Coccyx and Pelvic Issues: A Guide to Sciatica Relief

Coccygeal and pelvic issues?

Hello Doctor: I have been suffering from symptoms similar to sciatica, often experiencing soreness that extends from my buttocks down through my entire leg to my ankle.
Additionally, the joints in my feet (ankles, knees, and hip joints) also feel sore, and sometimes my foot soles and dorsum swell.
I have been receiving traditional Chinese medicine treatment for nearly two years, which has only alleviated the pain and frequency of attacks temporarily.
Recently, I have been undergoing physical rehabilitation with Western medicine for three weeks, but there has been no improvement; in fact, I sometimes feel worse, and the frequency of pain has increased.
Due to the lack of results, I had an X-ray taken, which showed that several segments of my coccyx are misaligned at different angles (tilted) and that my pelvis is also tilted.
There are white spots in the pelvic area (which he said are remnants of repeated inflammation).
He mentioned that my pelvis is prone to instability and easily shifts out of place, possibly due to overly lax ligaments.
He stated that surgery would be an overreaction (because after surgical correction, my ligaments may not hold, and the spine and pelvis could shift again).
However, he also mentioned that cases like mine are rare and complicated, and he cannot guarantee a cure.
I would like to know if my symptoms can be treated and what methods should be used.
This has been troubling me for over three years and has affected my ability to work, so I am currently not working and focusing on treatment, but the results have been minimal.
Is there a way to rehabilitate or treat this with medication? Can it be cured? Is this considered a type of sciatica? I apologize for the many questions, and thank you for your help!

candace, 20~29 year old female. Ask Date: 2005/04/11

Dr. Yang Zhengfan reply Orthopedics

Dear Candace, I have read your description three times and I’m sorry, but I still cannot understand the issue you are describing.
Is it pelvic instability? Are the ligaments too lax? Based on your symptom description, I can't even determine if it is sciatica, let alone these "strange diagnoses." I suggest you seek another orthopedic specialist for an examination to avoid misdiagnosing yourself or others.

Reply Date: 2005/04/11

More Info

Sciatica, or sciatic nerve pain, is a common condition that can cause significant discomfort and affect daily activities. It typically arises from irritation or compression of the sciatic nerve, which runs from the lower back through the hips and buttocks and down each leg. Given your symptoms, including pain radiating from the buttocks down to the ankle, joint discomfort, and swelling, it is understandable that you are seeking effective treatment options.

Based on your description, it seems that you may be experiencing a combination of sciatica and pelvic issues, particularly with the alignment of your coccyx (tailbone) and pelvis. The findings from your X-ray, indicating misalignment and inflammation, suggest that there may be underlying structural issues contributing to your pain. The mention of your ligaments being too loose could indicate a condition known as ligamentous laxity, which can lead to instability in the pelvic region.

In terms of treatment, it is important to adopt a comprehensive approach that addresses both the symptoms and the underlying causes. Here are some strategies that may help:
1. Physical Therapy: Engaging in a structured physical therapy program can be beneficial. A physical therapist can design a personalized exercise regimen that focuses on strengthening the muscles around the pelvis and lower back, improving flexibility, and enhancing stability. Core strengthening exercises are particularly important, as a strong core can help support the spine and pelvis.

2. Manual Therapy: Techniques such as chiropractic adjustments or osteopathic manipulative treatment may help realign the spine and pelvis, potentially alleviating pressure on the sciatic nerve. These treatments should be performed by qualified professionals who can assess your specific condition.

3. Pain Management: Non-steroidal anti-inflammatory drugs (NSAIDs) can help reduce inflammation and alleviate pain. However, given your history of limited response to treatments, it may be worth discussing alternative medications with your healthcare provider. In some cases, corticosteroid injections may provide temporary relief by reducing inflammation around the affected nerve.

4. Lifestyle Modifications: Maintaining a healthy weight, practicing good posture, and avoiding prolonged sitting or standing can help reduce strain on the lower back and pelvis. Incorporating regular low-impact exercises, such as swimming or walking, can also promote overall spinal health.

5. Alternative Therapies: Some individuals find relief through acupuncture, massage therapy, or yoga. These modalities can help reduce muscle tension, improve circulation, and promote relaxation.

6. Surgical Options: While surgery is often considered a last resort, it may be necessary in cases where conservative treatments fail to provide relief and there is significant nerve compression. However, as your physician mentioned, surgery carries risks, particularly if there is instability in the ligaments.

Regarding your question about whether your condition can be cured, it is essential to understand that while many individuals experience significant improvement with appropriate treatment, complete resolution may not always be possible, especially if there are structural issues involved. However, with a dedicated treatment plan, many patients can achieve a substantial reduction in pain and an improvement in function.

Lastly, it is crucial to maintain open communication with your healthcare providers. If you feel that your current treatment plan is not effective, do not hesitate to seek a second opinion or explore additional options. Your health and well-being are paramount, and finding the right approach may take time and persistence.

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