Tailbone Pain and Nerve Issues After a Motorcycle Accident

Coccydynia. Numbness and tingling in the legs?

When I stop riding my motorcycle, I experience pain in my coccyx, and the same occurs when I stand up from a chair.
This symptom has persisted for nearly two years and started after a car accident in December 2020, which resulted in a dislocated clavicle and contusions to my chest wall and right shoulder.
At the time, my shoulder was extremely painful, and my attention was focused on it.
Afterward, I mentioned this issue to my doctor, who said the focus should be on my hand and recommended rehabilitation exercises for my coccyx, but there has been no improvement.
In mid-March of this year, I began experiencing a tingling and prickling sensation that extends from the sole of my right foot up to my calf, and my left foot's sole and big toe also have a similar sensation, with the right foot being more severe.
I had X-rays taken of my spine, cervical spine, and shoulder, which indicated cervical degeneration, narrowing of the disc spaces, and bone spurs.
I underwent rehabilitation focusing on my lumbar and cervical spine.
After two sessions, the tingling sensation improved significantly, but by the fourth session, the tingling and pain became more pronounced again, and the coccyx pain has not improved at all.
Is the coccyx pain and the condition in my feet a result of the car accident? I have no prior history of these issues.
Should I undergo electromyography and nerve conduction studies, or are there other tests that should be considered? Thank you, doctor.

Jia You, 50~59 year old female. Ask Date: 2022/06/22

Dr. Wang Zhaomin reply Rehabilitation

Long-term sitting, friction and pressure, local contusions, and coccygeal fractures can all lead to coccydynia.
Traumatic injuries, such as those from car accidents, may also be contributing factors.
Numbness in the legs may be related to spinal degeneration or herniated discs, but establishing a causal relationship with car accidents is difficult.
Nerve conduction studies and electromyography are diagnostic methods used to identify nerve lesions and can help clarify nerve-related pathologies; however, the decision to arrange further testing should be made by a qualified clinical physician.

Reply Date: 2022/06/22

More Info

Tailbone pain, or coccydynia, can be a frustrating and debilitating condition, especially when it persists for an extended period, such as the two years you've described following a motorcycle accident. The symptoms you are experiencing—pain in the tailbone when standing up from a seated position, as well as numbness and tingling in your legs—could indeed be related to the trauma from the accident.
In your case, the motorcycle accident resulted in significant injuries, including a dislocated clavicle and bruising to the chest and shoulder. While the immediate focus of medical attention may have been on these injuries, it is crucial to recognize that trauma to the spine, including the tailbone, can lead to long-term complications. The tailbone is susceptible to injury from falls or direct impact, and if it was injured during the accident, it could explain the persistent pain you are experiencing.

The numbness and tingling in your legs, particularly the right leg, could indicate nerve involvement. This may be due to a herniated disc, spinal stenosis, or other degenerative changes in the spine, as suggested by the X-ray findings of cervical spine degeneration and bone spurs. These conditions can compress the nerves that exit the spinal column, leading to symptoms in the lower extremities.
Given that your symptoms have not improved with rehabilitation exercises and have even worsened after several sessions, it may be time to consider further diagnostic testing. Electromyography (EMG) and nerve conduction studies can be valuable in assessing the function of the nerves and determining if there is any nerve damage or compression that could be contributing to your symptoms. These tests can help clarify the relationship between your tailbone pain and the neurological symptoms in your legs.

In addition to EMG and nerve conduction studies, imaging studies such as MRI may be warranted. An MRI can provide a more detailed view of the soft tissues, including the discs and nerves, and can help identify any herniated discs or other abnormalities that may not be visible on X-rays.
As for your tailbone pain, treatment options can vary based on the underlying cause. If the pain is due to coccydynia, conservative measures such as using a cushion with a cut-out for the tailbone when sitting, applying heat or ice, and taking anti-inflammatory medications may provide relief. Physical therapy focused on strengthening the pelvic floor and improving posture can also be beneficial.
If conservative treatments fail, more invasive options, such as corticosteroid injections or, in rare cases, surgical intervention, may be considered. However, these options should be discussed thoroughly with your healthcare provider, who can help guide you based on your specific situation and the results of any further testing.

In summary, your tailbone pain and leg symptoms could indeed be related to the motorcycle accident, and further evaluation is warranted to determine the best course of action. It is essential to communicate openly with your healthcare provider about your ongoing symptoms and the impact they have on your daily life, as this will help in developing an effective treatment plan tailored to your needs.

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