Persistent Coccyx Pain After Three Months: Seeking Solutions

Coccydynia persists for three months despite treatment?

Hello Doctor: I have thoroughly researched all issues related to the coccyx.
My condition is that three years ago, I paid out of pocket for an MRI from the cervical spine to the sacrum, and at that time, my coccyx was normal.
In March of this year, I slipped and fell, resulting in a coccygeal contusion.
X-rays showed a rightward displacement.
I have been continuously taking non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief and inflammation, and I purchased a coccyx cushion to avoid irritation.
From March 1 to now, June 13, I have been doing heat therapy almost every day, but there has been no relief.
On June 5, I had an ultrasound examination of the ligaments in the rehabilitation department, and the doctor suspected that the ligaments were nearly torn and advised me to see an orthopedic surgeon.
However, when I went to Long X Hospital, the orthopedic surgeon dismissed it, stating it was not serious.
For over three months, I have been mostly lying down, and even when dining out or driving, I sit on the coccyx cushion.
Should I continue to wait for natural healing? I would appreciate your guidance.
Thank you very much.

Li Qi, 50~59 year old female. Ask Date: 2023/06/13

Dr. Wang Jiacheng reply Orthopedics

Coccyx contusions typically heal with rest and pain medication; what is needed is time for recovery, which usually takes about three to six months.

Reply Date: 2023/06/13

More Info

Persistent coccyx pain, especially after an injury such as a fall, can be quite challenging to manage. Your situation, where you have been experiencing pain for over three months despite conservative treatments, indicates that further evaluation and possibly a different approach to treatment may be necessary.

Firstly, it's important to understand that the coccyx, or tailbone, is a small, triangular bone at the base of the spine. Injuries to this area, such as fractures or dislocations, can lead to significant pain, especially when sitting or transitioning from sitting to standing. The fact that your X-ray showed a right displacement suggests that there may be a structural issue that could be contributing to your ongoing discomfort.

You mentioned that you have been taking non-steroidal anti-inflammatory drugs (NSAIDs) and using a special cushion to alleviate pressure on the coccyx. While these measures can provide some relief, they may not be sufficient if there is an underlying issue such as a ligament injury or a fracture that has not healed properly. The ultrasound examination indicating a possible ligament tear is particularly concerning, as this could lead to chronic pain if not addressed appropriately.

Given that you have already consulted with both rehabilitation and orthopedic specialists, it may be beneficial to seek a second opinion from another orthopedic surgeon who specializes in coccygeal injuries. They may recommend additional imaging studies, such as an MRI, to assess the soft tissues around the coccyx more thoroughly. This could help determine if there is any significant damage to the ligaments or surrounding structures that may require intervention.

In some cases, if conservative treatments fail, more invasive options may be considered. These can include corticosteroid injections to reduce inflammation and pain, or in rare cases, surgical intervention to remove the coccyx (coccygectomy) if the pain is debilitating and unresponsive to other treatments.

It's also worth considering physical therapy focused on the pelvic floor and coccygeal region. A physical therapist with experience in treating coccyx pain can provide targeted exercises and techniques to help strengthen the surrounding muscles and improve mobility, which may alleviate some of the discomfort.

Lastly, while waiting for natural healing is a common approach, it is essential to monitor your symptoms closely. If your pain worsens or if you develop new symptoms, such as numbness or weakness in your legs, it is crucial to seek immediate medical attention.

In summary, while it is possible that your coccyx may heal naturally over time, given the duration and severity of your pain, further evaluation and possibly a different treatment approach may be warranted. Don't hesitate to advocate for your health and seek additional opinions or treatments that may provide you with relief.

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