Can a Lumbar Disc cause Tailbone Pain?

If an MRI shows that there is a lumbar disc herniation, could this be the cause of your tailbone pain?

Usually not.

Lumbar disc “abnormalities”
  • “Abnormalities” in the lumbar discs are very very commonly seen on MRI studies.
  • Sometimes these abnormal-looking discs may cause symptoms such as low back pain or nerve pain that travels down your leg.
  • Perhaps even more commonly, those abnormal-looking discs might not be causing you any symptoms at all!
  • It is important for the treating physician to carefully evaluate each individual patient in order to see how any such MRI findings may or may not match up with the patient’s symptoms and physical exam findings.
Lumbar vs. Tailbone
  • If the patient has symptoms that are very well localized to the tailbone (coccyx), then it is very unlikely that those tailbone symptoms are coming from the lumbar spine.
  • It is vastly more common that tailbone pain is actually coming from the tailbone itself.
  • Let’s think about this the reverse way for a moment to see how crazy this approach is.
    • In someone with lumbar symptoms (in the “small of the lower back”) it would not be automatically assumed that those lumbar symptoms are due to referred pain from the tailbone.
    • Similarly, in someone with tailbone symptoms it should not be assumed that those tailbone symptoms are due to referred pain from the lumbar spine.
Problems caused by focusing only on the lumbar spine
  • Unfortunately, over the years, I have seen MANY patients who saw their doctors due to tailbone pain, but the following has occurred:
    • The doctor incorrectly lumps “tailbone pain” in with general “low back pain” (essentially LUMBAR pain), often without even examining the tailbone area where the patient is reporting her pain.
    • The doctor orders a “LUMBAR” MRI done (which does not even include the tailbone).
    • The lumbar MRI shows some “abnormal” looking findings. (In reality, the lumbar MRI findings such as a lumbar disc herniation might not be causing the patient any symptoms at all.)
    • Based on the lumbar MRI “abnormalities”, the patient is subjected to various lumbar treatments, which can include:
      • lumbar epidural steroid injections
      • lumbar facet joint injections
      • lumbar surgery
    • Not surprisingly, treating the lumbar spine for problems in a totally different part of the spine (the coccyx) usually fails to give any relief at all.
    • Meanwhile, the patient continues suffering while the doctor has failed to ever even examined the area of pain (the tailbone) and the doctor has failed to order the appropriate diagnostic tests for the area of pain (the tailbone).
    • Because the patient has not gotten any better despite extensive treatment (at the wrong body region!), the doctor assumes that the patient’s case is hopeless or that the patient is “”crazy” or that the pain is just “all in her head”.
Take home message:
  • If your symptoms are mainly localized to the tailbone area, then most likely they are being caused by a medical condition localized to the tailbone area.
  • Before jumping to conclusions that the tailbone symptoms are coming from MRI “abnormalities” in the lumbar spine, be sure to see a physician who will perform a careful and thoughtful evaluation specifically at the tailbone region.
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Book: “Tailbone Pain Relief Now! Causes and Treatments for Your Sore or Injured Coccyx” by Patrick Foye, M.D.

Patrick Foye, M.D.
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