Pain and Hard Lump Near the Tailbone: Causes and Solutions - Orthopedics

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Understanding pain and hard lumps near the tailbone can be quite complex, as it involves various potential causes and solutions. Based on your description, it seems you are experiencing pain in the left buttock area, particularly when sitting for extended periods, and you have a hard lump near your tailbone that has been present for years but has recently become painful.

Possible Causes
1. Coccyx Pain (Coccydynia): The pain you are experiencing could be related to coccydynia, which is pain in the coccyx or tailbone area. This condition can arise from trauma, prolonged sitting, or pressure on the coccyx, especially if you have been lifting heavy objects and bending frequently, as you mentioned in your job.
2. Soft Tissue Injury: The heavy lifting and pushing of cargo could have led to a soft tissue injury in the muscles or ligaments surrounding the coccyx. This can cause referred pain to the buttock and thigh area.

3. Bony Growth or Cyst: The hard lump you described could be a benign bony growth, such as an osteoma, or a cyst, such as a pilonidal cyst. While these lumps can be asymptomatic, they may become painful due to inflammation or infection, especially if they are subjected to pressure from sitting or physical activity.

4. Nerve Compression: If the lump is pressing on nearby nerves, it could lead to pain radiating down the leg or into the buttock. This is particularly relevant if you are experiencing pain when bending forward or leaning back.

5. Muscle Strain: The pain could also be due to muscle strain in the gluteal muscles or the muscles of the lower back, which may have been exacerbated by your recent physical activities.


Solutions and Recommendations
1. Rest and Activity Modification: It is crucial to rest and avoid activities that exacerbate the pain. Try to modify your sitting position, using cushions or a doughnut pillow to relieve pressure on the coccyx.

2. Ice and Heat Therapy: Applying ice packs to the painful area for 15-20 minutes several times a day can help reduce inflammation. After a few days, you may switch to heat therapy to relax the muscles and improve blood flow.

3. Over-the-Counter Pain Relief: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help alleviate pain and reduce inflammation. However, consult with a healthcare provider before starting any medication.

4. Physical Therapy: A physical therapist can provide exercises to strengthen the muscles around the pelvis and lower back, improve flexibility, and teach proper lifting techniques to prevent future injuries.

5. Medical Evaluation: Given that the hard lump has become painful and has been present for years, it is advisable to seek a medical evaluation. A healthcare provider may perform a physical examination and possibly imaging studies, such as X-rays or an MRI, to assess the lump and surrounding structures.

6. Surgical Intervention: If the lump is found to be a cyst or a growth that is causing significant pain or discomfort, surgical removal may be necessary. This is typically considered if conservative treatments do not provide relief.


Conclusion
In summary, the pain you are experiencing near your tailbone, along with the hard lump, could be due to various factors, including coccydynia, soft tissue injury, or nerve compression. It is essential to rest, modify your activities, and consider physical therapy. However, given the persistence of your symptoms and the recent onset of pain, a thorough evaluation by a healthcare professional is warranted to determine the exact cause and appropriate treatment plan. Early intervention can help prevent further complications and improve your quality of life.