx may crumble if you tried to put a sturdy screw into them.
  •  #4: Ideally, the tailbone needs to be able to MOVE.
    • Even if you could use orthopedic hardware or other approaches to fuse the tailbone together, that may create new problems. Normally, the tailbone needs to be able to move a small amount. When we sit, the tailbone normally flexes forward so that it is out of the way while we are sitting. Fusion would prevent that, which could potentially make the pain even worse.


Fortunately, most people with coccyx pain (tailbone pain, coccydynia) respond well to non-surgical treatment, including the use of cushions, medications, and local injections.

For more information on coccyx pain, click here to get a copy of Dr. Foye’s book, Tailbone Pain Relief Now!
4 Reasons Tailbone Pain is treated Differently

e-Book on Tailbone Pain: Now Available on Amazon

Get your e-book version of Dr. Foye’s internationally acclaimed book, Tailbone Pain Relief Now!
  • Yes, this week we are excited to announce that this book is now also available in electronic, e-book form, on Amazon.com, at a fraction of the cost of the paper book.
  • Learn the tips, tricks, and secrets you need to get an accurate diagnosis for your coccyx pain and the best possible treatments.
  • The book contains 31 chapters, 272 pages, providing crucial information for people suffering with tailbone pain (coccyx pain).
  • It is written in plain language, so it is easy to understand by people who do not have any medical training.
  • The book has an impressive 5-star rating by readers on Amazon.
  • You can get your copy of the book in the format of your choice: either as a printed paperback or as an e-book. Available internationally.
  • The e-book can be read on your Kindle, or via Amazon’s other options, including on your Windows or Mac computer, iPod Touch, iPad, iPhone, Android, Windows Phone 7, or BlackBerry.
Click here now to get your copy of the book!
or go to: http://amzn.to/2pbirSU

Get your copy of the book, Tailbone Pain Relief Now!

Get your book at: http://amzn.to/2pbirSU

Medical Books do NOT include Coccyx Pain, Tailbone Pain

VIDEO: Medical Books often FAIL to cover Tailbone Pain Coccyx Pain

Transcript of the video:
  • Medical Books often Fail to Cover Tailbone Pain.
  • Patrick Foye, M.D.     www.TailboneDoctor.com
  • Okay. Hi. I’m Dr. Patrick Foye, the Director of the Tailbone Pain Center in New Jersey, United States, online at  TailboneDoctor.com
  • And I’m here at a medical conference, actually in New Orleans, Louisiana, right now.
  • And one of the things I was noticing just looking at some of the different textbooks (medical textbooks: musculoskeletal medicine and pain management) is how few of them have anything about tailbone pain.
  • So I’ll show you that on some of the books inside right here.
  • Okay, this is a book called Physical Diagnosis of Pain, by Steven Waldman, who is well respected for publishing in pain management textbooks.
  • And if we look at the index here in the back of the book… index and going under the letter “C” of course for coccyx pain, we see that it is NOT listed at all.
  • So then you might think that Dr. Waldman’s textbook of “Uncommon” Pain Syndromes might include this. But again if we go to the index of this one… again we see that going alphabetical here again.. coccyx is pain is NOT listed at all.
  • Okay, this book is on “i-Spine” on interventional spine care. You know that the coccyx is part of the spine. But if you go to the index and we look under “C”… we’ve got Cervical, we’ve got Chest, we’ve got Collagen, but NO coccyx.
  • Here’s another example: this one is a book called Orthopedic Imaging by Greenspan, who I can tell you is a well respected author of musculoskeletal imaging books. This book is over eleven-hundred-pages-long and again if we look back to the index and we look under C… we see that the coccyx is NOT included at all! There’s NOTHING about the coccyx in this over 1,100 page book about orthopaedic imaging. Okay, this one is called Fundamentals of Pain Medicine, by Hoppenfeld, also a well-known author in musculoskeletal books. And again if I swing back to the index under “C” and look here there’s nothing on coccydynia within this.
  • Okay, this one is actually a terrific textbook Essentials of Musculoskeletal Care. They’re up to version 5. I had version 1 when I got out of residency myself 20 years ago. It’s actually a fantastic book that’s put out by the American Academy of Orthopaedic Surgeons.
  • So here is the book. But again if we go to the index section here and if we look under “C” for coccyx or coccydynia…
  • Basically, you can see that it does not include anything about coccydynia or the coccyx.
  • So I guess this orthopedic textbook is saying that the coccyx is not one of the “essential” areas of musculoskeletal care, unfortunately.
  • Okay, so hopefully that gives you just some idea about how many many musculoskeletal and pain management medical books and textbooks and procedure guides and all of those kinds of things unfortunately contain little or NOTHING ABOUT TAILBONE PAIN.
  • So, Again just my perspective as a doctor who treats many many patients with tailbone pain. It amazes me how little is known by medical professionals and maybe it’s no surprise because often they’re not taught much about the tailbone in medical school or in residency or fellowship or even in the medical textbooks that they are reading.
  • So, alright that’s all for now, if you want more information on tailbone pain you can certainly find me on my website at TailboneDoctor.com
  • Bye, bye.
  • Or to get your copy of the book that I’ve written on tailbone pain, go to TailboneBook.com
  • This is 272 pages, 31 chapters, all about coccyx pain (tailbone pain), diagnostic workup, treatment, etc.
  • Largely I wrote this because there was not much published in the medical literature.
  • Go to www.TailboneBook.com.
  • Thank you.


Pelvic Floor Physical Therapy Conference for Tailbone Pain (Coccyx Pain)

I spent this past weekend in Tampa, Florida, at a conference on Tailbone Pain (Coccyx Pain) for Physical Therapists who specialize in treating pelvic floor disorders.

I was honored to give them a lecture on Tailbone Pain (coccydynia) from my physician perspective.

I was also honored to learn lots about how a pelvic floor physical therapists (pelvic floor P.T.s) approach patients who are suffering from tailbone pain and other pelvic pain syndromes.

Some patients have diffuse pelvic floor pain and dysfunction in addition to their tailbone pain, and a pelvic floor physical therapist can often be very helpful at providing relief for those patients.

To see a VIDEO of Dr. Foye discussing the conference, click here:


Photos from the event:

PT Coccyx Conference 2017

Patrick Foye, M.D., (center) with Pelvic Floor Physical Therapists, at conference on Tailbone Pain (coccyx pain, coccydynia). Tampa, Florida. March 2017.


Patrick Foye, M.D., gave a Lecture on Tailbone Pain (Coccyx Pain), to Pelvic Floor Physical Therapists. Tampa, Florida. March 26, 2017. Photo courtesy of: @LilaAbbate



How Big is that Coccyx Mass, Cyst, Tumor, or Cancer?

  • Sometimes I find that my patients with tailbone pain (coccyx pain, coccydynia) actually have a mass, cyst, tumor, or cancer either within the tailbone itself or in the nearby tissues.
  • Examples can include pilonidal cyst, retro-rectal hamartoma (tailgut cyst), chordoma (a type of bone cancer that tends to happen at the coccyx and is often deadly), and abscess (a collection of pus or infected tissue).
  • Within an MRI report, or CT scan report, the radiologist who reads the images will typically report the size of any such abnormal structure in centimeters (cm).
  • Patients often see the centimeters listed and they will ask me, “Well, how big is that?”
  • (Since the United States has not adopted the metric system, many people here are not familiar with thinking about things in centimeter size.)
  • I recently came across a medical blog post (link below*) that gives examples of common foods, based on size (as measured by centimeters in diameter).
  • This is a great way to visualize how big your mass is, compared to foods that you are already familiar with.
How Big is that Coccyx Mass, Cyst, Tumor, or Cancer?
  • Pea = 1 cm
  • Grape = 2 cm
  • Walnut = 3.5 cm
  • Plum = 5 cm
  • Tennis ball = 6.5 cm
  • Orange = 6.6 cm
  • Baseball = 7.5 cm
  • Grapefruit = 10 cm
  • Cantaloupe = 12 cm
  • Honeydew melon = 16 cm


*Reference: http://www.fibroidsecondopinion.com/2013/04/what-size-are-my-fibroids/
That excellent blog post was mostly about the size of uterine fibroids, but the same reference measurements would  of course apply for coccyx-related masses.

Predicting doctoring… since 1972.

Wow! A shocker from my childhood…
  • My parents’ home bathroom recently had the wall tiles removed to install grab bars for their safety.
  • They called me to come see the insides of the walls, which were covered in cartoon sketches drawn by my siblings and I the last time the bathroom was renovated.
  • That was 45 years ago, when I was just 5 years old!
  • I immediately spotted my own handwriting, but was surprised to see what I had written… “Pat Foye was here 1972. When I grow up I want to be a doctor.”
  • It’s funny because my recollection was that I was mid-way through college when I first decided to become a doctor. There were no doctors in my family (my parents were farmers who immigrated to the USA).
  • But apparently my 5-year-old self knew my career path way back in 1972, and left myself a note to remind the mid-life me!
  • #Predictions.
Dr Patrick Foye M.D. circa 1972

“Pat Foye was here 1792. When I grow up I want to be a doctor.”

Dr Patrick Foye M.D. predicted his Doctor career

Patrick Foye, M.D., pointing to his wall doodlings from 45 years ago. 

Tailbone X-Rays (Coccyx X-Rays), NOT Lumbar

The Tailbone (Coccyx) is NOT the Same as the Lumbar Spine.
  • Practically every day, patients with tailbone pain come to see me from around the country or from around the world. Many have faced a similar  challenge regarding imaging studies.
  • Specifically, it is unfortunately VERY common that the patient has tailbone pain (coccyx pain, coccydynia), but the have a difficult time getting medical imaging studies such as basic x-rays (radiographs) of the tailbone.
  • There are unfortunately multiple reasons why the coccyx x-rays fail to be done:
    • The treating physician  may not know much about  tailbone pain, and if they would not know what kinds of x-rays to order or what kinds of abnormalities to screen for on those x-rays, then they do not know the benefit of ordering  and obtaining the x-rays in the 1st place.
    • The treating physician may not know much about treatment of tailbone pain, and how modern treatments are based upon taking the imaging results into consideration. If the treating physician incorrectly thinks that  x-rays will not make a difference, then they will be unlikely to order those x-rays.
    • The ordering physician may have absentmindedly “checked off” the order box that said “lumbar” or “lumbosacral” x-rays. Because pain in those areas is probably thousands of times more common than tailbone pain, the template forms probably do not even have a box to check off for coccyx x-rays.
    • Even if the ordering physician correctly orders tailbone x-rays, the radiology technician may be so familiar with doing lumbar x-rays (and rarely does any coccyx x-rays), that the technician is on autopilot-mode and when you come in with some pain in the low back or buttock area they just automatically do the lumbar or lumbosacral x-rays.
    • An insurance company or health care system may deny authorization for the x-rays, because they incorrectly believe that the x-rays are unlikely to have any impact on the patient’s subsequent treatment.
    • The insurance company or health care system may  incorrectly use authorization/denial criteria regarding the Lumbar spine, and inappropriately apply those lumbar criteria  to the coccyx region.
  • Every week here at the Tailbone Pain Center, new patients come to see me with similar stories, having suffered through the situations described above. While they are here, we review the prior images (x-rays, MRI, etc.) and we assess whether the studies did or did not give an appropriate evaluation of the coccyx. We also can obtain additional imaging studies, including x-rays done while the patient is sitting.
  • When the appropriate imaging studies are done, the majority of patients with tailbone pain will have an accurate diagnosis that appropriately  explains  the reason for their symptoms. The diagnosis then also provides a basis for a personalized treatment plan, that specifically treats the specific cause of the pain in that specific patient.

Video: How Tailbone Pain Causes Suffering: work, home, friends, doctors

SHARE this page / video with others so they can better understand tailbone pain.
  • Recently, someone online asked me to do a video explaining how people with tailbone pain (coccyx pain) often face challenges that are not understood or appreciated by coworkers, family, partners, friends, or even their treating physicians.
  • She wanted a video that she could publicly share with family, friends, and coworkers, so that they could better understand what she was going through.
  • The video is by Patrick Foye, M.D., Founder and Director of the Tailbone Pain Center (Coccyx Pain Center) at www.TailboneDoctor.com

Here is the video:


Cycling Pain Article Ignores Tailbone Pain, Coccyx Pain

  • In this video, Patrick Foye, M.D., gives his initial reactions to a medical journal article that covers the topic of Cycling and Low Back Pain.
  • Dr. Foye points out that the article completely ignores the issue of tailbone pain (coccyx pain, coccydynia) in cyclists.
  • Sitting on a bicycle seat, or saddle, can put direct pressure on the tailbone (coccyx), resulting in tailbone pain.
  • Click the image to see the video:

How to Distinguish between Sacral Tarlov Cyst Pain and Tailbone Pain

A few months ago I wrote about “Do Tarlov Cysts cause Pain?”

Today’s question is:

How to Distinguish between Sacral Tarlov Cyst Pain and Tailbone Pain

Usually it is not difficult to tell these conditions apart. Here’s how:

  1. Location: The location of a sacral Tarlov Cyst is more than a few inches ABOVE the location of the coccyx. An experienced physician should usually be able to tell the difference from a careful physical examination of the patient.
  2. Pressing on the tailbone: Coccyx pain can typically be reproduced by direct palpation (pressing) on to the coccyx, reproducing the patient’s typical symptoms. If the pain was coming from a sacral Tarlov cyst, then pressing on the coccyx would not reproduce the patient’s symptoms.
  3. Anesthetic injection at the tailbone: If a patient has a local anesthetic injection at the coccyx, and the initial anesthetic response gives relief of the patient’s symptoms for an hour or two (while the anesthetic is working), this would be consistent with the pain having been coming from the coccyx in the first place. (A local anesthetic at the coccyx would not be expected to in any way relieve pain/symptoms that were coming from a sacral Tarlov cyst.)


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

Get the Book at www.TailbonePainBook.com