Coccyx and Lumbar Pain: Solutions for Lasting Relief

Coccygeal issues and lumbar spine issues?

Since I started practicing track and field in junior high, I have had persistent issues with my lower back and coccyx that have not improved despite seeing many Western and traditional Chinese medicine practitioners.
My lower back hurts if I use it for extended periods or engage in high-intensity activities.
For example, sweeping and mopping the floor, which requires bending over for long periods, causes discomfort in my lower back.
Additionally, after long-distance jogging, my lower back feels tight.
A rehabilitation physician reviewed my X-rays and indicated that the pain is muscle-related, but I wonder if the pain in my lower back and coccyx, which often occurs simultaneously, is connected.

In the past, the pain was severe enough to affect my sleep; I could only sleep on my side or stomach and could not lie flat.
Now, it has improved significantly, and I can lie flat, but I still experience discomfort.
Furthermore, when I bend over for a long time and then straighten up, I feel pain in my coccyx, almost like a bone being compressed.
I also experience discomfort when standing up after squatting for a long time, possibly because my coccyx seems particularly prominent.
Prolonged sitting causes discomfort in my bones, even with a cushion.
I am wondering if there are any solutions to address the issues with my lower back and coccyx.

Zhi En, 20~29 year old female. Ask Date: 2023/12/27

Dr. Shi Guozheng reply Orthopedics

Coccydynia is primarily treated with medication and rehabilitation.
Applying heat can help reduce pressure on the coccyx.
If medication is ineffective, local corticosteroid injections may be considered.

Reply Date: 2023/12/27

More Info

Understanding coccyx and lumbar pain can be quite complex, especially when it has persisted for many years and has not responded well to various treatments. Your description of the pain, particularly its relationship with activities such as bending, prolonged sitting, and running, suggests a multifaceted issue that may involve muscular, skeletal, and possibly even neurological components.

Possible Causes of Your Pain
1. Muscle Strain: As indicated by your physical therapist, muscle strain is a common cause of lower back pain. This can occur due to overuse, improper lifting techniques, or even prolonged periods of inactivity followed by sudden activity. The muscles around the lumbar spine and the coccyx can become tight and fatigued, leading to discomfort.

2. Coccyx Pain (Coccydynia): The coccyx, or tailbone, can become painful due to trauma, prolonged sitting, or even repetitive strain from activities like running or bending. If the coccyx is particularly prominent, it may be more susceptible to pressure and discomfort when sitting or standing after prolonged periods.

3. Lumbar Disc Issues: While you mentioned that X-rays indicated muscle issues, it’s also worth considering that there could be underlying disc problems, such as herniation or degeneration, which may not always be visible on X-rays but could be assessed through MRI.

4. Postural Issues: Poor posture during activities like sweeping or prolonged sitting can exacerbate pain. If your posture is not optimal, it can lead to additional strain on the lumbar region and coccyx.

Recommendations for Relief
1. Physical Therapy: Continuing with physical therapy can be beneficial. A therapist can provide targeted exercises to strengthen the core and back muscles, improve flexibility, and correct posture. They may also use modalities such as ultrasound or electrical stimulation to alleviate pain.

2. Ergonomic Adjustments: If you spend long periods sitting, consider using an ergonomic chair that supports your lumbar spine. A coccyx cushion can also help relieve pressure on the tailbone when sitting.

3. Activity Modification: It may be helpful to modify activities that exacerbate your pain. For instance, when sweeping or doing household chores, try to alternate between standing and sitting, or take frequent breaks to avoid prolonged bending.

4. Stretching and Strengthening Exercises: Incorporate gentle stretching and strengthening exercises into your routine. Focus on the lower back, hips, and pelvic floor muscles. Yoga or Pilates can also be beneficial for improving flexibility and core strength.

5. Heat and Cold Therapy: Applying heat can help relax tight muscles, while cold therapy can reduce inflammation. Alternating between the two may provide relief.

6. Medication: Over-the-counter pain relievers such as NSAIDs (e.g., ibuprofen) can help manage pain and inflammation. However, consult with a healthcare provider before starting any medication, especially if you have underlying health conditions.

7. Mind-Body Techniques: Techniques such as mindfulness, meditation, or gentle yoga can help manage pain perception and improve overall well-being.

8. Consultation with a Specialist: If your pain persists despite conservative measures, consider consulting a pain management specialist or an orthopedic surgeon. They may recommend imaging studies like an MRI to further investigate any underlying issues.

Conclusion
Chronic pain in the lumbar region and coccyx can be challenging to manage, especially when it has been present for an extended period. A comprehensive approach that includes physical therapy, ergonomic adjustments, activity modification, and possibly medication can help alleviate symptoms. It’s essential to listen to your body and seek professional guidance as needed. If your symptoms continue to interfere with your daily life, do not hesitate to seek further evaluation and treatment options.

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