Fortunately, someone with tailbone pain in the UK looked into this further and shared the following information with me. They do not want to be named or given public credit, so I will of course respect their privacy. But I do acknowledge and greatly appreciate their efforts and the information they provided, which is below.
They tracked down the Royal College of Radiologists (RCR) latest national guidelines, called iRefer. “They list conditions and recommended imaging, with comments. These form the basis of Trust guidelines.”
“So I spent £30 on the latest set of iRefer RCR guidelines…. Lo and behold, as of December 2017, they do recommend sit/stand x-rays in intractable cases (SEE PHOTO). They mention that these need to be done at specialist centres. We need to find out where these centres are – ask your local spinal surgeon about this. Your GP [general practicioner] is unlikely to know as it is a specialist investigation. I suspect that the message has not trickled down to all radiology departments… and guidelines at most Trusts haven’t been updated yet.”
Summary on UK coccyx x-rays:
Good News: In the UK, the Royal College of Radiologists does have guidelines (from year 2017) that do indeed recommend sit/stand x-rays of the coccyx in intractable cases of coccyx pain.
Bad News: In the UK (and much of the world), you still may have a challenging time finding a radiology center that knows how to properly perform and interpret the sitting-versus-standing xrays.
Those in the UK suffering from coccyx pain should share this Royal College of Radiologists iRefer guidelines with their treating doctors.
Photos of the Royal College of Radiologists iRefer guidelines book, section on coccyx x-rays for tailbone pain:
Royal College of Radiologists, RCR, iRefer, Guidelines
Sit-Stand-Coccyx-Xrays, supported by UK criteria from the Royal College of Radiologists, RCR, iRefer, Guidelines
Sit-Stand-Coccyx-Xrays, supported via UK criteria from the Royal College of Radiologists, RCR, iRefer, Guidelines
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
Here’s an idea to help improve surgical outcomes when coccygectomy is done for coccydynia, coccyx pain, tailbone pain:
Intraoperative X-rays During Coccygectomy, To Improve Surgical Outcomes for Coccydynia, Coccyx Pain, Tailbone Pain
I wrote this up and submitted it to a medical journal called “Pediatric Surgery International” and they published it this past week.
Over the past 20 years, many patients have come to see me due to persistent coccyx pain after coccygectomy (surgical amputation of the coccyx).
In many cases, we find that the surgeon accidentally left fragments of the coccyx behind. Depending on the location, these can be painful.
In other cases, the primary site of the coccyx problem was never removed by the surgery.So the pain persists.
These problems happen mainly because the surgeon has only a limited view through a small incision during this surgery into a small area.
My proposed solution is for surgeons to take x-rays immediately before starting the surgery and before ending the surgery. This way, the surgeons could be more confident about whether they removed all of the bones that they wanted to remove. The x-rays would also show if the surgeons left a sharp or pointy edge at the site where they cut through the bone. (This is important since a sharp, pointy edge can cause pain when you sit on it.)
I brought this up in the context of a case where x-rays were used during removal of a cancer in the coccyx region. My proposal is that this approach should also be used for coccydynia patients who do not have cancer.
I am very happy that this international surgery journal has published this.
I hope that surgeons will read this and start to follow this recommendation.
I think this can decrease the number of coccygectomy patients who have a bad and painful outcome.
Dr Foye’s Letter- X-rays during coccygectomy for coccyx pain, tailbone pain
PubMed – X-rays during coccygectomy for coccyx pain, tailbone pain
Pediatric Surgery International, Journal Cover
Intraoperative X-rays during coccygectomy, Regarding Coccyx Pain, Tailbone 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
MRI Tips on How To See a Broken Tailbone, Coccyx Fracture.
You Can See what the Radiologist Missed!
Patrick Foye, M.D. discusses MRI (Magnetic Resonance Imaging) showing of a Broken Coccyx, or Tailbone Fracture.
MRI shows a Fractured Coccyx.
Radiologists often FAIL to see these abnormalities!
The actual VIDEO is at the bottom of this page.
Here is the TEXT from the video:
Okay. This is just a short video showing a fracture of the tailbone, a coccyx fracture or tailbone fracture or a broken tailbone, broken coccyx, however you want to say it.
This is a coccyx injury that has resulted in a bony fracture at the tailbone.
I am Dr. Patrick Foye.
I am Director of the Coccyx Pain Center here in New Jersey.
Just a quick F.Y.I., these videos are meant of course purely for educational purposes, they are not to be considered medical advice or medical care. For that you should see a physician with experience in treating tailbone injuries and tailbone pain.
So getting back to this here, what I am looking at is an MRI study.
And just to get people oriented for starters, I am just going to move this kind of front and center here and what you’ll see is that an MRI study typically includes lots of different ways that the images are taken, lots of different slices from different angles and with different emphasis on what the signals are showing as far as how water and other content shows up on the images.
So here you can see many different ones.
Now if I click the mouse over these you’ll see that as you hover for a moment it will show you this is a “T2” image, it’s also a “sagittal” image.
As I hover over the next one here for a moment it’ll show you that that’s a “T1 sagittal” image.
So if you can see that on the image as each one shows up, these are axial images T1 and T2 axial images.
Some of these are more up at the lumbar spine, like this one that I have the cursor (or arrow) on now.
Whereas this one here does extend down through the sacrum and coccyx.
The point being: there are hundreds and hundreds and hundreds of images in a thorough MRI study.
And sometimes it will only be one or two images that show the actual pathology that’s occurring at the tailbone.
So it’s very important that the evaluating physician look through the images carefully to look at the site where the person is actually having the pain, to make sure that the tailbone is included in the images and then to look and see whether it looks normal or abnormal.
What I’m going to do now is just to move this overview out of the way and I’ll show you some of the images that I’ve pulled up here, again just for educational purposes.
So it’s called a T1 sagittal image.
Sagittal images: you can think of slices being done from left to right.
So if a slice went right down the midline of the patient separating them into a right half and a left half, that would be a sagittal image.
And that’s what you can see here in this particular image.
Here up at this level would be, where my pointer is here, that would be up at the lumbar spine.
So up around the beltline and then down through here is the sacrum and the coccyx is down below that.
And one of the things we can see: typically the sacrum (usually not always, but usually) has five sacral segments.
So I’ll count those off here: segments one, two, three, four and five.
And what that means is that this dark line here is the sacral coccygeal joint, where the sacrum meets the coccyx.
And then down below that are the coccygeal bony segments: one, two, three, four that we can see in this particular slice or image here.
So where does that leave us?
Well, I have this pulled up for you already, typically you would have needed to scroll through perhaps hundreds of images to get to this image, but for efficiency on the video I’ve already pulled it up here.
And the main thing that should stand out to you is if you look at this first bony segment of the coccyx here, you can see that that sort of dark line going through it.
So instead of looking like a rectangle that has a similar shading or intensity throughout the entire bony segment and looking similar to the vertebral bony segments up here and the sacrum and the ones down here in the lower coccyx, this one right here you can clearly tell is abnormal in its appearance.
So that’s point number one.
And the reason it’s abnormal in this particular patient is that there is a fracture of this first bony segment of the coccyx.
Now one of the things you can also do in terms of looking at how recent that fracture may be, is also looking on other images such as T2 images or STIR images.
And I have over here some what are called STIR images which help to have fluid show up brightly.
And here what you can see is this same slice (because these if I scroll through these you’ll see that both of the images scroll through together and also you can see how you would be scrolling through image after image and you need to get to the right image or two, to show the pathology). And by looking here at the image on the left side of the screen, you can see right here where the abnormality comes into play, it matches up right here where there’s brightness within that particular segment of the coccyx.
The reason for that brightness is because there is fluid content, extra fluid content at the site of the coccyx fracture.
So again this is just a quick view of a couple of images on an MRI showing a tailbone fracture and the images here at the right showing that that fracture is relatively recent or at least that there’s ongoing inflammation at that fracture site.
So I hope that this is helpful in terms of evaluation of the sacrum and coccyx in particular on MRI studies when looking for a coccyx fracture.
This is the next in a series of videos where I’m going chapter by chapter through my book “Tailbone Pain Relief Now!” providing the highlights of each of the chapters along the way.
And for this one we are at Chapter 11, which is “Abnormal Position of the Tailbone” or coccyx, as a cause of tailbone pain, coccyx pain or coccydynia.
And the general idea here is that there’s variability from person to person in terms of the shape and size and position of the tailbone.
And sometimes that can be something that causes tailbone pain, particularly when somebody is sitting down and putting their body weight onto the tailbone.
So in this video we’re just going to talk very briefly about a couple of the highlights from Chapter 11 of the book and specifically we are going to touch on two topics… Number one: what if the tailbone is too far forward? And number two: what if it is too far backwards?
So if the tailbone is flexed too far forwards, I am going to grab a model here and show you what may happen.
So here we have the lumbar spine up here and then down here is the sacrum and down here is the coccyx or tailbone.
And sometimes the tailbone can swing too far forward and if it does if it’s flexed too far forward, where my finger is now, for example, it has the potential to cause certain problems.
Number one, the tailbone is too far pushed into the pelvis and what that means is that if the tailbone is here, then when you have a bowel movement, the stool collects in the rectum which is right in this area.
So some people will have tailbone pain because the coccyx or tailbone is flexed too far forward, it’s actually blocking or obstructing the area where stool collects in the rectum to have a bowel movement.
And those people, as the stool collects, will start to have soreness and pain and aching.
And also, while you’re having a bowel movement it may be painful because the stool is pushing down through the rectum and is pushing that tailbone out of the way.
So that’s a tailbone that is flexed too far forwards.
Sometimes you can actually see that on the M.R.I. studies, there’s a particular view that needs to be done that’s unfortunately usually not done with a standard or typical pelvic MRI.
But if it’s specifically requested, there is a view that can be done that will show this nicely.
And it can show if the tailbone is sort of indenting into the rectum, that lowest part of the colon or the lowest part of the large intestine.
So that’s if a tailbone is flexed too far forward.
What if a tailbone is extended too far backwards?
This particular model does not let me really crank on it to show that, because I don’t want to break the model.
But if the tailbone instead of curving too far forward or being in its kind of normal slightly forward position, if the tailbone was instead extended backwards, well that causes a different set of problems.
Number one is that when you sit, the tailbone is sticking out.
And by sticking out… then when you go to sit… if this is the chair that you’re sitting on, that tailbone that is… (I can actually swing this model around I guess and show you… here would be if the tailbone was extending backwards).
Now instead of the tailbone being out of the way when you go to sit down on the chair, the tailbone now is basically contacting the chair.
And instead of the normal sort of rocker bottom aspect of the coccyx where it’s like the bottom of a rocking chair, instead if that lowest segment is tilting back, you can see that that is not going to be able to perform that rocking motion smoothly.
And instead it’s going to be pinching against the chair that you’re sitting on. So that’s going to pinch the skin in that area.
It can cause pain and inflammation there and it can also transmit those forces or pressures upstream. Just like if you ever caught a baseball or football or basketball and sort of jammed your finger while you’re catching it. You know that by doing that you kind of jam the fingers and then you can get pain within those joints.
Well similarly here if you’re sitting on a tailbone that’s extended backwards, you can sort of jam the joints there and have pain not just where the tailbone is contacting the chair but also at the joints up along the way.
So that’s a tailbone that’s extending too far backwards.
It’s important to have the imaging studies to see what is the position of the tailbone in any given patient who has tailbone pain. And that’s also going to help you to know what type of treatment might be appropriate and what types of problems those patients may run into.
I should also mention that for the patient who had the tailbone very far forward, that tailbone may be extending into the pelvis in a way that blocks or obstructs the birth canal.
So if the tailbone is hooked very far forward and it’s in the way of the birth canal that the child passes through or baby passes through during childbirth or labor and delivery then that can cause problems during childbirth both for the mom and potentially even for the baby.
So again it’s important to know the position of the tailbone in order to know what you should do about it and what the situation would be in those different scenarios.
This is showing a tailbone that is hooked and heading kind of far forward in that way.
So anyway, those are just a few highlights from Chapter 11 of the book.
If you’re looking for a full copy of the book, either the e-book which is the electronic book, or the paperback copy, it’s 272 pages all about the coccyx.
You can get that on Amazon.
But the easiest way perhaps is to just go to the website www.TailboneBoook.com and that will have the links directly to the Amazon pages that have this; depending on what country you’re in you click the appropriate link that matches there. That’s one way to find it.
You can also find me online or if you’re interested in coming for an evaluation here at the Coccyx Pain Center. The easiest way to do any of those things or to find other educational content and videos and articles that I have on tailbone pain is to find me at www.TailboneDoctor.com.
If you have comments or thoughts or questions about an abnormal position of the tailbone, the topic from this chapter of the book, post your comments down below.
I will be interested to read those and hopefully respond to those.
And others I am sure will be interested to read and respond to those as well.
So I look forward to your comments down below.
Okay, bye bye.
Here is the actual VIDEO:
Here is the screenshot thumbnail image for the video:
Chapter 11 of Tailbone Pain Book, Abnormal Coccyx Position Causing 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
In this video we’re going to talk about ARTHRITIS as a cause of tailbone pain.
And this is the next in my series of videos going chapter by chapter through my book “Tailbone Pain Relief Now!”
I’m just doing short videos that give a glimpse as to some of the content that’s within each chapter.
And presenting it here in a video format so that it allows us to have an opportunity to interact.
And you can post your comments or questions or thoughts or your experiences with arthritis related to the tailbone down below.
And it gives us all a chance to interact down in the comments section.
So again back to the book.
We’re looking now at Chapter 10 within the book which is Arthritis of the Tailbone.
And most people are familiar with arthritis as a cause of pain in other parts of the body.
So you may have arthritis at your knee or at your hip.
Many people have arthritis within the small joints within their fingers.
And similarly people can have arthritis within the small joints within the coccyx.
And unfortunately many, many physicians forget to think about arthritis as a cause of coccyx pain.
Even though they would know enough to think about arthritis as a cause of pain in your fingers or your hip or your knee.
So let’s take a look for comparison again.
Just showing here where one joint meets the next… where one BONE, rather, meets the next.
That’s the joint.
And normally there’s a nice smooth appearance between one end of the one bone and the next.
But when there’s arthritic changes that happen that make it look abnormal.
And to show you a illustration from my book, this kind of overdramatizes the way the illustrator happened to draw it here.
But it makes the point which is you can see here the bones of the of the coccyx up one on top of the other.
And down in these lower joints in this example you can see that the bone surfaces are nice and smooth.
The bones may have a nice squared off appearance at the joint where one bone meets the next bone.
But at this bone up here you can see it doesn’t look so nice and neat and smooth anymore.
Instead it looks very kind of jagged or hazy or ragged around the edges.
And that’s because there’s arthritis at that joint.
There’s wear and tear at that joint.
Now this is sort of drawn in a very dramatic way for the illustration in the book.
It’s probably in most cases a little more subtle.
Something more like this where again over here you would have a nice neat joint as shown here as opposed to the arthritis.
Showing that the wear and tear within the joint over there on this part of the image.
So also at the edge of the joint you may have what’s called an osteophyte which is a little bit of a lip where the bone gets a little bit wider at that margin at the joint that has the arthritis.
So that’s a little bit about arthritis and some of the questions that come up about arthritis.
Well there are different types of arthritis.
The most common is osteoarthritis, which is also referred to as “degenerative joint disease.”
And this is normal wear and tear.
All of us go through life and we move around.
We put weight onto our joints.
Whether that’s by walking or running or sitting we’re putting weight onto our different joints throughout the body.
And some wear and tear happens at the joint over time.
And that wear and tear is referred to as arthritis.
The scenario can also happen where somebody can have trauma that causes arthritis.
Very commonly, you have a football player who has trauma to the knee and then at that knee joint they end up having arthritis much, much sooner… (many, many years or decades soone ) than they have normal aging arthritis at the same joint on the opposite side of the body.
So at the tailbone you can have trauma where maybe you had a slip and fall.
You landed on the tailbone.
You had an injury to the tailbone many, many, many years ago.
And it sort of did okay for a while.
Maybe for years or decades.
But arthritis starts to set in at that injured joint over time.
So that’s where you have trauma causing arthritis.
So whether the arthritis is caused by trauma or whether it’s just the micro-trauma of gradual wear and tear over the years, either way you can have arthritis at the tailbone.
The arthritis can cause pain because instead of having a nice smooth joint where one joint meets the next you have this irregular surface and that irregular surface is going to be associated with some extra friction now between one bone and the next and with any movement there.
And that can be quite painful for patients at the tailbone, just as it can be painful when they have arthritis in other parts of the body as well.
The other things we can talk about with arthritis is treatment of arthritis and diagnosis of arthritis.
So in terms of diagnosis really you need imaging studies to diagnose arthritis.
Whether that’s at the tailbone or at other parts of the body.
Most commonly this involves getting x-rays.
But you can get information from MRI and CT scans as well.
But really the x-rays are more or less the typical gold standard for diagnosing typical arthritis.
The x-rays need to be done in the proper way.
And what I mean by that is that it’s very, very common that the x-rays or other imaging studies at the tailbone will not be done in a way that adequately shows the tailbone.
So the imaging studies may be done of the lumbar spine which is higher up.
Or the imaging studies ARE done of the tailbone, BUT it doesn’t do the image at the proper angle in order to see the joints nice and clearly in order to make the diagnosis of arthritis.
So it becomes really important when the imaging studies are being done that the ordering physician understands and has experience in treating tailbone pain and orders the proper tests.
And also that the radiology technician does the tests properly.
And then that the radiologist that’s reading the images actually looks at the tailbone and comments on it and evaluates for some of these things.
And unfortunately it’s very, very common that there’s breakdown at each and every one of those steps along the way.
So although if I had arthritis within my finger the x-rays would be done properly.
The radiologist would read it properly etc.
But if I had arthritis instead of at my finger, if I had the arthritis at my tailbone, then often the system just sort of breaks down because most people are not familiar with treating tailbone pain.
As far as treatment of arthritis, the first step in treatment is actually having an accurate diagnosis in the first place.
And that’s why the imaging studies and the evaluation are so important.
The treatment sometimes can involve putting medication locally at the spot such as by a small local injection.
But we’re going to get into treatment in another chapter later within the book.
So we’ll have a chance to talk more about that there.
But for this purpose let’s just say that unless you make an accurate diagnosis in the first place, it’s very difficult to have a logical treatment plan.
Because if you just are labeled as having “tailbone pain” overall, which they call coccydynia, withOUT having a diagnosis made as to what’s CAUSING the tailbone pain, well then you don’t have a clear direction for what way you’re going to go with your treatment options.
Or you may have an injection done but they don’t do the injection at the specific joint within the coccyx that has the arthritis because they haven’t made that diagnosis in the first place.
So I hope that information is helpful about arthritis in the tailbone.
Definitely post your comments, questions, and stories related to tailbone arthritis down below.
So that gives us a chance to read and comment back on those.
If you’re looking for a copy of the entire book for more information on arthritis of the tailbone and lots of other things about the tailbone, the book is available online.
The easiest way to get it online is to go to the website www.TailboneBook.com and that’ll have the links to different amazon pages for different countries etc.
You can get it as a printed book which is 272 pages in paperback, or you can get the electronic book, the eBook version, if that’s easier for you.
You can get that pretty much anywhere in the world that has internet access.
You can download the electronic book and have access to all of the same information.
If you’re looking specifically for me online, the easiest place to find me is at the website www.TailboneDoctor.com.
So if you’re looking for more educational content, I have lots of educational videos and online articles and information written specifically about the tailbone and tailbone pain.
You can find all of that there.
Or if you’re looking to come to the Tailbone Pain Center for evaluation and treatment, all of that information is there as well at www.TailboneDoctor.com.
So I hope the information is helpful for you.
I’ll be looking for your comments down below regarding arthritis at the tailbone.
Bye bye.
Here is the actual VIDEO:
Here is the screenshot thumbnail image for the video:
In this video we’re going to talk about bone spurs causing tailbone pain or coccyx pain.
This is the next in my series of videos going chapter by chapter through my book “Tailbone Pain Relief Now!” to share some of the information that’s in each chapter.
To do that in a video format that’s available online as it is here allows us to interact more because you can post comments or questions or your stories down below this video.
So this now is Chapter 9 within my book.
So Chapter 9 is Bone Spurs Causing Tailbone Pain.
So what we’ll cover in this video is what is a bone spur, how does it happen, what is it made of, where is it located within the coccyx and how does it cause pain.
We’ll talk about a few other aspects as well.
So first of all what is a bone spur?
A bone spur is when there’s a little bit of additional bony material beyond the normal amount.
One thing I compare this to sometimes is: if you think about when you get calluses on your hands or feet. There’s thickening of the skin that causes a callus of the skin.
Well, similarly there can be thickening of the bone causing a callus of the bone and when that callus is located in a particular way that it forms a point that is called a bone spur.
Or some of my colleagues in Europe often will refer to it as a bone spicule.
It’s the same thing.
So if I show you here an illustration from the book probably will do a good job of showing you what we’re talking about here.
So basically this is a side view of the coccyx or tailbone.
So if we looked at the coccyx like the sacrum and coccyx like this normally you can see how the tailbone curves forward into the pelvis.
But now in this case it starts curving forward.
But you can see here down on the lower end there’s a little bit of extra bone.
I’ve highlighted in yellow here on the illustration just to make it more clear where there’s a little bit of extra bony material there.
That is a bone spur or a bone spicule.
And it’s often relatively small.
So you could say maybe smaller than the size of a pea or a pebble.
But it can cause a lot of pain.
Just like the same way that a small pebble within your shoe would be very, very painful if you were walking on that all day.
Every time you put your body weight on it you would obviously have a lot of pain in your foot after a while from doing that.
And similarly when you have a bone spur the size of a pebble down here at the lower tip of the coccyx that can cause a lot of pain as well.
Because every time that you go to sit down basically you’re sitting… if this is… I’ll have the book represent the chair.
Here you go to sit and now you’re going to be pinching the skin in between the bone spur and the chair that you’re sitting on.
And especially if you sit leaning partway back you’re really going to be poking that bone spur down on the skin and down towards the chair.
So the bone spur itself is made of bone.
It is bone just like the callus that you have on your hands or feet is made of skin.
It is skin.
So a bone spur is made of bone.
It’s a thickening of the bone that forms a focal point.
And where does it occur at the tailbone the vast majority of the time?
It is located down at the lowest tip of a tailbone.
So the lowest tip of the coccyx is the spot where you see the bone spur most commonly.
And the other question that comes up is well… what direction… if it’s coming to a point, what direction is that pointing typically?
It’s pointing behind you.
So it’s pointing backwards.
So back to our anatomic model here again…
This would be a model of the sacrum and down here is the coccyx.
You can see the whole thing is curving forward.
But if there was a bone spur it would be pointing back the other way.
The bone spur would be pointing back that way, the way that the pen is showing here.
So that’s a little bit about what the bone spur is made of, and where it’s located, and the direction that it points, and the way that it causes pain especially when you’re tilted leaning back.
But even with sitting upright it can often be very painful as well.
The things that are done to treat the bone spur we’re going to talk about in some of the later videos when we’re talking about treatments of various types of tailbone pain.
The book is sort of divided so that the first half of the book is about the diagnosis and what it is that causes tailbone pain, and goes through a variety of different causes.
And it’s super important that prior to starting treatment that you actually have a sense of what it is that’s causing your tailbone pain in the first place.
How is that assessment made when we’re looking at bone spurs? There’s two or three main ways.
Number one of course is listening to the patient’s symptoms.
They have pain at the coccyx.
Right in that area.
Pain with sitting, pain with sitting leaning part way back.
Sometimes they may have some pain during transitions from sitting to standing but those things are true about most causes of tailbone pain.
The ways that you would distinguish that the bone spur specifically would be… Number one, on physical examination if the physician is careful while they are touching even just pressing externally along the back of the sacrum and the back of the coccyx if there was a spur right here where my finger is you may be able to feel that projection coming backwards.
It’s almost pointing if this patient was laying on the table here and they’re facing down towards the floor or the table their back is pointing up towards the ceiling.
And in this example the bone spur would be here pointing somewhat up towards the ceiling.
And just from a careful physical exam just gently pressing along the back wall of the sacrum and coccyx you can kind of walk your finger down and and you can sometimes feel the spur pointing upwards.
So another way you can assess for that is by getting imaging studies.
Most commonly that’s done by x-rays or radiographs.
And it’s important that they do the side view and not the front view because the side view will show you that silhouette that will show if there is a bone spur sort of sticking out.
And we’ll talk more in another video covering another chapter about the different tests that are done for tailbone pain.
You can see it on x-rays, MRI CT scans, etc but only if any of those tests are done properly.
Unfortunately a large percentage of the time the imaging studies are NOT done properly.
So that’s a general scoop about bone spurs causing tailbone pain.
Obviously there’s a lot more information within that chapter within the book.
But I wanted this video to provide us an opportunity to generally cover the topic.
And also for you to post your comments down below.
Comments or questions or thoughts.
Or if you’ve had a bone spur someplace else… at your shoulder or sometimes people get them on the sole of their foot with plantar fasciitis.
It’s the same idea that that bone spur, that pointy projection of bone, starts to pinch things.
So if it’s your shoulder it pinches into the rotator cuff muscles when you try to reach up overhead.
At the sole of the foot it pinches the skin when you take that first step in the morning and press down.
It can pinch the soft tissue structures on the sole of the foot.
So that’s a little bit about bone spurs.
Post your comments down below and if you’re interested in getting the the book itself the easiest way to get that is to go to the website www.TailboneBook.com.
It is available on Amazon, but if you go to www.TailboneBook.com it will give you the direct link for the Amazon site for your country.
Whether you’re getting the e-book (which is available worldwide you do not need an e-book reader. You can just read it online.)
So anyplace that has internet access you can get the e-book and also the paper copy.
I’m In My Bookshelf! Making Tailbone Pain Videos. 🙂
This is very break from my series of coccyx pain videos that have been giving you highlights from the chapters of Dr. Foye’s book, “Tailbone Pain Relief Now!”
In this video, I show you how I make the educational videos that I have been posting online.
Summary: My very basic, no-frills set-up is usually just propping up my iPhone to show me and the educational props I have on my bookshelf. I usually do not edit the videos after I record them. It does then take some time to upload them, label them, create captions (for hearing impaired people), etc.
The actual VIDEO is at the bottom of this page.
Here is the TEXT from the video:
Hi. I’m Dr. Patrick Foye, M.D., Director of the Coccyx Pain Center or Tailbone Pain Center, online at www.TailboneDoctor.com.
And in one of my videos in the comments down below the video, somebody was asking me where I was doing these videos because it looked like there was this weird low ceiling, or something along those lines. So I thought I would show you just very briefly where I am doing these videos lately.
I am basically doing these videos inside a shelf on my bookcase. It turns out to be a pretty easy way for me to do it. I have a shelf that is mostly empty except for a lot of educational stuff that I have: a coffee mug that looks like a part of the vertebral spine and I have my plastic model of the pelvis including of course the sacrum and coccyx and I have other versions of the coccyx that move around a little so if I need to demonstrate that in some of the videos.
And basically I have been setting the camera up here so I can put up whatever is the chapter in my book that I am covering in that video and I will choose some kind of a colored paper background just mainly so that I can see the borders and at a glance I can see from the different videos that from the color and from the title it will remind me which video is which so that I can keep them straight when I am uploading them.
And then down here on the next shelf I have got some images printed out from my book so that if I am talking about a fracture and I need to show a fracture or I need to show a dislocation, or I need to show the coccyx and the spine in general, etc, that I have those things on hand as I am making these videos in my bookshelf.
So anyway, if you were wondering, maybe you are not, but if you were, that is what I am doing lately as a way to try to keep creating these videos, because a lot of people seem to find them helpful for providing educational content for the topics related to the tailbone and lately going chapter by chapter through my book, “Tailbone Pain Relief Now!”
So anyway, I thought you might be interested if you have been watching the videos and wondering where I was or what this was, now you know.
This video is about tailbone dislocations. This video is the next in my series of videos going chapter by chapter through my book, “Tailbone Pain Relief Now!”
The idea of the videos is to give you some sense of what is covered in each of the individual chapters. And also in this format to provide a way for us to interact about the topics.
So you can post comments and questions and your experiences down below this video if you have things to say about tailbone dislocations, coccyx dislocations.
This is Chapter 8 within my book. and the most important thing with tailbone dislocations often is to distinguish a dislocation from a fracture and these are very very different.
And if you think about it, a tailbone dislocation is when one bone is no longer lined up and attached to the next bone. So I will show you that here.
Here is an image from my book. This would be showing a partial dislocation where this bone is no longer lined up with the bone beneath it. It is almost a complete dislocation in this illustration here.
But, the thing I will call your attention to is that each of the individual bony segments is intact. none of those are broken. So that is very different than a FRACTURE where there is a CRACK in the bone or a CHIP off the bone.
In this example with a DISLOCATION, by contrast here, there is NO chip in the bone. There is NO crack in the bone. Each individual bony segment is INTACT. So it is NOT a FRACTURE. This IS a DISLOCATION. It is very very common that I see this mistake (mixing up coccyx fractures and coccyx dislocations) made by emergency room physicians or primary care doctors or even by musculoskeletal physicians or radiologists who should know better and would know better in other parts of the body.
But what they will do is they will see this separation here between one bone and the next. And because they think of the tailbone as being a singular bone rather than a series of bones, they will think, “Oh, well this segment must have fractured off that one above.”
But that is NOT how we you make a diagnosis of a fracture versus a dislocation. We look to see IS THE INDIVIDUAL BONE ITSELF INTACT?
And that becomes important because it is important in terms of having an accurate diagnosis first so that then you can decide what you need to do or don’t need to do in terms of your treatment options.
So the way that you diagnose a dislocation at the tailbone is typically after your history and your physical examination is imaging studies. Often x-rays will be able to make this determination, especially if you can get sitting-versus-standing x-rays. Because there are times where the patient will have something that looks normal in one position, but when they are sitting (which is their painful position) they may have a dislocation that only appears while they are sitting. That is called dynamic instability, which is one of the other chapters in the book which I have covered in another video as well.
So the idea about the dislocations is that you want to make an accurate diagnosis. And you want to know exactly what joint is dislocating.
So that if treatments are being provided in the form of injections or things of that nature then the physician should know where to target any such procedure or any such injection.
Or in severe severe cases of a small percentage of the time that need surgery, then the surgeon needs to make sure that he or she has taken care of the area where you are actually having the dislocation.
So that becomes really important.
Again, dislocations can be very common at the tailbone.
They can be very challenging to treat.
And you need the proper imaging studies in order to make the diagnosis in the first place. If the proper imaging studies are NOT done, then often the patient, unfortunately, is told, “Everything was normal, everything looked fine, there is nothing wrong with your tailbone.” When really you have a dislocation or some other injury or problem.
What is it that causes the dislocation? Well, basically it is a problem with the LIGAMENTS. Normally, ligaments are what hold one bony segment to the next. Whether that is here in my fingers or in the bones of the coccyx, the ligaments span from one bone to the next bone. And if those ligaments are stretched or torn, then you no longer have that stable connection holding one bone to the next. And then the bones will shift or move which is, again by definition, a dislocation.
There is a lot more in the book in terms of the appropriate tests to get and the whole second half of the book is about different treatment options. But hopefully you have a sense now at least of how to distinguish a dislocation from a fracture and understand what a dislocation is. And also understand that some dislocations only show up on the x-rays while you are actually sitting and putting your body weight onto it, which is why it is important to have the sitting or seated x-rays performed.
I hope that information is helpful for you. If you are looking for a copy of the full book, the easiest way to get that is to go to www.TailboneBook.com. And on there I have the links to all the different Amazon pages for whatever country you may be in.
You can get the paperback copy. It is 272 pages.
Or you can get the electronic copy of the book, the e-book, which you can download that worldwide, any place where you have an internet access, you can get the book that way if that works best for you.
So, post your comments down below. I will be interested to read those and see your thoughts or comments. If you have been told you had a dislocation but they never did the imaging studies, which would be crazy, or if you were told you did not have a dislocation but the imaging studies showed you actually did, or they never did the proper tests or what have you, post your comments or questions down below.
If you are looking to find me online or to come for an evaluation here at the Coccyx Pain Center, the easiest way to find me is to just go to my website which is www.TailboneDoctor.com
Okay. Bye bye now.
Here is the actual VIDEO:
Here is the screenshot thumbnail image for the video:
Chapter 8 of Tailbone Pain Book: Coccyx DISLOCATIONS, DISLOCATED Coccyx
Severe Tailbone Dislocation on coccyx X-ray, causing coccyx pain, tailbone pain, coccydynia
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
The electronic book is now published containing all of the papers written by those who lectured at The First International Symposium on Coccyx Disorders, which was in Paris in 2016.
The book is available for purchase in e-book format only. (Currently it can be purchased and read on an iPad or on an android tablet. Currently it can not be downloaded onto a regular laptop or desktop computer nor onto an iPhone, but those options may be available in the future.)
Here is the link: https://www.bestpractice-publishing.com/index.php/product/coccyx-disorders/
Here is the cover, which I think looks beautiful:
Coccyx Book Cover, from Paris 2016 Symposium
Here is the first page of Dr. Foye’s chapter on Ganglion Impar (Walther) Sympathetic Nerve Procedures for Coccydynia.
Ganglion Impar Chapter by Dr Foye, from Coccyx Book from Paris Symposium 2016, Just Page 1
Here is the citation for referencing this chapter:
Foye, PM, Shenouda M. In: Maigne J-Y, Doursounian L. (ed.) Coccyx Disorders. (Best Practice Publishing, 2018). Papers from The First International Symposium on Coccyx Disorders. Chapter: Ganglion Impar (Walther) Sympathetic Nerve Procedures for Coccydynia. Pages 106-116. Online at: https://www.bestpractice-publishing.com/index.php/product/coccyx-disorders/
