The video below will summarize in less than one minute the difference between coccyx pain (tailbone pain) versus sacroiliac joint pain.
The biggest thing is that the coccyx is right at the midline versus the sacroiliac joint which is off to either side right or left.
Also, the coccyx is significantly lower than the sacroiliac joint.
The tailbone or coccyx is just slightly above the anus, whereas the sacroiliac joints are higher up.
So, if you’re looking along the skin landmarks on the back, the tailbone is way down here, just above the anus.
Sacroiliac joint pain tends to be in the mid to upper buttocks, to the right or left.
On physical exam the best thing you can do is directly pressing over the tailbone to see if that reproduces the pain. If so then the pain is NOT the sacroiliac joint.
There are also physical exam maneuvers you can do for sacroiliac joint pain.
If you want more information about tailbone pain you can grab my book on Amazon or come to see me through www.TailboneDoctor.com
It is unfortunately VERY common that patients suffering from coccyx pain (tailbone pain, coccydynia) end up having the wrong imaging studies done or they end up with a radiology report that fails to even mention the coccyx!
There are multiple reasons why this problem happens:
The ordering physician: If your doctor ordered imaging studies of the LUMBAR spine, or the LUMBOSACRAL spine, then those images usually will NOT actually show the coccyx! The ordering doctors needs to EXPLICITLY request that the imaging studies INCLUDE the COCCYX.
The radiology technician: If your treating physician DID order the radiology test properly, it is still common that the Radiology center might not do them properly. This is because they may not be very experienced with doing imaging studies specifically for the tailbone pain.
The Radiologist who reads the images: Even if the technician at the Radiology center maybe DID the test properly, it is still common that the Radiologist fails to actually even mention or comment upon the appearance of the coccyx! It is crazy, but this happen VERY commonly!
What can a patient do?
When your doctor orders imaging studies for your coccyx pain, make sure to ask them if it EXPLICITLY requests that the imaging studies INCLUDE THE COCCYX!
Remind the radiology technician that you really need the imaging studies to INCLUDE THE COCCYX.
LOOK at the radiology report. Use a yellow highlighter to highlight every time you see the word coccyx or coccygeal. Unfortunately, in many cases you will be disappointed to discover that the Radiology never even mentioned the coccyx.
If your radiology report failed to mention the coccyx, you can ask the ordering physician to request an “Addendum” to the radiology report, specifically requesting that the radiologist specifically comment on the appearance of the coccyx.
If the imaging studies failed to include the coccyx, you can ask your treating physician to start over with a new set of orders, this time specifically requesting imaging of the coccyx.
You can search for another doctor with more expertise in evaluating and treating tailbone pain.
COME FOR RELIEF: For more information on coccyx pain, or to be evaluated in-person by Dr. Foye’s Coccyx Pain Center in the United States, go to: www.TailboneDoctor.com
– Patrick Foye, M.D., Director of the Tailbone Pain Center, New Jersey, United States.
Tailbone Pain Specialists attended the International Coccyx Pain Symposium, July 2023, in Paris, France. Three of the lecturers made this video in Paris after one of the conference days.
Here is the text from what they said, and then the video is below.
Okay, we are here in Paris, France, for the International Coccyx Pain Symposium. It’s the fourth one ever. Here’s the Arc de Triumph behind us.
I’m going to have a few of my colleagues from around the world introduce themselves. Hi this is Dr. Elif Gurkan from Istanbul, Turkey. We are having our fourth Symposium altogether.
Yes, and I’m Sytske Lohof, pelvic floor physical therapist from the Netherlands and we are so happy we are here for the fourth time and the second time in Paris. The first time was also in Paris and it’s so nice to be here. The weather is fine. The people are fine. And it’s a good Congress.
And I’m Dr. Patrick Foye from Rutgers New Jersey Medical School, Coccyx Pain Center. And basically, this is a conference where we have clinicians from around the world talking about the latest in the diagnosis and treatment of coccyx pain. We had the first day of the conference today. We have the second day tomorrow. And I’ve been learning a lot from the lectures, even though I’ve been treating patients with coccyx pain for years, as I know you have as well for many years. There’s always new things to learn from our colleagues around the world.
It’s a relatively uncommon condition so there’s not a lot of physicians who really specialize in this or have a lot of expertise.
So it’s wonderful to have my colleagues from other countries around the world to get together and talk about this topic.
Anything else? Thank you. And we will help those people with coccyx pain that’s our intention. And share our experience. Exactly. Bye-bye. “Au revoir.”
COME FOR RELIEF: For more information on coccyx pain, or to be evaluated in-person by Dr. Foye’s Coccyx Pain Center in the United States, go to: www.TailboneDoctor.com
– Patrick Foye, M.D., Director of the Tailbone Pain Center, New Jersey, United States.
International Coccyx Pain Symposium, July 2023, in Paris, France. I made this video after Day #1.
Here is the text from what I said, and then the video is below.
I’m currently in Paris, France, for the International Coccyx Pain Symposium. I’m Dr. Patrick Foye from the Coccyx Pain Center at Rutgers New Jersey Medical School online at TailboneDoctor.com
Every couple of years (every two or three years) we have an International Coccyx Pain Symposium where physicians from around the world who have a particular special interest and expertise in coccyx pain get together. We give lectures . We talk to each other. And really about understanding what are the latest thoughts as far as diagnosis and treatment of coccyx pain or tailbone pain.
So there are lecturers from France and Norway and Germany and Turkey and New Zealand and I’ll be lecturing from the United States. So really it’s a terrific opportunity to for physicians in this very specialized area to get together learn from each other, teach each other, and teach others who come to the conference to learn more about tailbone pain.
And I’ll be posting more information about things or topics that have come up at the conference things that we’ve talked about. I’ll post those on my website TailboneDoctor.com and my YouTube channel and Facebook page which is facebook.com/TailbonePainCenter. So you can find the information there or post your comments down below or comments or questions and I can try to answer them there.
So okay I’ve gotta go to bed because day one is over of the conference it’s roughly midnight in Paris right now and there’s more lectures… I’m actually giving the first lecture tomorrow. So I’ll call it a night all right. Bye-bye.
COME FOR RELIEF: For more information on coccyx pain, or to be evaluated in-person by Dr. Foye’s Coccyx Pain Center in the United States, go to: www.TailboneDoctor.com
– Patrick Foye, M.D., Director of the Tailbone Pain Center, New Jersey, United States.
The 4th INTERNATIONAL SYMPOSIUM ON COCCYX DISORDERS was held on July 6 & 7, 2023, in Paris, France, at the Cochin Hospital. This medical conference is held every 2 to 3 years. Experts from around the world give lectures regarding coccyx pain, tailbone pain, coccydynia.
Below is the list of topics and speakers:
Thursday, July 6 2023
Bony anatomy of the coccyx WOON Jason (NEW ZEALAND)
Anatomical basis of sacrococcygeal pain PLOTEAU Stéphane (FRANCE)
Dynamic films. The different lesions of the coccyx. Pitfalls in interpretation MAIGNE Jean-Yves (FRANCE)
Clinical examination of the painful coccyx MAIGNE Jean-Yves (FRANCE)
Pelvic floor, perineum and coccyx. A 3D reconstruction THIRIET Patrice (FRANCE)
Contribution of ultrasound to the understanding and treatment of coccydynia RIANT Thibault (FRANCE)
Role of the sacrococcygeal junction in the damping of abdominal hyper pressure. A 3D reconstruction THIRIET Patrice (FRANCE)
Sacrococcygeal morphologic and morphometric risk factors for idiopathic coccydynia: an MRI study MESREGAH Mohamed Kamal (EGYPT)
Can a sacrococcygeal or coccygeal lordosis predict instability? MAIGNE Jean-Yves (FRANCE)
A novel radiological classification for displaced os coccyx: the Benditz–König classification BENDITZ Achim (GERMANY)
Classification of coccygeal fractures MAIGNE Jean-Yves (FRANCE)
Friday, July 7 2023
Conservative treatment for chronic coccydynia: a 36-month prospective observational study of 115 patients MAIGNE Jean-Yves (FRANCE)
Fluoroscopic injections and ganglion impar sympathetic nerve blocks for coccyx pain FOYE Patrick (USA)
Patch of Capsaïcin 8% and coccygodynia: a case series of 80 patients LEVESQUE Amélie (FRANCE)
Interdisciplinary multimodal pain therapy for pelvic pain THOMA Reinhard (GERMANY)
The efficacy of extracorporeal shock wave therapy for chronic coccydynia AYDIN Canan Gonen (TURKEY)
Ultrasound-guided, pulsed radiofrequency treatment of painful coccygeal spicules. About 20 cases RIANT Thibault (FRANCE)
Why do manual treatments for coccydynia differ between practitioners? MILES Jon (UNITED KINGDOM)
First scientific results of conservative treatment of coccygodynia with the non-invasive mobilization of the os coccyx (NIMOC) technique in the Netherlands (n=439) LOHOF-VENEMA Sytske (THE NETHERLANDS)
Rectal and/or vaginal therapeutic mobilization of the coccyx. Comparative study on 30 patients GURKAN Elif (TURKEY)
Development of the Dutch diagnostics and treatment protocol of coccydogynia, also in relation to pelvic pain and posture LOHOF-VENEMA Sytske (THE NETHERLANDS)
What is coccygectomy? DOURSOUNIAN Levon (FRANCE)
The extent of resection in coccygectomy: a decision guide GUNTER KNOBLOCH Rainer (NORWAY)
Fascial ruptures after coccygectomy: diagnosis, treatment and results GUNTER KNOBLOCH Rainer (NORWAY)
Prevention of post-coccygectomy infection DOURSOUNIAN Levon (FRANCE)
MRI aspects at 3 and 6 months after coccygectomy in cured and failed patients JACQUOT Frédéric (FRANCE)
Persistent pain after coccygectomy PLOTEAU Stéphane (FRANCE)
The treatment of coccydynia in adolescents – an update GUNTER KNOBLOCH Rainer (NORWAY)
Crazy images of the coccyx MAIGNE Jean-Yves (FRANCE)
The good timing for surgery JACQUOT Frédéric (FRANCE)
COME FOR RELIEF: For more information on coccyx pain, or to be evaluated in-person by Dr. Foye’s Coccyx Pain Center in the United States, go to: www.TailboneDoctor.com
– Patrick Foye, M.D., Director of the Tailbone Pain Center, New Jersey, United States.
Tailbone cushions (coccyx cushions) can help decrease tailbone pain (coccyx pain, coccydynia) while sitting.
BUT, some people do not like walking around in public with an obvious cushion.
So, I recently created a video on the topic of carrying a coccyx cushion that is HIDDEN inside a large bag or large purse.
The video is shown down below. Meanwhile, here is the text from that video.
Let’s talk briefly about having a coccyx cushion that doesn’t look like a cushion that looks like it’s just a purse or a bag.
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, online at www.TailboneDoctor.com
And this is a bag that someone let me let me borrow for purposes of the video.
Here you can see that this is a coccyx cushion.
The way that the cushion works is that you sit with the opening at the back so that when you’re sitting the tailbone is essentially hovering over the opening within the cushion.
But the idea of having it of carrying around a cushion that looks like this for some people they may be self-conscious about it or not want people asking them “What’s that cushion?” or “Why are you using that?”
So, what the patient did was just got a bag (she tells me she got it on Amazon) and basically pop the cushion into the bag.
And then when she carries it around. It just looks like a bag it just looks like a slightly large purse and zippered shut.
And then when she goes to sit down, she just puts that on her chair. She sits down and now her coccyx is hovering over that over that soft spot (you can see it even through here) within the cushion. so inside of the bag.
So, I just share this idea because sometimes people are either self-conscious about their cushion or just they don’t want people asking them about their business or “Why do you need to have this cushion?”
So, I thought I would share that as a as an interesting idea for people with tailbone pain.
If you want more information about tailbone pain you can certainly find me on my website www.TailboneDoctor.com or to come and see me.
Or for my book on tailbone pain you can find that on amazon it’s called “Tailbone Pain Relief Now!”
COME FOR RELIEF: For more information on coccyx pain, or to be evaluated in-person by Dr. Foye’s Coccyx Pain Center in the United States, go to: www.TailboneDoctor.com
– Patrick Foye, M.D., Director of the Tailbone Pain Center, New Jersey, United States.
Coccyx pain (tailbone pain, coccydynia) is usually painful while sitting. But sometimes the pain is even WORSE during the few seconds while you start to stand up. This tailbone pain exacerbation during standing up is an important symptom. This is often seen in patients who have coccyx hypermobility (excessive movement of the coccygeal bones while sitting).
I recently created a video on this topic, which is shown down below. Meanwhile, here is the text from that video.
Let’s briefly discuss coccyx pain or tailbone pain that gets worse during that transition when going from sitting to standing.
I’m Dr Patrick Foye I’m an M.D. or medical doctor.
I’m the director of the Coccyx Pain Center (or Tailbone Pain Center) here in the United States, online at www.TailboneDoctor.com
Classically, coccyx pain (or tailbone pain, coccydynia) typically is worse when you’re sitting and worse when you’re sitting leaning back.
Because when you’re sitting and sitting leaning back, you’re putting more of your body weight onto the coccyx, or tailbone.
However, a significant number of people with coccyx pain (or tailbone pain) will report that their pain gets significantly worse during the first few seconds of that transition of going from sitting to standing.
As they first stand up their pain level skyrockets for just those first few seconds in particular.
And there was an interesting study that was done on this by Dr. Jean-Yves Maine. Dr. Maine in Paris France found that that particular symptom pain with going from sitting to standing specifically that coccyx pain was associated with people who had something called dynamic instability which is hyper mobility (so excessive movement of the coccygeal joints).
The test that’s done to assess for that is something called the sitting-versus-standing x-rays or dynamic x-rays.
And what’s done is to take an x-ray of the tailbone while somebody is sitting.
So they’re sitting and putting their body weight onto the tailbone and sitting leaning back.
And then they compare the position of the coccyx in that position with the position of the coccyx while they’re standing up and not putting their body weight onto it.
And you can assess for whether there’s abnormal or excessive movement in between those two positions.
The difficulty is that there’s it’s challenging to find a radiology center that’s experienced at performing those.
But if you can, they can be very helpful.
So, not every single patient who has pain with sit-to-stand always has hypermobility and not every patient who has hypermobility has that pain that’s worse with sit to stand.
But it is an important association those two are commonly linked.
And it’s one more reason why the sitting-versus-standing x-rays can be really important if you’re able to find a place that can do those properly for you.
So, I hope that’s helpful information about that pain with going from sitting to standing for people who have coccyx pain or tailbone pain.
If you want more information on coccyx pain certainly if you go to Amazon you can get a copy of my book “Tailbone Pain Relief Now!”
It’s 272 pages all about the coccyx.
Or if you’re interested in seeing me in person in the United States, in New Jersey, you can go to my website which is www.TailboneDoctor.com
COME FOR RELIEF: For more information on coccyx pain, or to be evaluated in-person by Dr. Foye’s Coccyx Pain Center in the United States, go to: www.TailboneDoctor.com
– Patrick Foye, M.D., Director of the Tailbone Pain Center, New Jersey, United States.
Here is the transcript from Dr. Foye’s video about Ankylosing Spondylitis and Coccyx Pain, Tailbone Pain. The actual video is below.
Let’s talk about Ankylosing Spondylitis and coccyx pain, or tailbone pain.
I’m Dr. Patrick Foye. I’m an M.D. (or medical doctor) and Director of the Coccyx Pain Center (Tailbone Pain Center) here in the United States, online at www.TailboneDoctor.com.
Ankylosing spondylitis: what does the term mean?
Ankylosing refers to joints that have stiffness or rigidity or even fusion from between one bone and the next across a joint or across a series of joints.
So that’s the ankylosis or ankylosing.
Spondy refers to spine.
So everywhere from the cervical spine up at the neck to the coccygeal spine down at the coccyx or tailbone.
So that’s the spine from top to bottom.
And “-itis” at the end of a word refers to that there may be a component of inflammation.
So ankylosing spondylitis is a condition where the spine has rigidity or stiffness or decreased movement or fusion… along with potential inflammation.
Now because the coccyx is part of the spine (it’s the lowest part of the spine) it’s not surprising that the coccyx can be involved in ankylosing spondylitis.
So you can have stiffness or rigidity or decreased movement at the coccyx.
And the reason that creates a problem is that… here’s a plastic model of the spine… lumbar spine here then the sacrum and then the coccyx here down at the bottom.
And if we look from the side you can see when you sit and you’re sitting on a chair for example… the coccyx is supposed to flex itself slightly forward by about 20 degrees so it tucks itself a little bit into the pelvis, so it’s not hitting as directly against the chair.
If the coccyx is rigid or stiff or fused and fails to flex forward, then it’s going to hit into the chair, have more pressure on the tailbone, and that can be a source of coccyx pain or tailbone pain.
So, the way to diagnose that is by sitting-versus-standing x-rays.
But, unfortunately, very few radiology centers are familiar or experienced with doing sitting-versus-standing x-rays.
Those are x-rays that are done to see how much movement there is at the tailbone when you sit, and sit and lean back for example which tends to put pressure onto the tailbone.
But that would be the way to officially diagnose whether there is decreased mobility at the coccyx in a condition like ankylosing spondylitis.
If you’re interested in more information about coccyx pain you can certainly get my book on Amazon. It’s “Tailbone Pain Relief Now!”.
or if you’re interested in more information go on my website… that is www.TailboneDoctor.com.
Or if you’re interested to come and see me in-person again just go to www.TailboneDoctor.com and there’ll be lots of information for you there.
So, I hope that’s helpful at explaining how Ankylosing Spondylitis can include the coccyx and can cause coccyx pain.
COME FOR RELIEF: For more information on coccyx pain, or to be evaluated in-person by Dr. Foye’s Coccyx Pain Center in the United States, go to: www.TailboneDoctor.com
– Patrick Foye, M.D., Director of the Tailbone Pain Center, New Jersey, United States.
Here is the transcript from the video on Ehlers Danlos Syndrome and tailbone pain. The actual Video is at the bottom of this article.
Let’s talk briefly about EDS (or Ehlers-Danlos Syndrome) and EDS as a cause of coccyx pain or tailbone pain or coccydynia.
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, online at www.TailboneDoctor.com.
EDS is a condition where it’s a connective tissue disorder.
And it results in increased joint laxity, meaning looseness of the joints… that the joints are not as stiff or well supported as they normally should be.
And that causes increased mobility or movement of the joints.
Now, the joints then can become unstable or hyper-mobile, meaning that they move too much.
Now, coccyx pain is a condition down at the bottom of the spine.
So, here’s an anatomic model of the spine showing the lumbar spine and then the sacrum and then down at the lowest tip of the spine is the coccyx or tailbone.
And the tailbone is supposed to have a little bit of movement but not too much.
And the most common cause of tailbone pain or coccyx pain overall is patients that have hyper-mobility.
The ligaments of the coccyx are relatively thin. They’re not very strong. And they can become loose over time or as a result of trauma.
And that can happen in all of us, even people without EDS.
So, the number one cause of coccyx pain overall in patients is hyper mobility… that there’s dynamic instability (there’s excessive movement at the tailbone)… that when you go to sit and if you and your tailbone is supposed to flex forward just a little… but it flexes forward too much and there’s excessive movement and pain associated with that.
So, given that, overall, hypermobility is the number one cause of coccyx pain… and given that EDS causes hypermobility of joints in general… it’s no surprise that people with EDS may run into problems with hypermobility at the tailbone.
The way to diagnose that is by doing sitting-versus-standing x-rays.
That way the x-rays can be done while you’re standing but also while you’re sitting and putting your body weight onto the tailbone… so sitting leaning part way back the x-rays can be done in that position as well.
And we can compare the position and the angle of the coccyx while you’re sitting compared with while you’re standing.
And that’s the way we diagnose hypermobility at the coccyx.
The problem though is that many radiology centers have never heard of doing the sitting-versus-standing coccyx x-rays or they don’t have experience or expertise in doing them.
So, admittedly, that is one potential challenge.
But that’s a little bit of information about EDS and coccyx pain or coccydynia and hypermobility and sit-stand x-rays.
Hopefully you found that helpful.
If you are interested in more information about tailbone pain, certainly you can find my book on Amazon, which is called “Tailbone Pain Relief Now!”
And if you’re interested in more information you can also go to my website www.TailboneDoctor.com.
And you can if you’re interested in seeing me in-person you can also go to the www.TailboneDoctor.com website and there’ll be information on that there.
COME FOR RELIEF: For more information on coccyx pain, or to be evaluated in-person by Dr. Foye’s Coccyx Pain Center in the United States, go to: www.TailboneDoctor.com
– Patrick Foye, M.D., Director of the Tailbone Pain Center, New Jersey, United States.
(Scroll down for Dr. Foye’s VIDEO on this topic. Here is the typed transcript from the video.)
Okay, let’s talk for a minute or two about coccyx pain or tailbone pain on airplanes.
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, online at www.TailboneDoctor.com.
Many, many, many patients of mine when they come to see me, they tell me that one of the things that is most painful for them is flying on airplanes with tailbone pain.
And it’s a significant problem because on an airplane you don’t have a lot of wiggle room.
You don’t have the ability to lean to the right or lean to the left or lean forward which are positions that often will unload some of the weight bearing on the coccyx.
You have to sit for an extended period of time.
You can’t just get up whenever you want to because the captain says the flight the seat belts have to stay on at times.
In fact I have a lot of patients who are airline pilots or flight attendants from planes and it’s a significant challenge for those people.
So what can you do when it comes to flying with tailbone pain one thing you can do is remember of course to bring your cushion.
Put it on your packing list.
Make sure you bring it along with you.
Many cushions… these are the wedge cushions they’re shaped a bit like a wedge here. and they have kind of a wedge shaped cut out here and the tailbone hovers over that empty spot on the wedge.
Many of them have a handle you can carry it along with you.
you can slide the handle over the edge of your suitcase handle… pull out telescoping all of that and remember to bring your cushion.
also remember not to forget your cushion when you’re exiting the plane.
I have many, many patients who fly in to see me and they tell me that when they are getting off the plane with all of grabbing their bags and their papers and all of this kind of thing that they left their cushions.
So do whatever it takes.
These tend to be dark in color just like the seats of the plane.
So you may want to tie a red ribbon on it.
Or set your timer on your watch or your phone to set a reminder at landing time to remind you to grab your cushion when you’re done.
And even I would say in terms of using the cushion even if your tailbone pain is doing relatively better (if let’s say you were someone who received treatment for tailbone pain and maybe you haven’t had any symptoms for a few months or six months or even a year)… if you’re taking a really long flight you may still want to bring your cushion along. Because that may make the difference between whether you have an exacerbation if there’s a lot of turbulence or if the flight goes longer than expected or if the chair is particularly uncomfortable.
So those are a few a few thoughts on airline flights and tailbone pain.
If you want more information certainly on amazon you can grab a copy of my book “Tailbone Pain Relief Now!’.
Or if you’re interested in coming to see me in person you can find all the information on that on my website which is www.TailboneDoctor.com.
Airplane Flights and Tailbone Pain, Coccyx Pain, Pilots, Flight Attendants, Patrick Foye MD
COME FOR RELIEF: For more information on coccyx pain, or to be evaluated in-person by Dr. Foye’s Coccyx Pain Center in the United States, go to: www.TailboneDoctor.com
– Patrick Foye, M.D., Director of the Tailbone Pain Center, New Jersey, United States.
