(Scroll down for Dr. Foye’s VIDEO on this topic. Here is the typed transcript from the video.)
This is a short explanation about how a straight coccyx can be a cause of coccyx pain.
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.
And this is a explanation for why a straight coccyx can be a source of coccyx pain.
The coccyx is the lower part of the spine.
So lumbar spine would be above and then at the back of the pelvis is the sacrum and coccyx.
And you can see that normally it has this gradual forward curve to the sacrum and coccyx.
And one of the nice things that that does is that the normal gradual forward curve of the sacrament coccyx means that the coccyx (the lowest part of the spine) is sort of tucked into the pelvis.
So that when you go to sit the fact that it’s curved forward means that the coccyx does not bear a lot of weight… that the coccyx doesn’t immediately touch the sitting surface that you’re sitting on.
However, you can see that if, instead of curved forward, if the coccyx was straight down… like instead of curve forward like my finger is now here at the coccyx… if it was pointing straight down… then it does not have quite as much clearance.
So it’s going to hit the chair a little bit sooner.
And then it’s going by hitting the chair. It’s going to cause increased pressure at that area.
And if my finger is the coccyx and now it’s hitting the chair as it sits as you sit down.
Number one it can cause pain locally at that lower tip. Sometimes there’s also a bone spur there which can be another source of pain.
But, also, from hitting straight down it transmits some of those mechanical forces upwards through the coccyx and can sort of be like jamming the joint up above.
So just like the same way that if you ever caught a basketball or a football and it kind of hits straight onto your finger and kind of jams the finger or can even push it into extension sometimes. So, it can be painful at the joint.
So that’s the general story for how a coccyx that is too straight uh can sometimes be a source of tailbone pain
For more information you can always get a copy of my book on Amazon.
Or if you want to be evaluated by me in person you can go to my website which is www.TailboneDoctor.com to either find more information or find out about coming to see me in person.
I hope that’s helpful and I’m wishing you all the best.
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.
Sitting on a COUCHES can cause or worsen coccyx pain (tailbone pain, coccydynia). For many people with tailbone pain, sitting on a hard chair may be more comfortable than sitting on a soft COUCH or sofa.
Hundreds of patients with tailbone pain have told me how much they hate sitting on couches. Below, I explain why this happens.
The VIDEO is at the bottom of the page.
Here is the transcript from the video:
I’m Dr. Patrick Foye, M.D. and this is just a short explanation for why many people with tailbone pain have pain when they’re sitting specifically on couches or soft surfaces like a couch.
Many people think well, a couch is comfortable a couch is soft.
That should be easy and should be a great place for someone with tailbone pain to sit.
However very frequently the opposite is true.
This is an anatomic model showing the pelvis and at the back of the pelvis is the sacrum and right down here is the coccyx or tailbone and over here where my fingers are pointing now those are the other sit bones referred to as the ischial bones so right down at the bottom here.
And the thing is that when somebody is sitting on a hard surface what they can do is they can shift their body weight somewhat from one side to the other or they can sit leaning forward all of those things take pressure off of the tailbone at the midline.
So sitting on a hard surface might not be so bad for many people with tailbone pain however if we use this soft surface here to simulate sitting on a couch.
You can see that when you sit on a couch you sink down into it and part of that soft couch surface is not so soft now when it’s hitting the tailbone if you have somebody with tailbone pain.
So you can see how in that situation for many people sitting on a hard surface might actually be better for their tailbone pain than sitting on a soft surface where they can’t get sort of the relief by putting the pressure onto some of the other areas.
So we see this very very commonly.
I’m the Director and Founder of the Coccyx Pain Center (or Tailbone Pain Center) here in the United States.
You can find more information online at www.TailboneDoctor.com or you can grab a copy of my book on tailbone pain all about causes and treatments and all of that.
I hope that’s a helpful explanation for you about tailbone pain while sitting on couches.
Here is the VIDEO:
VIDEO: Tailbone Pain while sitting on COUCHES. Coccyx Pain when you Sit on a COUCH.
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 screen-capture from the video:
Tailbone Pain Sitting on Couches, Coccyx pain when you sit on a couch or sofa, coccydynia, Patrick Foye MD
(Usual disclaimer: This is intended as helpful education for those with tailbone pain, but this is not individual medical advice and does not establish any doctor-patient relationship.)
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.
This eBook on Tailbone Pain is Free on Amazon worldwide a few times per year.
“Tailbone Pain Relief Now! Causes and Treatments for Your Sore or Injured Coccyx” by Patrick M. Foye, M.D., Director of the Coccyx Pain Center at Rutgers New Jersey Medical School.
Learn all about how to find answers and relief for your Tailbone Pain, Coccyx Pain, Coccydynia.
If you have been told the date that the book will be FREE and you have been directed here then this webpage explains how to get the book for free from Amazon on the date that you have been told will be free.
First, use the links below to go to the Amazon webpage for this book.
Then… Click on “see all formats” (as shown by the red arrow in the image below) and then choose the e-book / Kindle version, which is FREE all day. You do not need a Kindle to get this free book… you just need an Amazon account, which is free. You can download the ebook to your laptop, desktop computer, iPad, e-reader, Kindle, etc.
Tailbone Pain, Coccyx Pain, Free-Book, June 1, 2021, coccydynia, by Patrick Foye MD
Below is a List of Amazon Links Worldwide to get the Book “Tailbone Pain Relief Now!” The book is filled with useful information about coccyx pain (tailbone pain), including causes, tests, and treatments. You can use the Amazon website specific to your part of the world.
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 Book, for Coccyx Pain, Coccydynia, by Patrick Foye MD
I have thousands of patients with coccyx pain (tailbone pain, coccydynia). Some of them had their tailbone pain caused by, or worsened by, activities such as snow-boarding, skate-boarding, skiing, etc.
Some people with tailbone pain want to continue doing activities like snowboarding, skateboarding, etc.
Some of them tell me that they like the way that “Ass Armor” shorts protects their coccyx from further injury/pain if they fall.
So I am sharing this here in case it may help others. (Note: I do not endorse any particular commercial product and I do not get any financial benefit or compensation from them for sharing this.)
Ass Armor, shorts to protect from tailbone pain, coccyx pain, coccydyniaAss Armor, shorts to protect from tailbone pain, coccyx pain, on Amazon
To find this, go to Amazon and search for “Ass Armor” shorts.
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.
This eBook on Tailbone Pain is Free on Amazon worldwide: June 1, 2021, Pacific Time.
“Tailbone Pain Relief Now! Causes and Treatments for Your Sore or Injured Coccyx” by Patrick M. Foye, M.D., Director of the Coccyx Pain Center at Rutgers New Jersey Medical School.
Learn all about how to find answers and relief for your Tailbone Pain, Coccyx Pain, Coccydynia.
Click on “see all formats” (as shown by the red arrow in the image below) and then choose the e-book / Kindle version, which is FREE all day. You do not need a Kindle to get this free book… you just need an Amazon account, which is free. You can download the ebook to your laptop, desktop computer, iPad, e-reader, Kindle, etc.
Tailbone Pain, Coccyx Pain, Free-Book, June 1, 2021, coccydynia, by Patrick Foye MD
Below is a List of Amazon Links Worldwide to get the Book “Tailbone Pain Relief Now!” The book is filled with useful information about coccyx pain (tailbone pain), including causes, tests, and treatments. You can use the Amazon website specific to your part of the world.
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.
Wedge cushions have the hole or cut-out at the edge. It is usually a wedge-shaped cut-out (like a small, triangle-shaped slice removed from a a square pie).
The goal is for the painful tailbone to ‘hover’ over the cut-out, so that you are not putting as much of your body weight onto the tailbone. Less coccyx weight-bearing results in less coccyx pain.
The wedge cushions often also have a slight incline that tends to have the patient sit leaning forwards, which also takes some pressure off the coccyx.
I did a research study on this topic in 2009, assessing whether patients with tailbone pain preferred sitting on wedge cushions versus donut cushions.
Many patients with tailbone pain preferred neither cushion. But among patients who had a preference, they were ~ 5 times more likely to prefer wedge rather than donut cushions.
So, for patients who have not yet tried either cushion, it probably makes sense to start by trying a wedge cushion.
But each patient needs to find the cushion that works best for them.
Tailbone Pain Tip 11, Coccyx WEDGE CUSHIONS are usually better than doughnut cushions, for Coccyx Pain, CoccydyniaTailbone Wedge Cushion, for coccyx pain, tailbone pain, coccydynia Tailbone Donut Cushion, for coccyx pain, tailbone pain, coccydynia Coccyx Wedge Cushions for Tailbone Pain, Coccyx Pain, coccydynia
Video on Cushions for Tailbone Pain, Coccyx Pain, Coccydynia
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.
BUT… it is important to SCREEN for cancer since CHORDOMA tends to occur at the sacrum/coccyx and unfortunately is often FATAL within a few years of diagnosis.
MRI needs to be ordered properly and done properly to assess for this.
MRI is especially important if the coccyx pain is not responding to the usual treatments.
There are also other pelvic cancers to screen for, including cancers of the rectum / colon, uterus, ovaries, cervix, bladder, prostate, etc. Those cancers often involve assessment by specialists such as Gynecologists, Gastroenterologists, Colorectal specialists, Urologists, etc.
Tailbone Pain Tip 10, Tailbone CANCER can be Deadly, Chordoma, Tailbone Pain, Coccyx Pain, Coccydynia
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.
There are many causes of coccyx pain (tailbone pain, coccydynia). This article will focus on coccyx pain being caused by the lower coccyx being in extension, which is called a pseudo-spur.
NORMAL COCCYX POSITION = FLEXION:
Normally, the coccyx position has a mild, gradual forward flexion. This means that the coccyx is flexed forward. This results in the lower coccyx being nicely “tucked in” (tucked into the pelvic, which protects the coccyx from hitting the chair or floor when you sit or fall).
ABNORMAL COCCYX POSITION = EXTENSION:
Sometimes the lower coccyx is positioned with the angle going the opposite way. The “opposite way” means that the coccyx may be in extension, instead of flexion. This results in the lower coccyx “sticking out” or “pointing backwards”. In this extended (“sticking out”) position, the tailbone is at risk for hitting against the chair or seat when you are sitting. Usually there is pain with sitting, and sitting leaning back makes the pain even worse. In this extended (“sticking out”) position, the tailbone is also at risk for hitting forcefully/traumatically against the floor or ground if you land on your butt after you slip and fall.
PHRASES and SIMILARITIES: Coccyx “BONESPUR” (SPICULE) and “PSEUDO-SPUR”
There are a few different phrases that doctors use to describe this abnormal, extended position of the tailbone.
One phrase is to just say that the coccyx is in extension, instead of flexion.
Another phrase is to say that there is a coccyx PSEUDO-SPUR. “Pseudo ” means “like” or “similar to”. So, pseudo-spur means “like a spur”.
So, pseudo-spur means that the extended position of the lower coccyx results in the same type of symptoms as a bone spur. Usually there is pain with sitting, and sitting leaning back makes the pain even worse.
What is the DIFFERENCE between a coccyx BONE SPUR versus a PSEUDO-SPUR?
BONE SPUR:
A bone spur is an area where there is thickening of the bone. It is made of bone. It is bone.
A bone spur is additional, extra bone that the body has formed at a focal spot.
Just like your skin can become “thickened skin” and form a skin callous. Similarly, the bone can become “thickened bone” and form a spur.
A spur has EXTRA (ADDITIONAL) bone that has formed.
When the bony thickening is focal and makes a pointy projection, we refer to it as a bone spur. European doctors sometimes call it a bone “spicule”.
On imaging studies, a bone spur often looks like an icicle hanging down from your rain gutter.
A lower coccyx bone spur can cause coccyx pain when the patient sits on the bone spur, thus impinging the skin and subcutaneous tissue in between the bone spur and the sitting surface.
PSEUDO-SPUR = EXTENSION = RETROVERSION:
As discussed above, “pseudo-spur” means “like a spur”.
But, the difference is that a SPUR has EXTRA (ADDITIONAL) bone. The pseudo-spur does NOT have an “extra” bone, it just that the normal amount of bone is going into extension instead of flexion.
So, instead of the coccygeal joints being flexed, one or more of them are extended. Imaging trying to put your hand into your pocket if your index finger was extended, instead of flexed. The extended finger would get ‘hung up’ and would bump into the edge of the pocket rim, instead of being smoothly “tucked in” like the other fingers. Similarly, your extended coccyx may bump into the seat that you are sitting on, instead of being smoothly “tucked” into the pelvis.
European doctors sometimes refer to this extension as “retroversion” of the lower coccyx.
MAKING A CLINICAL DIAGNOSIS = 3 FACTORS:
To make a clinical diagnosis, the doctor needs to consider three main factors:
Symptoms: Does the patient report pain at one specific location? For example, is the patient having focal pain specifically at the lower tailbone? Also, is the pain worse with sitting, and especially worse with sitting while leaning slightly backwards?
Physical exam findings: The doctor needs to specifically look at the skin over the location of pain. Then, the doctor needs to touch or press on different locations along the length of your tailbone (palpation) to see if this reproduces your pain or other symptoms. For a distal coccyx bone spur or a pseudo-spur, the specific location of tenderness will usually be at the lower half or lowest tip of the coccyx. (The doctor will usually also assess for other possible sources of pain in the pelvic or buttock region, beyond just the coccyx.)
Imaging studies: Medical imaging studies of the coccyx include x-rays, MRI, and CT scans. If done properly, the imaging studies can show details of your coccyx anatomy. Typically the imaging studies will help to show if you have a coccyx bone spur (spicule) or a coccyx pseudo-spur (a retroverted coccyx, meaning that it is extended instead of flexed).
All 3 Factors: All three of the above factors are important, in combination, in making a clinical assessment. If the patient’s symptoms, physical exam findings, and imaging studies all point to the same thing as being the cause of the patient’s symptoms, then the diagnosis is considered to be confirmed and well-established. Then we can move on to treatment options.
SUMMARY: I hope you have found this to be a helpful explanation of the coccyx pseudo-spur (extended, retroverted coccyx) as a source of coccyx pain (tailbone pain, coccydynia). I hope this has also helped to explain the similarities and differences between coccyx bone spurs and coccyx pseudo-spurs.
Coccyx Bone Spur Causes Tailbone Pain, Coccyx Pain, Bone Spicule
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.
What is a bone spur? A bone spur is thickening of the bone. Just like you can get a callous on your hands or feet from thickening of the skin, you can also get thickening of bone in certain places in your body. When the bony thickening is focal and makes a pointy projection, we refer to it as a bone spur. (European doctors sometimes call it a bone “spicule”.)
Where do bone spurs happen? The most common locations where people have heard of bone spurs are: a heel spur on the sole of the foot (painful when you take a step) and a bone spur at the shoulder (painful when you reach your arm up and overhead). When a spur happens at the coccyx, it is almost always extending backwards from the lower tip of the coccyx. This causes pain when someone sits on this (especially if you sit leaning backwards). You can read more about that here: Coccyx Bone Spurs, Plantar Heel Spurs, Shoulder Bone Spurs
Why not just surgically “shave down” a coccyx bone spur?
Firstly, just like with bone spurs at the foot/heel and shoulder, it essentially always make sense to start with non-surgical treatment options first. The reason is simple: MOST people will get good relief without needing surgery. This is true for bone spurs at the heel, at the shoulder, and at the coccyx.
Secondly, there are some unique challenges with trying to shave down a bone spur when it is specifically at the coccyx, which are listed below:
A) The coccygeal bones are small and fragile. Sometimes surgeons will note that the coccyx “crumbles” into pieces as they remove it. So, if you were to try to shave off the spur, you would risk causing trauma and fracture to the coccygeal that is attached to the spur. (Comparison: If you had a bit of cement/concrete stuck to the side of a large cargo ship, then you could chisel it off without damaging the big strong cargo ship. But if you had a bit of cement/concrete stuck to the side of a glass/crystal earring, then trying to chisel it off would risk damaging the glass/crystal earring.
B) The coccyx is a weight-bearing surface. You actually put some of your body weight onto the coccyx for prolonged durations of time, specifically while you are sitting. So, if you had the coccyx bone spur “shaved down”, you would be sitting and putting your body weight onto a raw, cut edge of bone. That is not good for your pain level and is not good for healing of the site at the surgical shaving.
SUMMARY regarding distal coccyx bone spurs:
1) It makes sense to try the non-surgical treatment options first, since they work for most people, thus avoiding surgery.
2) There is no good or standard surgical procedure to “shave down” a coccyx bone spur. If surgery is needed, it will typically involve amputating (removing) most or all of the coccyx (coccygectomy), rather than just removing the spur.
Coccyx Bone Spur Causes Tailbone Pain, Coccyx Pain, Bone SpiculeChapter 9 of Tailbone Pain Book: Coccyx BONE SPUR, Tailbone Spicule
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.
