MANY coccyx pain patients tell me that their Doctors NEVER EVEN EXAMINED (touched / palpated) their coccyx.
This happens all the time! It’s BIZARRE!
IMAGINE someone treating your thumb without ever examining it. Unthinkable!
Clinicians (primary care, pain or musculoskeletal specialists, P.T.’s, etc.) should EVALUATE THE SITE OF PAIN!
Patients DESERVE proper evaluations.
Tailbone Pain Tip 9, Find a Clinician who will TOUCH your Coccyx, for Tailbone Pain, Coccyx Pain, Coccydynia, by 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.
Coccyx Dislocations and Fractures can BOTH be a cause for Tailbone Pain, (Coccyx Pain, Coccydynia).
Coccyx DISLOCATIONS are ~ 100 x more common than Coccyx FRACTURES.
Dislocations = due to sprained or torn ligaments.
Fractures = a break in the actual bones.
The VAST majority of the time when a new patient tells me that their prior x-rays or MRI showed a fracture… I look at the images and it is NOT a fracture, it is a dislocation. This mistake happens all the time at the coccyx, whether it was misinterpreted by the Emergency Room doctor, the musculoskeletal doctor, the pain specialist (if any of them actually even looked at the images themselves) and by the Radiologists (who really should know better). Part of the problem is that even doctors have the misunderstanding that it is a tailBONE (which sounds singular, as if there is only one single bone at the coccyx)… so when they see separate bits of bone then incorrectly assume that it used to be one solid singular fused bone that fractured (when usually it is multiple individual boneS, plural).
Tailbone Pain Tip 8, Coccyx DISLOCATIONS versus FRACTURES, COCCYX PAIN, Tailbone 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.
I was recently contacted by a woman who had undergone a coccygectomy (which is surgical amputation/removal of the coccyx/tailbone).
Her question was whether, after having undergone coccygectomy, it would or would not be advisable for her to undergo a cesarean section rather than a vaginal delivery for any subsequent pregnancy.
Perhaps you, the reader, are in a similar situation and have this same question.
This is an excellent question and one that I do not think I have ever seen explicitly addressed within the published medical literature.
On the one hand, if the coccyx is no longer present, then it should no longer be presenting any obstruction to the baby passing through the birth canal, and therefore a vaginal delivery may indeed be possible.
However, if the patient is still having significant pain at the coccygectomy surgical site (such as from scar tissue, etc. at the surgery site), or if that area is currently symptom-free but still more prone to being exacerbated, then it is possible that a vaginal delivery could cause a flareup/worsening or return of your pain in the coccyx region.
So, I do not have a hard and fast rule by which to advise my patients on this.
In general, if the patient has little or no pain at the coccyx region and the pregnancy overall seems normal (e.g., just one baby rather than twins or triplets, for example, and the baby is of normal body weight rather than being significantly enlarged), it is possible that the patient could deliver vaginally without substantial flareup at the tailbone.
Conversely, if the coccygectomy site is still very painful, or if the pregnancy is complicated by twins/triplets or a larger than usual baby, then delivery by a cesarean section may be more advisable.
But again, these would be general topics for how to consider this decision rather than firm advice on which choice to make.
All of this should be topics that the patient should discuss in person with their treating obstetrician/gynecologist.
Lastly, if the patient does end up having a vaginal delivery, or even a C-section, they would generally want to make sure that while they are at the hospital they do not flare up the coccyx region just from the sitting in a reclined position that is common on the typical delivery table.
Tailbone Pain Tip 7, PREGNANCY and CHILDBIRTH Can Cause or Worsen COCCYX PAIN, Tailbone 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.
A standard “Lumbar” or “Lumbosacral” MRI does NOT include the COCCYX.
The most common MISTAKE that I see when patients have an MRI done for coccydynia (tailbone pain) is that the MRI does NOT even include the coccyx!
Often, the wrong MRI is ordered/done.
Look at the radiology report and see if they even commented on the coccyx.
Ask your doctor to point to the coccyx on the images. It may not be there!
Tailbone Pain Tip 6, Lumbar MRI does NOT include the Coccyx, for Tailbone 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.
The word TAILBONE is MISLEADING since it implies that it is one, singular bone.
In reality, the tailbone (coccyx) is made of 3-to-5 boneS (plural).
It is less common for all of these bones to be fused.
Tailbone Pain Tip 5, the Coccyx is 3-5 bones, not one, 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.
Discussing coccyx pain (tailbone pain, coccydynia) and other pelvic pains should NOT be TABOO.
Talking with family, friends, online groups, physicians, and physical therapists may help you find answers and relief.
Tailbone Pain Tip 4, Discussing Coccyx Pain should NOT be Taboo, 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.
This term just says that the pain is AT the tailbone.
Just like “chest pain” or “knee pain”, you need to find out WHY the pain is there.
Tailbone Pain Tip 3, Coccydynia means 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.
•I love interacting, learning, and teaching on social media. And…
•My social media posts, comments, replies, videos, website, etc.:
•are intended to be educational information.
•are not to be considered individual medical advice.
•are not a doctor-patient relationship.
•are not endorsements of any products, treatments, or people.
•are not representing the views of any employer or University or hospital.
•are not implying that I know you in ‘real life’.
•mainly focus on a niche area of clinical expertise: coccyx pain (tailbone pain).
•Consult with your own treating clinicians regarding your own care. Please discuss with them anything you learn from my posts.
•I generally do not use direct/private messages on social media.
•I do not do formal radiology readings (MRI, x-rays, etc.) on social media. (I do that privately for my actual patients, off social media.)
•If you ARE an actual patient of mine… Note: on social media I will generally notexplicitly acknowledge that I know you in ‘real life’.
•If you want me to become your treating physician (e.g. for tailbone pain) go to: www.TailboneDoctor.com and call my office for a formal appointment. Thank you! — Patrick Foye, M.D.
In other parts of the body, immobilization and fusion are done after fractures/dislocations/instability/etc. Meanwhile, at the coccyx, these options are very, very limited.
We can’t put the coccyx into a cast or sling or brace they we could for an injured wrist/ankle/etc.
Also, the small fragile bones of the coccyx are not really sturdy enough to hold the rods, pins, or screws that are used after fractures of the hip, for example.
There have been a very limited number of publications about injecting surgical cement after coccyx fracture. The research is very limited, and there is the potential side-effect of fusing the coccyx into a bad position (since you can’t immobilize it after cement injection). Also, I have inherited one patient whose pain was MUCH worse after her cement injection (basically, she said that she still had her original coccyx pain, PLUS now felt like she was sitting right on a blob of cement, which she actually was). Lastly, some movement at the coccyx is needed and normal to help the coccyx to move out of the way (flexing to tuck itself into the pelvis when you sit, or extending to create more space in the pelvis during bowel movements and during childbirth).
I’ve published a little on this topic. See:
Cement or Calcitonin to Coccyx Fractures, for Tailbone Pain, Coccydynia, by 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.
