This eBook on Tailbone Pain is Free on Amazon worldwide: June 1, 2021, Pacific Time.
“Tailbone Pain Relief Now! Causes and Treatments for Your Sore or Injured Coccyx” by Patrick M. Foye, M.D., Director of the Coccyx Pain Center at Rutgers New Jersey Medical School.
Learn all about how to find answers and relief for your Tailbone Pain, Coccyx Pain, Coccydynia.
Click on “see all formats” (as shown by the red arrow in the image below) and then choose the e-book / Kindle version, which is FREE all day. You do not need a Kindle to get this free book… you just need an Amazon account, which is free. You can download the ebook to your laptop, desktop computer, iPad, e-reader, Kindle, etc.
Tailbone Pain, Coccyx Pain, Free-Book, June 1, 2021, coccydynia, by Patrick Foye MD
Below is a List of Amazon Links Worldwide to get the Book “Tailbone Pain Relief Now!” The book is filled with useful information about coccyx pain (tailbone pain), including causes, tests, and treatments. You can use the Amazon website specific to your part of the world.
COME FOR RELIEF: For more information on coccyx pain, or to be evaluated in-person by Dr. Foye’s Coccyx Pain Center in the United States, go to: www.TailboneDoctor.com
– Patrick Foye, M.D., Director of the Tailbone Pain Center, New Jersey, United States.
Wedge cushions have the hole or cut-out at the edge. It is usually a wedge-shaped cut-out (like a small, triangle-shaped slice removed from a a square pie).
The goal is for the painful tailbone to ‘hover’ over the cut-out, so that you are not putting as much of your body weight onto the tailbone. Less coccyx weight-bearing results in less coccyx pain.
The wedge cushions often also have a slight incline that tends to have the patient sit leaning forwards, which also takes some pressure off the coccyx.
I did a research study on this topic in 2009, assessing whether patients with tailbone pain preferred sitting on wedge cushions versus donut cushions.
Many patients with tailbone pain preferred neither cushion. But among patients who had a preference, they were ~ 5 times more likely to prefer wedge rather than donut cushions.
So, for patients who have not yet tried either cushion, it probably makes sense to start by trying a wedge cushion.
But each patient needs to find the cushion that works best for them.
Tailbone Pain Tip 11, Coccyx WEDGE CUSHIONS are usually better than doughnut cushions, for Coccyx Pain, CoccydyniaTailbone Wedge Cushion, for coccyx pain, tailbone pain, coccydynia Tailbone Donut Cushion, for coccyx pain, tailbone pain, coccydynia Coccyx Wedge Cushions for Tailbone Pain, Coccyx Pain, coccydynia
Video on Cushions for Tailbone Pain, Coccyx Pain, Coccydynia
COME FOR RELIEF: For more information on coccyx pain, or to be evaluated in-person by Dr. Foye’s Coccyx Pain Center in the United States, go to: www.TailboneDoctor.com
– Patrick Foye, M.D., Director of the Tailbone Pain Center, New Jersey, United States.
BUT… it is important to SCREEN for cancer since CHORDOMA tends to occur at the sacrum/coccyx and unfortunately is often FATAL within a few years of diagnosis.
MRI needs to be ordered properly and done properly to assess for this.
MRI is especially important if the coccyx pain is not responding to the usual treatments.
There are also other pelvic cancers to screen for, including cancers of the rectum / colon, uterus, ovaries, cervix, bladder, prostate, etc. Those cancers often involve assessment by specialists such as Gynecologists, Gastroenterologists, Colorectal specialists, Urologists, etc.
Tailbone Pain Tip 10, Tailbone CANCER can be Deadly, Chordoma, Tailbone Pain, Coccyx Pain, Coccydynia
COME FOR RELIEF: For more information on coccyx pain, or to be evaluated in-person by Dr. Foye’s Coccyx Pain Center in the United States, go to: www.TailboneDoctor.com
– Patrick Foye, M.D., Director of the Tailbone Pain Center, New Jersey, United States.
There are many causes of coccyx pain (tailbone pain, coccydynia). This article will focus on coccyx pain being caused by the lower coccyx being in extension, which is called a pseudo-spur.
NORMAL COCCYX POSITION = FLEXION:
Normally, the coccyx position has a mild, gradual forward flexion. This means that the coccyx is flexed forward. This results in the lower coccyx being nicely “tucked in” (tucked into the pelvic, which protects the coccyx from hitting the chair or floor when you sit or fall).
ABNORMAL COCCYX POSITION = EXTENSION:
Sometimes the lower coccyx is positioned with the angle going the opposite way. The “opposite way” means that the coccyx may be in extension, instead of flexion. This results in the lower coccyx “sticking out” or “pointing backwards”. In this extended (“sticking out”) position, the tailbone is at risk for hitting against the chair or seat when you are sitting. Usually there is pain with sitting, and sitting leaning back makes the pain even worse. In this extended (“sticking out”) position, the tailbone is also at risk for hitting forcefully/traumatically against the floor or ground if you land on your butt after you slip and fall.
PHRASES and SIMILARITIES: Coccyx “BONESPUR” (SPICULE) and “PSEUDO-SPUR”
There are a few different phrases that doctors use to describe this abnormal, extended position of the tailbone.
One phrase is to just say that the coccyx is in extension, instead of flexion.
Another phrase is to say that there is a coccyx PSEUDO-SPUR. “Pseudo ” means “like” or “similar to”. So, pseudo-spur means “like a spur”.
So, pseudo-spur means that the extended position of the lower coccyx results in the same type of symptoms as a bone spur. Usually there is pain with sitting, and sitting leaning back makes the pain even worse.
What is the DIFFERENCE between a coccyx BONE SPUR versus a PSEUDO-SPUR?
BONE SPUR:
A bone spur is an area where there is thickening of the bone. It is made of bone. It is bone.
A bone spur is additional, extra bone that the body has formed at a focal spot.
Just like your skin can become “thickened skin” and form a skin callous. Similarly, the bone can become “thickened bone” and form a spur.
A spur has EXTRA (ADDITIONAL) bone that has formed.
When the bony thickening is focal and makes a pointy projection, we refer to it as a bone spur. European doctors sometimes call it a bone “spicule”.
On imaging studies, a bone spur often looks like an icicle hanging down from your rain gutter.
A lower coccyx bone spur can cause coccyx pain when the patient sits on the bone spur, thus impinging the skin and subcutaneous tissue in between the bone spur and the sitting surface.
PSEUDO-SPUR = EXTENSION = RETROVERSION:
As discussed above, “pseudo-spur” means “like a spur”.
But, the difference is that a SPUR has EXTRA (ADDITIONAL) bone. The pseudo-spur does NOT have an “extra” bone, it just that the normal amount of bone is going into extension instead of flexion.
So, instead of the coccygeal joints being flexed, one or more of them are extended. Imaging trying to put your hand into your pocket if your index finger was extended, instead of flexed. The extended finger would get ‘hung up’ and would bump into the edge of the pocket rim, instead of being smoothly “tucked in” like the other fingers. Similarly, your extended coccyx may bump into the seat that you are sitting on, instead of being smoothly “tucked” into the pelvis.
European doctors sometimes refer to this extension as “retroversion” of the lower coccyx.
MAKING A CLINICAL DIAGNOSIS = 3 FACTORS:
To make a clinical diagnosis, the doctor needs to consider three main factors:
Symptoms: Does the patient report pain at one specific location? For example, is the patient having focal pain specifically at the lower tailbone? Also, is the pain worse with sitting, and especially worse with sitting while leaning slightly backwards?
Physical exam findings: The doctor needs to specifically look at the skin over the location of pain. Then, the doctor needs to touch or press on different locations along the length of your tailbone (palpation) to see if this reproduces your pain or other symptoms. For a distal coccyx bone spur or a pseudo-spur, the specific location of tenderness will usually be at the lower half or lowest tip of the coccyx. (The doctor will usually also assess for other possible sources of pain in the pelvic or buttock region, beyond just the coccyx.)
Imaging studies: Medical imaging studies of the coccyx include x-rays, MRI, and CT scans. If done properly, the imaging studies can show details of your coccyx anatomy. Typically the imaging studies will help to show if you have a coccyx bone spur (spicule) or a coccyx pseudo-spur (a retroverted coccyx, meaning that it is extended instead of flexed).
All 3 Factors: All three of the above factors are important, in combination, in making a clinical assessment. If the patient’s symptoms, physical exam findings, and imaging studies all point to the same thing as being the cause of the patient’s symptoms, then the diagnosis is considered to be confirmed and well-established. Then we can move on to treatment options.
SUMMARY: I hope you have found this to be a helpful explanation of the coccyx pseudo-spur (extended, retroverted coccyx) as a source of coccyx pain (tailbone pain, coccydynia). I hope this has also helped to explain the similarities and differences between coccyx bone spurs and coccyx pseudo-spurs.
Coccyx Bone Spur Causes Tailbone Pain, Coccyx Pain, Bone Spicule
COME FOR RELIEF: For more information on coccyx pain, or to be evaluated in-person by Dr. Foye’s Coccyx Pain Center in the United States, go to: www.TailboneDoctor.com
– Patrick Foye, M.D., Director of the Tailbone Pain Center, New Jersey, United States.
What is a bone spur? A bone spur is thickening of the bone. Just like you can get a callous on your hands or feet from thickening of the skin, you can also get thickening of bone in certain places in your body. When the bony thickening is focal and makes a pointy projection, we refer to it as a bone spur. (European doctors sometimes call it a bone “spicule”.)
Where do bone spurs happen? The most common locations where people have heard of bone spurs are: a heel spur on the sole of the foot (painful when you take a step) and a bone spur at the shoulder (painful when you reach your arm up and overhead). When a spur happens at the coccyx, it is almost always extending backwards from the lower tip of the coccyx. This causes pain when someone sits on this (especially if you sit leaning backwards). You can read more about that here: Coccyx Bone Spurs, Plantar Heel Spurs, Shoulder Bone Spurs
Why not just surgically “shave down” a coccyx bone spur?
Firstly, just like with bone spurs at the foot/heel and shoulder, it essentially always make sense to start with non-surgical treatment options first. The reason is simple: MOST people will get good relief without needing surgery. This is true for bone spurs at the heel, at the shoulder, and at the coccyx.
Secondly, there are some unique challenges with trying to shave down a bone spur when it is specifically at the coccyx, which are listed below:
A) The coccygeal bones are small and fragile. Sometimes surgeons will note that the coccyx “crumbles” into pieces as they remove it. So, if you were to try to shave off the spur, you would risk causing trauma and fracture to the coccygeal that is attached to the spur. (Comparison: If you had a bit of cement/concrete stuck to the side of a large cargo ship, then you could chisel it off without damaging the big strong cargo ship. But if you had a bit of cement/concrete stuck to the side of a glass/crystal earring, then trying to chisel it off would risk damaging the glass/crystal earring.
B) The coccyx is a weight-bearing surface. You actually put some of your body weight onto the coccyx for prolonged durations of time, specifically while you are sitting. So, if you had the coccyx bone spur “shaved down”, you would be sitting and putting your body weight onto a raw, cut edge of bone. That is not good for your pain level and is not good for healing of the site at the surgical shaving.
SUMMARY regarding distal coccyx bone spurs:
1) It makes sense to try the non-surgical treatment options first, since they work for most people, thus avoiding surgery.
2) There is no good or standard surgical procedure to “shave down” a coccyx bone spur. If surgery is needed, it will typically involve amputating (removing) most or all of the coccyx (coccygectomy), rather than just removing the spur.
Coccyx Bone Spur Causes Tailbone Pain, Coccyx Pain, Bone SpiculeChapter 9 of Tailbone Pain Book: Coccyx BONE SPUR, Tailbone Spicule
COME FOR RELIEF: For more information on coccyx pain, or to be evaluated in-person by Dr. Foye’s Coccyx Pain Center in the United States, go to: www.TailboneDoctor.com
– Patrick Foye, M.D., Director of the Tailbone Pain Center, New Jersey, United States.
MANY coccyx pain patients tell me that their Doctors NEVER EVEN EXAMINED (touched / palpated) their coccyx.
This happens all the time! It’s BIZARRE!
IMAGINE someone treating your thumb without ever examining it. Unthinkable!
Clinicians (primary care, pain or musculoskeletal specialists, P.T.’s, etc.) should EVALUATE THE SITE OF PAIN!
Patients DESERVE proper evaluations.
Tailbone Pain Tip 9, Find a Clinician who will TOUCH your Coccyx, for Tailbone Pain, Coccyx Pain, Coccydynia, by Patrick Foye, MD
COME FOR RELIEF: For more information on coccyx pain, or to be evaluated in-person by Dr. Foye’s Coccyx Pain Center in the United States, go to: www.TailboneDoctor.com
– Patrick Foye, M.D., Director of the Tailbone Pain Center, New Jersey, United States.
Coccyx Dislocations and Fractures can BOTH be a cause for Tailbone Pain, (Coccyx Pain, Coccydynia).
Coccyx DISLOCATIONS are ~ 100 x more common than Coccyx FRACTURES.
Dislocations = due to sprained or torn ligaments.
Fractures = a break in the actual bones.
The VAST majority of the time when a new patient tells me that their prior x-rays or MRI showed a fracture… I look at the images and it is NOT a fracture, it is a dislocation. This mistake happens all the time at the coccyx, whether it was misinterpreted by the Emergency Room doctor, the musculoskeletal doctor, the pain specialist (if any of them actually even looked at the images themselves) and by the Radiologists (who really should know better). Part of the problem is that even doctors have the misunderstanding that it is a tailBONE (which sounds singular, as if there is only one single bone at the coccyx)… so when they see separate bits of bone then incorrectly assume that it used to be one solid singular fused bone that fractured (when usually it is multiple individual boneS, plural).
Tailbone Pain Tip 8, Coccyx DISLOCATIONS versus FRACTURES, COCCYX PAIN, Tailbone Pain, Coccydynia
COME FOR RELIEF: For more information on coccyx pain, or to be evaluated in-person by Dr. Foye’s Coccyx Pain Center in the United States, go to: www.TailboneDoctor.com
– Patrick Foye, M.D., Director of the Tailbone Pain Center, New Jersey, United States.
I was recently contacted by a woman who had undergone a coccygectomy (which is surgical amputation/removal of the coccyx/tailbone).
Her question was whether, after having undergone coccygectomy, it would or would not be advisable for her to undergo a cesarean section rather than a vaginal delivery for any subsequent pregnancy.
Perhaps you, the reader, are in a similar situation and have this same question.
This is an excellent question and one that I do not think I have ever seen explicitly addressed within the published medical literature.
On the one hand, if the coccyx is no longer present, then it should no longer be presenting any obstruction to the baby passing through the birth canal, and therefore a vaginal delivery may indeed be possible.
However, if the patient is still having significant pain at the coccygectomy surgical site (such as from scar tissue, etc. at the surgery site), or if that area is currently symptom-free but still more prone to being exacerbated, then it is possible that a vaginal delivery could cause a flareup/worsening or return of your pain in the coccyx region.
So, I do not have a hard and fast rule by which to advise my patients on this.
In general, if the patient has little or no pain at the coccyx region and the pregnancy overall seems normal (e.g., just one baby rather than twins or triplets, for example, and the baby is of normal body weight rather than being significantly enlarged), it is possible that the patient could deliver vaginally without substantial flareup at the tailbone.
Conversely, if the coccygectomy site is still very painful, or if the pregnancy is complicated by twins/triplets or a larger than usual baby, then delivery by a cesarean section may be more advisable.
But again, these would be general topics for how to consider this decision rather than firm advice on which choice to make.
All of this should be topics that the patient should discuss in person with their treating obstetrician/gynecologist.
Lastly, if the patient does end up having a vaginal delivery, or even a C-section, they would generally want to make sure that while they are at the hospital they do not flare up the coccyx region just from the sitting in a reclined position that is common on the typical delivery table.
Tailbone Pain Tip 7, PREGNANCY and CHILDBIRTH Can Cause or Worsen COCCYX PAIN, Tailbone Pain, Coccydynia
COME FOR RELIEF: For more information on coccyx pain, or to be evaluated in-person by Dr. Foye’s Coccyx Pain Center in the United States, go to: www.TailboneDoctor.com
– Patrick Foye, M.D., Director of the Tailbone Pain Center, New Jersey, United States.
A standard “Lumbar” or “Lumbosacral” MRI does NOT include the COCCYX.
The most common MISTAKE that I see when patients have an MRI done for coccydynia (tailbone pain) is that the MRI does NOT even include the coccyx!
Often, the wrong MRI is ordered/done.
Look at the radiology report and see if they even commented on the coccyx.
Ask your doctor to point to the coccyx on the images. It may not be there!
Tailbone Pain Tip 6, Lumbar MRI does NOT include the Coccyx, for Tailbone Pain, Coccydynia
COME FOR RELIEF: For more information on coccyx pain, or to be evaluated in-person by Dr. Foye’s Coccyx Pain Center in the United States, go to: www.TailboneDoctor.com
– Patrick Foye, M.D., Director of the Tailbone Pain Center, New Jersey, United States.
The word TAILBONE is MISLEADING since it implies that it is one, singular bone.
In reality, the tailbone (coccyx) is made of 3-to-5 boneS (plural).
It is less common for all of these bones to be fused.
Tailbone Pain Tip 5, the Coccyx is 3-5 bones, not one, Coccydynia
COME FOR RELIEF: For more information on coccyx pain, or to be evaluated in-person by Dr. Foye’s Coccyx Pain Center in the United States, go to: www.TailboneDoctor.com
– Patrick Foye, M.D., Director of the Tailbone Pain Center, New Jersey, United States.
