Tailbone Pain Despite Surgery (Coccygectomy)

Many patients ask me what to do about tailbone pain that continues or returns despite the person having undergone surgical removal of the tailbone (coccygectomy).

Find the CAUSE of the ongoing tailbone pain after coccygectomy
  • In general, it is important for the treating physician to start by searching for an underlying cause for the current pain.
  • Imaging studies:
    • Often I find that despite many months and years of pain  the treating physicians have failed to order any imaging studies of the surgical site.
    • This would be extremely uncommon in the other body regions. If someone had severe persistent or recurrent pain despite surgery at their lower back,  shoulder, knee, etc.,  typically the treating physicians would obtain current, up-to-date imaging studies to try to find the cause of the pain.
  • Did the surgery address the specific problem?
    • Sometimes the pain may be caused by the surgery having failed to address the actual problem that was causing the pain in the first place. For example, perhaps the pain was being caused by an unstable joint at the upper part of the coccyx, but the surgery only removed the lower part of the coccyx. In that case, the problematic joint still remains, and so it continues to cause painful problems.
  • Or, perhaps a new problem has occurred. For example, sometimes there might be a bone infection (osteomyelitis) at the surgical site.
  • Updated imaging studies can be helpful in these situations.
  • Imaging studies of the coccyx after coccygectomy can include x-rays, MRI, CT scans, and sometimes triple phase bone scans.

 

 

Patrick Foye, M.D.

Founder and Director at The Tailbone Pain Center
Patrick Foye, M.D.
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2 comments to Tailbone Pain Despite Surgery (Coccygectomy)

  • Alex

    I went to my first pain clinic visit after the surgery and the doctor thinks I need an epidural injection. It’s only been 3 months. Isn’t it too soon for that? Shouldn’t you wait a little longer before resorting to that?

    • hi, Alex. I’m very sorry to hear about your pain.

      While of course I cannot give you specific medical advice online or to patients I have not met, overall I would say a question about whether it’s too soon to have an epidural depends on many factors.

      First and foremost is a question as to what is the source of the pain. If it is truly tailbone pain (coccyx pain) then epidural steroid injections are typically not very helpful.

      Epidural injections tend to be more helpful for pain that travels down the leg (lumbar radiculopathy) rather than for tailbone pain.

      You should discuss this with your treating physician.

      I hope my thoughts have been helpful. I wish you well.

      – Patrick Foye, M.D.

      Founder and Director at The Tailbone Pain Center

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