Tailbone Book, Chapter 6: Unstable Tailbone. Dynamic Instability Causing Coccyx Pain, Tailbone Pain

Tailbone Book, Chapter 6: Unstable Tailbone. Dynamic Instability Causing Coccyx Pain, Tailbone Pain
The actual VIDEO is at the bottom of this page.
Here is the TEXT from the video:
  • Hi. I’m Dr. Patrick Foye.
  • I’m an M.D., or Medical Doctor, and I’m the director of the Coccyx Pain Center, or Tailbone Pain Center, here in the United States.
  • I’m online at www.TailboneDoctor.com.
  • And this is the next in a series of videos looking at the different chapters in my book “Tailbone Pain Relief Now!”
  • And the idea is just to give a glimpse into the general material that’s covered within the different chapters, which then provides us with an opportunity to talk about those areas and to post questions and comments down below, to have a dialogue about this.
  • This chapter, for this video, is Chapter number Six, which I think is perhaps the most important chapter in the book because it it’s about unstable joints of the coccyx or tailbone.
  • And the reason I say it’s perhaps the most important chapter is for two reasons.
  • Number one is that this is perhaps the most common cause of tailbone pain.
  • Certainly in our practice here patients fly in from around the country and internationally, and far and away the most common diagnosis that we find is that they have instability, an unstable joint or more than one unstable joint at the tailbone.
  • And the second reason why this is such an important topic is that this is an area that is widely under-diagnosed.
  • The vast majority of people who have this condition have never had the proper testing done to evaluate for it so.
  • So, in this chapter… again we’re looking at here Chapter 6 about the unstable tailbone, which is basically that the joints are unstable and that contributes to a condition that medically we call that instability and specifically dynamic instability which we’ll talk about.
  • So in this chapter… it starts off with a story of a patient, like hundreds and hundreds of patients who I have seen who have been told that there’s nothing wrong with their tailbone, that everything is fine, that the plain x-rays and even the MRI or CT scan looked okay.
  • But the patient failed to have a sitting versus standing x-ray done.
  • So, given that your pain with tailbone pain is usually worse WHILE YOU’RE SITTING, the x-rays really should be done WHILE YOU’RE SITTING.
  • But unfortunately very few places know about how to do those properly.
  • Very few radiology centers or hospitals have even heard of doing these x-rays of the tailbone while sitting.
  • So that means that they don’t get done.
  • And because they don’t get done we don’t get to see what happens to the tailbone when you’re putting your body weight on it by sitting.
  • When we sit, sitting down puts pressure on to the tailbone.
  • And the tailbone then may move or shift depending on the on the pressure that’s placed upon it while sitting.
  • So what can happen is the following… you can have x-rays that look totally normal while the person is standing up or laying down, they’re not putting their body weight onto the tailbone as shown in this part of the image here.
  • The alignment looks okay. Everything looks fine.
  • But then when the patient sits, the body weight pushing on that unstable joint can cause the joint to go into a partial or complete dislocation position, as shown in this part of the image here.
  • So this is very very common.
  • I would say at least 60% or more of the patients who I see for tailbone pain have instability.
  • They have hypermobility as another way of referring to this: “hyper” means “increased”, and “mobility” is just talking about the “motion.”
  • So a couple of medical terms that are saying the same thing: it might be described as “hyper- mobility” or “instability” and “coccygeal” referring to “coccyx hypermobility”, “coccygeal instability”.
  • It is sometimes referred to as “dynamic instability.”
  • The dynamic part being that the tailbone is not just dislocated, but it’s actually moving.
  • It’s dynamic. It’s in one position while you are standing up or laying down, and it’s in a different position when you’re putting your body weight on it by sitting (and especially if you’re sitting leaning part way back, that puts even more of your body weight and pressure onto the tailbone).
  • So in the chapter, Chapter Six, is really, really super important because for people who are suffering with tailbone pain if you have not had an evaluation to see if you have dynamic instability, hypermobility (again all saying the same thing here), if you have not had that evaluation done with sitting-versus-standing x-rays, then really you have not had the appropriate or adequate testing to find the cause of your tailbone pain.
  • So the chapter goes into a lot more of the details really the point of the video is just to give you a taste for the topic and that allows us to have more of a dialogue in the comment section down below.
  • For more of the details they’re certainly in here about different types of dynamic instability.
  • This shows one type which is where there’s what’s called listhesis or sliding.
  • But there are other types as well. There are patients who have a tailbone that flexes too far forward or too far backwards, which we can show that on this model.
  • (This model is a little worn down from over the years…)
  • But if you sit then the tailbone flexes or bends too far into the forward position.
  • Or in some patients it actually extends backwards.
  • Those are examples of increased mobility, or hypermobility.
  • Any of those can be painful because when you’re having that increased movement at the joint then you’re having extra mechanical stress and forces and pressure on the joint, which can be very painful.
  • Just like if my thumb was going into this kind of a dislocation,   if it was shifting that much of course it would be painful.
  • And any doctor or clinician would understand that.
  • But at the tailbone unfortunately it’s a little bit “out of sight out of mind.”
  • Physicians are not aware of this phenomenon at the tailbone, even though they’re well aware of it in other parts of the body and throughout the rest of the spine.
  • So again it becomes really important to have the appropriate testing done to evaluate for that. There are specific criteria for how much movement there is supposed to be at the tailbone in terms of that sliding or movement forward and backward up to 25% of the of the width of the of the actual bone itself.
  • There are cut-offs also for how much the tailbone is supposed to flex forwards when you sit and put your body weight onto it.
  •   The original sources typically say flexing forward by 20 degrees.
  • And again if it’s moving more than the standard normal amount, then that by definition would be hypermobility or increased mobility.
  • So I go into a lot of that here in terms of the different types of hypermobility and the tests that can be done, which as we mentioned is the sitting versus standing x-rays.
  • You do the x-rays in the side view looking from both positions: while you’re sitting and also while you’re standing. And then we compare because that comparison is really what’s important: to see how much movement there is when you go from one position to another.
  • So that’s the general idea.
  • The toughest part which is actually the last part here, which is   where can you find a place that will do this sitting versus standing x-rays.
  • And that becomes a real challenge unfortunately for many many patients, because again most radiology departments are not familiar with this. There is information that that is available online that will help to   give instructions to the radiology centers or certainly you can share with them the information that’s in the book so that that can help you to   get things going in the right direction hopefully.
  • But admittedly I do understand it is an uphill challenge for places that are not familiar with it to convince them to do the appropriate testing.
  • So that’s the general the general gist.
  • There’s a lot more detail in here but I’m trying to keep the videos   less than 10 minutes and really just to provide an opportunity then for us to discuss down in the comment section down below.
  • So post your comments down there and myself and others can interact and comment on the topic.
  • So if you have questions about sitting versus standing x-rays or hypermobility at the coccyx post your comments down below.
  • If you’re looking for a copy of the book, the easiest way to find that is to go to www.TailboneBook.com
  • and if you’re looking to find me online, or to come for evaluation here, the easiest way to find me is to go to the website www.TailboneDoctor.com
  • I hope that’s helpful.
  • Post your comments down below.
  • Bye-bye, now.
Here is the actual VIDEO:

Here is the screenshot thumbnail image for the video:
Chapter 6 of Tailbone Pain Book, UNSTABLE JOINTS Causing Coccyx Pain, Hypermobility, Dynamic Instability

Chapter 6 of Tailbone Pain Book, UNSTABLE JOINTS Causing Coccyx Pain, Hypermobility, Dynamic Instability

 To get your copy of the book “Tailbone Pain Relief Now!” go to: www.TailboneBook.com
For more information on coccyx pain, or to be evaluated at Dr. Foye’s Tailbone Pain Center in the United States, go to: www.TailboneDoctor.com
Patrick Foye, M.D.
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Patrick Foye, M.D.

Founder and Director at Tailbone Pain Center
Dr. Foye is an expert at treating tailbone pain (coccyx pain).

His personable, private-practice office is located on a modern, renowned, academic medical school campus, at Rutgers New Jersey Medical School.

For an appointment, call 973-972-2802.

http://tailbonedoctor.com/
Patrick Foye, M.D.
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