Tailbone X-Rays (Coccyx X-Rays), NOT Lumbar

The Tailbone (Coccyx) is NOT the Same as the Lumbar Spine.
  • Practically every day, patients with tailbone pain come to see me from around the country or from around the world. Many have faced a similar  challenge regarding imaging studies.
  • Specifically, it is unfortunately VERY common that the patient has tailbone pain (coccyx pain, coccydynia), but the have a difficult time getting medical imaging studies such as basic x-rays (radiographs) of the tailbone.
  • There are unfortunately multiple reasons why the coccyx x-rays fail to be done:
    • The treating physician  may not know much about  tailbone pain, and if they would not know what kinds of x-rays to order or what kinds of abnormalities to screen for on those x-rays, then they do not know the benefit of ordering  and obtaining the x-rays in the 1st place.
    • The treating physician may not know much about treatment of tailbone pain, and how modern treatments are based upon taking the imaging results into consideration. If the treating physician incorrectly thinks that  x-rays will not make a difference, then they will be unlikely to order those x-rays.
    • The ordering physician may have absentmindedly “checked off” the order box that said “lumbar” or “lumbosacral” x-rays. Because pain in those areas is probably thousands of times more common than tailbone pain, the template forms probably do not even have a box to check off for coccyx x-rays.
    • Even if the ordering physician correctly orders tailbone x-rays, the radiology technician may be so familiar with doing lumbar x-rays (and rarely does any coccyx x-rays), that the technician is on autopilot-mode and when you come in with some pain in the low back or buttock area they just automatically do the lumbar or lumbosacral x-rays.
    • An insurance company or health care system may deny authorization for the x-rays, because they incorrectly believe that the x-rays are unlikely to have any impact on the patient’s subsequent treatment.
    • The insurance company or health care system may  incorrectly use authorization/denial criteria regarding the Lumbar spine, and inappropriately apply those lumbar criteria  to the coccyx region.
  • Every week here at the Tailbone Pain Center, new patients come to see me with similar stories, having suffered through the situations described above. While they are here, we review the prior images (x-rays, MRI, etc.) and we assess whether the studies did or did not give an appropriate evaluation of the coccyx. We also can obtain additional imaging studies, including x-rays done while the patient is sitting.
  • When the appropriate imaging studies are done, the majority of patients with tailbone pain will have an accurate diagnosis that appropriately  explains  the reason for their symptoms. The diagnosis then also provides a basis for a personalized treatment plan, that specifically treats the specific cause of the pain in that specific patient.
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Book: “Tailbone Pain Relief Now! Causes and Treatments for Your Sore or Injured Coccyx” by Patrick Foye, M.D.

Patrick Foye, M.D.
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