GET THE BOOK: To get your copy of the book “Tailbone Pain Relief Now!” go to: www.TailboneBook.com or go to Amazon.
COME FOR RELIEF: For more information on coccyx pain, or to be evaluated in-person at Dr. Foye’s Tailbone Pain Center in the United States, go to: www.TailboneDoctor.com
– Patrick Foye, M.D., Director of the Coccyx Pain Center, New Jersey, United States.
How Soon After a Coccygectomy can you have a Steroid Injection?
The answer is: “it depends.”
Most patients tolerate corticosteroid (steroid) injections very well. These injections can be very helpful for a wide variety of painful musculoskeletal conditions. But it is important to recognize that there are some people who are at increased risk of running into problems when receiving steroid injections. Let’s consider this further…
Some people have a weak immune system and you would want to avoid or be cautious about giving any steroid injections while they are recovering from surgery.
By “weakened immune system” we mean that the person has a decreased ability to fight off infections.
For example, some people may have a weakened immune system due to HIV/AIDS, cancer, chemotherapy treatment, immunosuppressant medications after organ transplantation, etc.
In those situations, it may sometimes even be advisable to have a consultation from a physician specializing in “infectious diseases” or immunology, in order to get a formal opinion regarding whether a steroid injection would be likely to be problematic or not.
People with diabetes should be aware that sometimes steroid injections can cause an increase in their blood sugar levels. This is especially true if their baseline blood sugar levels are already high even prior to injection. That is typically in people who do not have their diabetes under adequate control.
After coccygectomy, there is a significant risk of infection at the surgery site. So, it makes sense to be cautious about giving a steroid injection at the surgery site, since doing so may even further increase the risk of infection at that surgery site. This is mainly true during the initial weeks/months after the surgery.
So, there may be some increased risk of infection at the coccygectomy site if there is a steroid injection done close to the coccygectomy site, especially within the first couple of months or so. After that, the risk would never be zero, but would be expected to be less and less the further someone is out from the coccygectomy.
Steroid injections at OTHER parts of the body:
The further away the steroid injection is from the surgical site, the less likely it is to cause any infection or other problems at that surgical site.
For example, a steroid injection at the sacroiliac joint would be less likely to be problematic than an injection directly at the coccygectomy surgery site.
An injection up at the lumbar spine is even further away from the coccygectomy surgery site, and therefore would be expected to be even less likely to cause problems at the coccygectomy surgical site.
An injection even further away than that (such as an injection in the arms or legs) is even further away from the coccygectomy site and therefore would be expected to be even less likely to cause problems at the coccygectomy surgery site.
Of course all of this would need to be considered/discussed with the in-person treating physicians.
GET THE BOOK: To get your copy of the book “Tailbone Pain Relief Now!” go to: www.TailboneBook.com or go to Amazon.
COME FOR RELIEF: For more information on coccyx pain, or to be evaluated in-person at Dr. Foye’s Tailbone Pain Center in the United States, go to: www.TailboneDoctor.com
– Patrick Foye, M.D., Director of the Coccyx Pain Center, New Jersey, United States.
Screen capture image of the publication in the journal Pain Medicine:
Stigma Against People with Coccyx Pain, Tailbone Pain, Published in Pain Medicine
GET THE BOOK: To get your copy of the book “Tailbone Pain Relief Now!” go to: www.TailboneBook.com or go to Amazon.
COME FOR RELIEF: For more information on coccyx pain, or to be evaluated in-person at Dr. Foye’s Tailbone Pain Center in the United States, go to: www.TailboneDoctor.com
– Patrick Foye, M.D., Director of the Coccyx Pain Center, New Jersey, United States.
Regarding “Bone Scans” for Tailbone Pain, Coccyx Pain…
Someone recently asked me to explain the difference between a DEXA Scan and a Nuclear Medicine Bone Scan.
DEXA: A dual energy X-ray absorptiometry (DEXA) scan, also called a bone density scan, is a common technique used to measure bone density. This test is basically done to assess for osteoporosis. I do not believe that there are any “normal values” that have been established/published for the expected bone density at the coccyx. Typically the DEXA scan is done at the lower back (lumbar spine) and hip bones. I have never heard of a DEXA scan being used at the coccyx and I do not think that it would have any role there. So, in general, if someone’s “bone scan” was a “DEXA” scan (or a “bone density” scan), then it almost certainly was NOT being done to evaluate the coccyx.
Nuclear medicine bone scan (such as a technetium 99m scan): this is a nuclear medicine study sometimes used to assess for problems of the brain, heart, bones, etc. It can be helpful sometimes at looking at blood flow to a given area, and essentially the radioactive material is generally injected into the bloodstream and the SPECT test is used to show the blood flow to different areas. Sometimes an area of abnormality may have increased blood flow, for example, which can then be detected because you can see the increased amount of the radioactive material going to the area of increased blood flow.
Regarding SPECT: This is essentially a combination of a nuclear medicine bone scan plus a CT scan (computerized tomography scan), to show additional details at bones.
Typically, if there is evidence of an abnormality on the x-rays, MRI, or CT scan, and if there is concern as to whether this might be something more worrisome (such as cancer within the bone, or infection within the bone), then a nuclear medicine bone scan can sometimes be done to look further at whether the suspicious site essentially seems hyperactive. Basically, it can be done to try to assess whether the “abnormality” seen on the x-rays or MRI or CT scan is something more ominous, or not. For example, sometimes the bone scan will show an underlying cancer (malignancy) or bone infection (osteomyelitis).
Overall, it is probably less than 1% of patients with coccyx pain that will need a nuclear medicine bone scan. But in those few cases, it can be very important.
The most challenging situations are sometimes those where the results are not definitive (meaning that the tests are not able to conclusively determine whether a given site is normal or abnormal). Or,there are instances where there is a notable “abnormality” such as a cyst or other finding within the bone, as seen on the x-rays or MRI or CT scan, but where it remains unclear what is “causing” that to be there. An aggressive approach would be to do a bone biopsy at that site, so that tissue could be sent to the pathology department to make sure that it is not a cancer. But, such procedures are painful and they do have their own risks as well. Also, sometimes even a biopsy can fail to give a conclusive diagnosis. Challenging topic.
GET THE BOOK: To get your copy of the book “Tailbone Pain Relief Now!” go to: www.TailboneBook.com or go to Amazon
COME FOR RELIEF: For more information on coccyx pain, or to be evaluated in-person at Dr. Foye’s Tailbone Pain Center in the United States, go to: www.TailboneDoctor.com
– Patrick Foye, M.D., Director of the Coccyx Pain Center, New Jersey, United States.
Dr. Patrick Foye reviews his thoughts on 30 years since first coming to New Jersey Medical School (NJMS).
Dr. Foye arrived at NJMS in ~August-September 1998, starting medical school.
At the time, NJMS was part of UMDNJ (the University of Medicine and Dentistry of New Jersey).
He graduated from medical school 4 years later, receiving his M.D. in 1992.
After residency, Dr. Foye returned to NJMS in 1996 as a faculty member and since then he has treated thousands of patients here and educated thousands of medical students, resident physicians, and allied health professionals.
Here is the video:
Here is the photo/screenshot from the video:
New Jersey Medical School, 30 Years and Counting, Since 1988. – Patrick Foye, MD
30 years at NJMS, Patrick Foye MD, Rutgers New Jersey Medical School
In the video below, Patrick Foye, M.D., discusses the 3 years since publishing the book: Tailbone Pain Relief Now!
The book is all about: Coccyx Pain, Tailbone Pain, Coccydynia.
Here is the Text Transcribed from the video: (The actual Video is down below the text.)
This video marks the three-year anniversary since the publication of my book: Tailbone Pain Relief Now! and I really wanted to take this opportunity to reflect on the past three years since the book came out.
I’m Dr. Patrick Foye.
I’m an MD or medical doctor.
And I’m the director of the Coccyx Pain Center or Tailbone Pain Center here in New Jersey in the United States.
And I’ve been the Director of the Tailbone Pain Center here for many many years…
almost 20 years now.
And really the idea to write a book for patients is something that was on my to-do list for more than a decade before I actually took on the project and did it and completed that.
And it was published about three years ago, in September of 2015, so three years ago this month from the time that I’m making the video now.
And really it has been a terrific experience writing the book and putting things down in what I hope is an organized and easy to read of me way.
And prior to that most of the things I was publishing were really things that I was publishing for other physicians.
And I still do a lot of that.
I’m a Professor here at the Medical School.
so I write book chapters, and research articles in journals, and I give Grand Rounds lectures, and lectures at national and international conferences and all of those kinds of things.
And I teach our medical students here…
I’ve trained thousands of young doctors over the years.
And the idea for the book though was to write something that was NOT for physicians, but rather that was for people that were actually suffering from tailbone pain.
And one of the things I’ve found is that people have a tough time finding information.
they have a tough time finding doctors who understand their condition.
So the idea for the book was as a means or a way to empower patients with knowledge, because with the knowledge of how to navigate the healthcare system and advocate for themselves and describe to their doctors the proper types of x-rays or MRI or CT scan that they might need or treatment options, because a lot of doctors unfortunately don’t know that much about this area.
Compared to low back pain for example tailbone pain is probably ten or twenty thousand times less common.
So many doctors and radiology centers just are not that familiar with evaluating or treating problems of the tailbone or coccyx.
So the idea of the book was to put all of that in an organized fashion.
the first half of the book is mostly about diagnosis for tailbone pain: the various things that can cause tailbone pain…
Everything from fractures and dislocations and arthritis and unstable joints and bone spurs and cancer or malignancy in the area and a whole variety of other things.
And then the second half of the book is all about treatment…
Everything from cushions and physical therapy and manipulation and local injections and medications by mouth and surgical removal of the tailbone.
So each of those different topics that I just mentioned and many more have their own chapter in here.
So that there’s more than 30 chapters in all, 272 pages all about the coccyx or tailbone.
I can hold up the table of contents here if you want to see some of that for what’s in there.
But really I wanted to take this opportunity to reflect on what it’s been like in the three years since the book came out.
First of all in the making of the book my publishing team sort of thought I was crazy because it is such a small focal niche area to write a 272 page book about a part of the body that is about half the size of your pinky finger.
To some of them this seemed a little bit crazy and mostly I had publishing companies that wanted me to change it into a book about low back pain in general.
And certainly again low back pain is far more common and from a publisher perspective I can understand how publishers would be more interested in a book on low back pain because again there’s 10 or 20 thousand times more potential interested readers.
But the problem with this is that there really was nothing previously available for as in a book form for people who are suffering from tailbone pain, whereas there are many resources and books available specifically on the topic of low back pain.
So really my focus was to stay specific to the coccyx or tailbone.
And it may seem crazy to have 272 pages all about that but I really wanted to have a comprehensive and easy to read sort of manual for people to go by as they’re figuring out or understanding what seems to be causing their pain.
The response has really been terrific.
There’s certainly not a huge number of the books printed compared to something on low back pain, but there have been a couple thousand copies of the book now out in circulation largely through Amazon or Barnes and Noble’s and other places online that that people can obtain the book.
I have heard from people who’ve read the book in essentially every continent on the planet except for Antarctica.
So if you’re making a trip to Antarctica and you take the book along send me a photo of you there so we’ll complete the continents with that.
But it has really been one of the most gratifying academic projects that I’ve done in a quarter of a century or more now as a physician, really empowering patients with the knowledge that they need to understand what’s causing their pain and the best ways to work with their doctors for treatment.
So I’ve had people who have emailed me or contacted me and have told me specifically parts of the book that became helpful to them or how it helped them to have a conversation with their treating physician about everything from as simple tips in here like how to find a physician who’s experienced in this area or what types of x-rays or MRI or CT scan or other things might be most helpful or how to evaluate whether the radiology report even shows that whether this study even included the coccyx or how to look at the imaging studies with your treating physician and ask them to specifically point to the tailbone.
That one tip alone is probably one of the most common things that I hear from people around the world who say I had my my MRI or x-rays done two or three or four years ago I was told everything was fine when I read the book and it said have your doctor point out to you point out your tailbone on the imaging studies and very very common that it will turn out that the tailbone was not included at all on the x-rays or MRI and physician were told was normal…
Or that it was included but there was a blatant of abnormality that the radiologist missed.
And then that lays the groundwork for further treatment and and changing things from something that may at times seem hopeless to a patient, to something that really is treatable with the careful and thoughtful approach by an by a physician or medical team experienced in evaluating and treating the coccyx…
Or even if they’re not as experienced as ideally they would be, if they’re at least open to learning more about that area then there’s a lot of information that can be helpful.
Again it’s written mostly for patients, this particular book, but there’s a lot of information that doctors could learn as well.
In fact if you’re a patient and you read this book, these 272 pages, I guarantee you you will know more about coccyx pain than 99.9% of physicians out there.
So at any rate those are some of my thoughts now three years since the book was first published and it’s been really one of the most gratifying things that I’ve done as a physician as far as academic projects.
And really the whole goal of course is to try to make a positive difference in the world wherever we can just like all of us try to in our in our day to day lives.
So if you are looking for the book you can get that either online at amazon.com or Barnes and Noble’s or other places you can get it or through the website www.TailboneBook.com if you’re interested in coming to see me in person easiest way to find me online is www.TailboneDoctor.com and again this is just some of my thoughts on three years since the book first came into publication.
Okay. if you have comments on the book or feedback on the book certainly post that online at Amazon that would be helpful or if you have questions you can post them dow below this video and I’ll be happy to to read those and hopefully respond as well.
Okay. Bye bye.
Here is the video:
Here is a screenshot image from the video:
3 years for coccyx pain book, Tailbone Pain Relief Now!
GET THE BOOK: To get your copy of the book “Tailbone Pain Relief Now!” go to: www.TailboneBook.com or go to Amazon
COME FOR RELIEF: For more information on coccyx pain, or to be evaluated in-person at Dr. Foye’s Tailbone Pain Center in the United States, go to: www.TailboneDoctor.com
– Patrick Foye, M.D., Director of the Coccyx Pain Center, New Jersey, United States.
Someone recently asked me whether it was possible for someone to have coccyx pain being caused by TWO different causes in the same patient.
Yes, it is certainly possible for patients to have more than one location of coccyx problem.
For example, I frequently see patients who have both the most common cause of coccyx pain (hypermobility, diagnosed by sitting-versus-standing x-rays) and they may ALSO have the 2nd most common cause of coccyx pain, which is a bone spur at the distal/lowest tip of the coccyx.
Or, some patients may have pain being caused by hypermobility or other abnormalities at TWO different joints within the coccyx, not just one joint.
Or, a patient may have arthritis at the upper coccyx, and tables for at the lower coccyx.
Other combinations are also possible.
The best way to help figure all this out is to have a thorough and thoughtful medical evaluation by a physician who is experienced at evaluating and treating coccydynia (coccyx pain, tailbone pain).
GET THE BOOK: To get your copy of the book “Tailbone Pain Relief Now!” go to: www.TailboneBook.com or go to Amazon
COME FOR RELIEF: For more information on coccyx pain, or to be evaluated in-person at Dr. Foye’s Tailbone Pain Center in the United States, go to: www.TailboneDoctor.com
– Patrick Foye, M.D., Director of the Coccyx Pain Center, New Jersey, United States.
