If you suffer from tailbone pain (coccyx pain), your doctor may order an MRI (magnetic resonance imaging, which are detailed medical pictures). MRI of the tailbone (coccyx) can help you and your doctor to figure out whether you have a tailbone fracture (a coccyx that is broken, chipped, cracked, or shattered), or if it is a dislocated tailbone, or if the area is bruised. MRI can also sometimes reveal other causes of pain in the tailbone region, such as cancer (tumor, malignancy), infection (abscess), pilonidal cyst (a painful lump that may drain to the skin over the tailbone), etc. Thus, MRI can be very useful in helping doctors and patients figure out what is causing the sore, aching, painful tailbone (coccyx bone pain, etc.). But if the wrong type of MRI is done then it fails to help the doctor or patient. In my medical career as a physician who has treated at least hundreds of patients with tailbone pain, I commonly see patients who (prior to coming here for consultation) have already previously undergone MRI testing for tailbone pain, but the MRI did NOT even include imaging of the tailbone at all! These patients have routinely been told that the MRI was "normal" without the patient or the treating doctor having realized that the MRI never even included the tailbone in the first place! The steps below should help you and your doctor make sure that the proper MRI testing is being done if you are having an MRI because of tailbone symptoms.
First, you need to see a physician because you typically will not be able to have an MRI without orders from a doctor.
You need the physician to agree that it would be worthwhile to order the MRI. Showing him or her my list of reasons above might help.
If your physician is ordering the MRI, make sure that his or her orders very clearly specify that the MRI is being ordered because of tailbone (coccyx) symptoms.
Before the doctor writes the orders, diplomatically remind him or her that you want to make sure that the MRI images will actually include the tailbone (coccyx).
Recognize that a "lumbosacral" MRI only includes the "lumbosacral" spine. This means that it includes the “lumbar” spine and the “sacrum”, but typically does NOT include the tailbone (coccyx)! Thus, if the doctor orders a "lumbosacral" MRI, it is very unlikely that there will be good imaging of the tailbone.
In my experience, the MRI usually needs to be ordered as a "sacrum-coccyx" MRI or as a "pelvic MRI with attention on the coccyx." Also, it helps if the orders will very specifically request including "sagittal images through the coccyx" since these are the special views most likely to reveal tailbone problems.
When you are at the MRI facility to have the test, remind the receptionist and the actual radiology technician that the MRI is for your coccyx. (Note: Most MRI centers perform “lumbosacral” MRI studies hundreds or thousands of times more commonly than MRI studies for the coccyx. Thus, unless you politely remind them, do not be surprised if they give you the more common type of MRI, even though it may not be the correct type of MRI for you and your tailbone.)
After the MRI is done, ask your doctor to give you a photocopy of the actual, official radiology report from the MRI. Ask your doctor to go over the official report with you.
Look at the report and see what type of MRI was done. (Did they do an MRI of the coccyx, or was it just a lumbosacral MRI without including the coccyx?)
Read the text within the MRI report and see if the radiologist specifically mentions the appearance of the tailbone (coccyx). If the radiologist does not specifically and explicitly mention the coccyx, then it is possible (and perhaps likely) that the radiologist may not have even looked at or seen the coccyx.
If you or your doctor have the actual MRI images, ask your doctor to point to your coccyx on the actual MRI images/films.
Consider going for a second opinion with a tailbone specialist, if your own doctor is not experienced at evaluating tailbone pain, or is not compassionate about your tailbone symptoms, or is unwilling/unable to order the proper tests, or seems uncomfortable interpreting the MRI results, or is not aware of non-surgical treatments to offer you. By searching on the Internet, you can probably find a physician who offers specialized care for patients with tailbone problems. Sometimes you may need to travel to reach such a specialist, but it may be worthwhile if you can get the answers, treatment and relief that you deserve.
Overall Tips & Warnings
For more information on Tailbone pain, please see Dr. Foye’s other TailboneDoctor articles on eHow, or go to www.TailboneDoctor.com and www.Tailbone.info
WARNING: This information is intended to be educational and is NOT to be considered as medical advice. This information is NOT a substitute for direct medical care from a physician who evaluates you in person.
WARNING: coccyx pain can sometimes be due to very serious underlying medical conditions, so it is important to seek in-person evaluation by a medical professional.
WARNING: Many physicians and other health providers have little or no experience in evaluating or treating tailbone pain or coccyx injuries. If you are not satisfied with the first physician you see, then seek medical attention from a specialist with experience in treating tailbone pain.
Tailbone MRI (MRI of the Coccyx), which in this case shows a sharp (abrupt) angle where the tailbone flexes forward, into the pelvis.
Disclaimer: This web site is for general informational purposes only.
The information should not be considered as medical advice.
The information is not a substitute for appropriate in-person care by a physician with expertise in evaluating and treating tailbone pain. This website is not meant to represent official views of any university, medical school, hospital, etc.
Effective July 2013:
New Jersey Medical School is part of Rutgers, The State University of New Jersey.