Patrick Foye, M.D. asks you to “Submit Your Tailbone Questions,” so he can ask and discuss them with other worldwide experts at the 2nd International Coccyx Pain Symposium, in The Netherlands, in late June 2018.
Dr. Foye will be giving lectures on non-surgical treatment of tailbone pain.
The Egg-Sitter is one of Many Different Cushions for Tailbone Pain, Coccyx Pain
There are many different types of cushions used by people suffering from coccyx pain (tailbone pain).
Patients come to the Coccyx Pain Center from around the world, bringing their coccyx cushions with them.
Sometimes if someone has a type of cushion that I have not previously done a video on… I will ask them if I can borrow it for a few minutes to make a video about that type of cushion.
This is one of those videos. It is about the Egg Sitter Cushion. This is a honeycomb style of gel cushion.
Here is the video:
Here is a photo screenshot from the video:
EggSitter Cushion for Tailbone Pain, Honeycomb Gel Cushion for Coccyx Pain
New Book Chapter on Coccyx Fractures and Tailbone Dislocations, Last Chapter in New Medical Textbook
In this video, Dr. Foye discusses the chapter he wrote on Tailbone Fractures and Coccyx Dislocations.
This is the very last chapter in a recently published medical textbook.
Patrick Foye, M.D., is director of the Coccyx Pain Center at Rutgers New Jersey Medical School.
Dr. Foye has many publications in medical journals and medical textbooks, especially on the topic of coccyx injuries and tailbone pain. He also lectures on this topic within the United States and internationally.
This book chapter will help physicians understood more about how to evaluate and treat fractures and dislocations of the coccyx.
Here is the TEXT from the video: (The actual VIDEO is lower down on this webpage.)
This video is about a new medical textbook that just came out (it’s 2018) with a chapter about coccyx dislocations and fractures (tailbone dislocations and fractures).
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.
And just within the last couple of months I announced a different medical textbook, which was this one.
It was an atlas of spinal injection procedures.
And that was one where I had written a chapter on ganglion Impar injections for this medical textbook.
But now there is just another one that came into print.
This one is not so much on procedures but on general musculoskeletal, sports and spine disorders.
And this is a medical textbook mainly for physicians that practice musculoskeletal medicine (that treat sports injuries and other musculoskeletal injuries).
And basically the idea of this book is to help those physicians to learn about different topics.
And in this book the chapter that I wrote is specifically on coccyx fractures and dislocations.
It is the very last chapter in the book.
The idea of these chapters that I write in medical textbooks…
I’m an academic physician in the sense that I’m full-time faculty at a medical school and educating not only patients but also educating physicians.
It’s a large part of what I do as part of my profession, as part of my career, and in this case really trying to spread knowledge about how to evaluate and treat patients with tailbone injuries.
So… many, many patients fly in to see me from around the country and occasionally internationally.
And very commonly one of the things they’ll say is that their local doctors did not know very much about how to evaluate their coccyx pain (tailbone pain) or coccyx injuries (tailbone injuries) and let alone how to treat them.
So in addition to the things that I publish and write for patients I also try of course to continue publishing for other physicians to help them with understanding these conditions as well.
So it is the very, very last chapter in this book.
So… Chapter 102 out of 102 chapters.
So the tailbone comes at the end. But that’s fine because it’s in there.
So hopefully this will serve as a valuable resource for physicians.
You can see that this chapter is specifically on coccyx fractures and dislocations.
This image here showing a fracture at the tailbone and then the text describing all about that.
Basically discussing here everything from the definition as far as fracture versus dislocation.
The diagnosis of fractures and dislocations.
There’s another image here you may like to see.
This is showing a dislocation at the coccyx or tailbone right there where the arrow is pointing.
Talking about the things to consider…
How to make the diagnosis by your history… your physical examination findings…
The different types of imaging studies…
Getting the appropriate x-rays or MRI or in some cases CT scans bone scans, etc. depending on the specifics in a given patient…
And then talking about the different treatment options.
So, again… many patients who are watching my videos will know me from either the videos or the online articles that I write, or from the book that I’ve written specifically for patients, which is “Tailbone Pain Relief Now!”
But the bulk of what I do over the last twenty some years in academic medicine is actually working to educate physicians as well, which is through textbook chapters and things along those lines.
So it is the last chapter but the important thing is that it’s in there to serve as an educational resource for physicians who are evaluating patients with tailbone pain.
So this is one book I would recommend certainly if you’re a musculoskeletal physician interested in learning more about a wide variety of musculoskeletal conditions.
This is available through Springer which is a major medical publisher.
Or certainly available through your medical textbook bookstores and online of course at Amazon etc.
If your patient more interested in reading from a patient perspective.. that book as this is more geared for physicians.
This book Tailbone Pain Relief Now! is geared towards patients.
And this is 272 pages.
And it has chapters specifically on tailbone fractures and chapter on tailbone dislocations as well as a wide variety of other tailbone-related conditions.
This book you can get online.
The easiest way is by going to www.TailboneBook.com and it will give you the links to the appropriate pages on Amazon in your different countries and things of that nature.
You can get the book either as a paperback copy or in an electronic book e-book version.
So that’s information about the books and about the new publication.
For me it’s always exciting.
This project for this textbook I’ve probably been working on for about I’m going to say about three years since I first started or was asked to write the chapter.
It takes a relatively long time for things to come to print within the world of medicine.
So I just thought I’d share that.
It’s always nice when it finally comes in print because that’s when it can go out and make a positive difference hopefully in the world.
If you’re interested in coming to see me or find more information that I have about tailbone pain you can find that on my website which is www.TailboneDoctor.com
Bye bye.
Here is the video:
Here are photos and screenshots from the video:
Coccyx Fracture and Dislocations, Tailbone Pain, Chapter in Textbook on Musculoskeletal Sports and Spine Disorders, by Patrick Foye MD
Coccyx Fractures and Dislocations, Tailbone Pain, Chapter in Textbook on Musculoskeletal Sports and Spine Disorders, by Patrick Foye MD
Severe Tailbone Dislocation on coccyx X-ray, causing coccyx pain, tailbone pain, coccydynia
I am happy to report that The Journal of Emergency Medicine has just published my research article, titled, “Tailbone Pain from Coccyx Injuries on Water Slides: A Case Series.”
Waterslides Causing Coccyx Injuries, Patrick Foye, Journal of Emergency Medicine, 2018
The Journal of Emergency Medicine has the article available online here:
(Note: the journal does charge a fee if you want to read more than just the abstract/summary.)
When: Wednesday, May 9, 2018, at 12:00 noon eastern time (New York City time).
Why: I already am on Twitter, Google+, Facebook, Pinterest. Reddit is a way to educate a new group of people about tailbone pain.
Limitations: I generally avoid giving actual individual medical advice online to those who I have not evaluated in person. But I can provide information and answers that you can discuss with your in-person treating physician.
Watch the VIDEO:
Here is the screenshot thumbnail image for the video:
Reddit, AMA Ask Me Anything about Tailbone Pain, Coccyx Pain, Coccydynia
And this is the next in this series of videos going chapter by chapter through my book Tailbone Pain Relief Now.
The idea is to give you highlights of each chapter and provide a format where we can interact and have questions and conversations about the chapter by putting your comments down below the video.
So here now we are up to chapter number 12, which is Sympathetic Nervous System Pain at the Coccyx ,or causing tailbone pain essentially.
And the idea here is that our pain pathways are set up to sort of sound an alarm system.
So if I touch my hand to a hot stove, the pain will signal me to pull my hand away from the stove and then the pain should stop.
But sometimes at the tailbone what happens is that somebody has a bone spur or a dislocating bony segment or arthritis and the pain doesn’t stop.
The pain is painful every time the person sits.
They’re not able to get relief either because their local doctors are not able to give them an accurate diagnosis or an effective treatment plan.
So the pain goes on and on day after day week after week month after month.
And after a while, the nerves themselves can become hypersensitive and hyper irritable.
And at the tailbone there’s a particular type of nerve structure that’s there that’s part of what’s called the “sympathetic nervous system.”
And the “sympathetic” nervous system has nothing to do with feeling “sympathy” or empathy for the person that’s having pain.
It’s just the medical term for that type of nerve pathway.
The sympathetic nervous system is known as the part of the fight-or-flight response.
So the idea is that if for example thousands of years ago if a saber-toothed tiger or something were to attack us as humans, then we would have a response where we’re either going to fight it off or we’re going to run away. So, fight or flight.
And the idea is that when we have a perceived threat we’re going to react to that.
And lots of things happen as part of that sympathetic nervous system: our blood pressure goes up, our heart rate goes up as our heart beats faster to get more blood out to our brain and to our muscles and our pupils get bigger so we can look around and assess the threats.
All kinds of chemicals are released in our body. So things like adrenaline, epinephrine is sort of running through our system.
So it’s really this sympathetic nervous system response that happens.
Now, very interestingly, the entire sympathetic nervous system has this pathway where the sympathetic nervous system is right along the spine on each side right and left.
But when it gets down to the tailbone instead of having a right and left ganglion or hub for each of the stopping points along the way for the sympathetic nervous system, there’s just one at the midline and that’s called the ganglion impar.
And impar means solitary or unpaired because it does not have a right and a left.
It has just the one at the midline and that’s located right at the level of the upper coccyx.
So now you have this pathway for sort of sounding the alarm when there’s a threat to you.
And the very final train stop (if we want to call the ganglion that)… the very final hub or stop along the way of the sympathetic nervous system ganglion (those chains of nerves that are linked together)… the very final one is right at the front of the tailbone.
So you can imagine that if there’s a cause of tailbone pain such as a dislocation, an unstable joint, arthritis in the joint etc, that the local pain driving that irritation in the area can start to have a phenomenon where in addition to the musculoskeletal cause of pain, there can actually also be a nerve pain on top of that.
So nerves are hyperirritability or hypersensitivity in that area.
So that’s part of the sympathetic nervous system that can be painful at the coccyx.
And this becomes really important because if you only treat the musculoskeletal cause of pain without also treating the nerve pain then to the patient they just know that they still have pain.
And the doctor and the patient maybe are not aware of why the pain is persisting.
So, maybe there was a bone spur or arthritis or a dislocating segment and perhaps there was an anti-inflammatory injection done to help with the musculoskeletal pain and inflammation.
But the pain persists and the pain persists in those cases perhaps because the sympathetic nervous system is irritated and nothing was done to quiet that down as well.
So, often it can be helpful to, in addition to treating the musculoskeletal cause of the pain, to also put some local anaesthetic such as Lidocaine, etc., on that sympathetic nerve ganglion, that ganglion impar at the coccyx.
How you would do that depends. It needs to be “custom done” essentially depending on the specific anatomy of a given patient.
I’ve published a number of different techniques for doing this.
The original publication was way back in the 1990s by Dr Plancart down in Mexico City.
But I’ve more recently published other techniques.
This is an area I lecture on quite a bit.
But basically, that’s the idea as far as the ganglion impar and sympathetic nervous system pain.
Other examples of sympathetic nervous system pain that happen in the body… sometimes people may be familiar with things like R.S.D. or Reflex Sympathetic Dystrophy or Complex Regional Pain Syndrome (sometimes abbreviated as C.R.P.S.).
Those are conditions where there’s essentially a hyperactive, irritable sympathetic nervous system causing pain usually in an arm or a leg.
And doing a local anesthetic block for that limb, that arm or leg, can give a lot of relief.
And, similarly, doing a sympathetic block for patients with a sympathetic nervous system pain at the tailbone can give a lot of relief in that area.
So that’s the general idea.
There is a lot more information, of course, within the chapter, within the book.
So, again, Chapter 12 about that type of nerve pain at the coccyx.
If you have further questions or comments on that, definitely post them in the comments down below.
I’ll be interested to read those and respond to those and I’m sure others will find your comments helpful as well.
If you are looking for a copy of the book, the easiest way to get that is to go online at www.TailboneBook.com
And from that web page I have the links to the Amazon sites in different countries and such that you would use to purchase the book, depending on where you are located.
You can get the paperback book, the whole thing is two hundred and seventy-two pages.
Or you can get it as an e-book, an electronic book which you can basically download for a couple of dollars. And that’s available anywhere in the world where you have internet access. You can get the electronic book and you can read that online, you don’t need any special device other than however you access the internet.
So anyway, I hope that that information is helpful for you.
If you have questions, again, post them down below.
To get the book, go to www.TailboneBook.com.
And to find me online or to come for an evaluation here at the Coccyx Pain Center, you can find me by going to www.TailboneDoctor.com.
All right, I hope that’s helpful.
Bye-bye now.
Here is the actual VIDEO:
Here is the screenshot thumbnail image for the video:
Chapter 12 of Tailbone Pain Book, Sympathetic Nervous System Pain of the Coccyx, Causing Tailbone Pain, Coccyx Pain
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
Below (at the bottom of this page) is a VIDEO of Dr. Patrick Foye, M.D., who will be giving lectures at the conference.
Dr. Foye will be giving two lectures on non-surgical treatments for coccyx pain (tailbone pain, coccydynia).
Dr. Foye will post updated information from the conference, either during or after the coccyx, as much as possible.
Here is the text from Dr. Foye’s video:
This video is about the upcoming second International Coccyx Pain Symposium, which will be taking place in the end of June 2018 in the Netherlands.
I’m Dr. Patrick Foye. I’m an M.D. or Medical Doctor and Director of the Coccyx Pain Center here in the United States.
I’m online at www.TailboneDoctor.com.
And this upcoming conference is online at www.Coccyx Symposium2018.com.
So, the first International Coccyx Pain Symposium was two years ago in 2016, that was in Paris, France.
It was a terrific success. I got to meet clinicians and researchers, anatomy folks etc, from literally around the world who came and spoke at or attended the first International Coccyx Pain Symposium, in Paris.
And that was really, really terrific.
People whose research I have been reading for years… to be able to meet them in person and really learn a lot from different people in different specialties.
And I’m really optimistic that this second International Coccyx Pain Symposium will be a terrific success as well.
There is a wide variety of different speakers represented, both physicians and non-physicians and within physicians there are surgeons and non surgeons and other specialties.
So it really gives a diverse bunch of different viewpoints as to how different doctors or clinicians in different specialties may approach patients who have similar problems.
And really that’s how we all learn from each other.
Coccyx pain is a rare and uncommon enough condition that for many of us who treat this we don’t have a lot of other physicians around us who have a lot of experience in treating this as well.
So it’s really valuable to have a conference like this where many of us from around the world get together and exchange ideas about the best ways that we can help these patients.
The speakers: there’s more than a dozen speakers from literally around the world.
So right from within the Netherlands there are a number of physical therapists who be speaking so Pelvic Floor Physical Therapist for example.
There is a Colorectal Surgeon from the Netherlands as well.
There are Orthopedic Surgeons from both Paris, France, and also elsewhere in France, and two Orthopedic Surgeons will be coming down from Norway.
There is a Physical and Manual Medicine and Rheumatology Physician from Paris, France, who is certainly well known for his work in coccyx pain, he will be speaking as well.
There is a Physical Medicine Rehabilitation and Pain Physician from Turkey who will be speaking, an Anesthesiology Pain Physician from the United Kingdom who will be speaking, a Chiropractor from the UK as well, a Physicist from the UK who is a patient advocate representing the patient perspective for people suffering with tailbone pain, there is an anatomy PhD researcher who is coming all the way from New Zealand who specializes in some of his research specifically about issues related to the anatomy of the tailbone.
And I’m sure there’s others I’m forgetting as well.
I’ll be speaking, giving a couple of lectures as well,.
So I’ll be coming from the United States.
So again, a wide variety of speakers.
I’m really looking forward to the conference and I’ll be of course posting information from the conference and maybe doing some live streaming if I have adequate Wi-Fi while I’m there to do so.
So if you’re interested in the conference, it’s mostly attended by clinicians but if you have an interest in the coccyx or tailbone pain in general you may be interested in attending, if you’re anywhere able to reach the Netherlands in the end of June.
Again, the information for that is online at www.CoccyxSymposium2018.com.
Or I’ll be putting more information up about it as it’s upcoming and as I attend the conference myself.
Should the Coccyx Bones be Fused Together? Does that Cause Tailbone Pain?
There is a lot of variability from person to person regarding fusion of the coccygeal joints.
The Completely Fused Coccyx: A Rigid, Non-mobile Tailbone
In some people, the entire coccyx is fused, meaning that the individual bones of the coccyx are fused into one solid bone.
When this happens, there is no mobility or movement possible. In that situation, the tailbone is stiff or rigid.
A stiff, rigid coccyx is not able to move out of the way when you sit. So, it may be more prone to pressure and pain while sitting.
The Completely Patent Coccyx: a Tailbone where None of the Joints are Fused
In other people, the individual joints may all be patent (not fused).
When those joints are patent, it means that there can be movement at those joints.
The movement of those joints could be either normal or abnormal, depending on how sturdy the ligaments are.
Ligaments attach one bone to the next bone. If the ligaments are torn, stretched, or loose, then there can be excessive movement at the joint (also called hyper mobility or instability).
The best way to assess for hypermobility is by doing sitting versus standing x-rays and comparing the position of the tailbone while someone is standing compared with while they are sitting. You can read more about sit-stand coccyx x-rays here at this link.
A Coccyx where SOME Joints are Fused and SOME Joints are Patent
Many people have some of their coccygeal bones fused together, while some of their other joints at the coccyx are not fused.
The take home message is that this varies from patient to patient.
It is important to CORRELATE the imaging findings with the exact site of the patient’s pain.
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
