Severe Coccyx Pain: Unable to Stand After Long Sitting

Coccydynia causing inability to stand?

Yesterday, I spent several hours sleeping on the floor while leaning back against a lazy chair to accompany my kitten.
During that time, I experienced issues such as numbness in my legs and back pain.
By evening, I found it difficult to stand up straight; any attempt to do so resulted in pain.
I took an anti-inflammatory painkiller and went to sleep, but when I woke up today, the situation had worsened.
Shifting my weight to my lower body causes severe pain, making it impossible to stand or maintain an upright position.
Even sitting is painful, and my legs become numb.
Currently, the only comfortable positions are lying down or prone, and I can only crawl on the floor to move, as I cannot do so otherwise.

Hsu, 20~29 year old female. Ask Date: 2021/12/31

Dr. Chen Bochen reply Orthopedics

Hello, this is inflammation of the ligaments connecting the pelvic muscles to the coccyx.
It usually improves on its own within 3 to 4 weeks.
Using anti-inflammatory and pain relief medication for about a week can help alleviate the symptoms.
During the recovery period, avoid sitting on hard chairs and maintain an upright posture.

Reply Date: 2021/12/31

More Info

Severe coccyx pain, especially after prolonged sitting in an awkward position, can be quite debilitating and is often referred to as coccydynia. This condition can arise from various factors, including trauma, prolonged pressure on the coccyx, or even muscle strain in the surrounding areas. Given your description of the pain worsening after sleeping on the floor and the inability to stand or sit without significant discomfort, it is crucial to address this issue promptly.

Firstly, the coccyx, or tailbone, is a small triangular bone at the base of the spine, and it can become inflamed or irritated due to prolonged pressure or awkward positioning. When you sat on the floor for an extended period, especially if your posture was not supportive, it could have led to inflammation of the coccyx or surrounding soft tissues. The pain you are experiencing when shifting your weight or standing could indicate that the area is sensitive and possibly inflamed.

The symptoms of pain radiating to the legs and causing numbness or tingling could also suggest that there may be some nerve involvement, possibly due to pressure on the nerves that exit the spine in that region. This can happen if the muscles around the coccyx are tense or if there is swelling that compresses nearby nerves.

In terms of immediate management, here are some recommendations:
1. Rest and Positioning: Since lying down or being prone is more comfortable for you, continue to rest in that position. Avoid sitting for prolonged periods, especially on hard surfaces. If you must sit, consider using a cushion or a doughnut-shaped pillow to relieve pressure on the coccyx.

2. Pain Relief: Over-the-counter anti-inflammatory medications, such as ibuprofen or naproxen, can help reduce inflammation and alleviate pain. However, be sure to follow the recommended dosages and consult with a healthcare provider if you have any underlying health conditions or are taking other medications.

3. Heat and Cold Therapy: Applying a cold pack to the affected area for the first 48 hours can help reduce swelling. After that, switching to heat therapy, such as a warm compress or heating pad, may help relax the muscles and alleviate pain.

4. Gentle Stretching and Strengthening: Once the acute pain subsides, gentle stretching of the lower back and hip muscles can help relieve tension. Strengthening exercises for the core and pelvic floor may also provide support to the coccyx.

5. Consult a Healthcare Provider: If your symptoms persist or worsen, it is essential to seek medical attention. A healthcare provider may perform a physical examination and possibly imaging studies, such as X-rays, to rule out any fractures or other underlying issues. They may also refer you to a physical therapist who specializes in pelvic pain or musculoskeletal disorders.

6. Consideration of Other Conditions: If the pain continues despite conservative management, it may be necessary to evaluate for other conditions, such as sacroiliitis or herniated discs, which could contribute to your symptoms.

In summary, while coccyx pain can be quite severe and limiting, there are several strategies you can employ to manage the discomfort. It is crucial to listen to your body and avoid positions that exacerbate the pain. If symptoms do not improve with home care, do not hesitate to seek professional medical advice for further evaluation and treatment.

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