Post-Abortion Pain: Coccyx Pain and Its Impact on Mobility

Post-abortion soreness?

Hello Doctor: In May of this year, I had to undergo a medical abortion due to embryonic resorption.
Although I followed the traditional postpartum confinement practices, it has now been three months, and I am experiencing increasingly severe body aches.
I often feel sharp pain and numbness in my pelvis, hips, and the area connecting to my thighs, making me walk with a limp.
I also cannot sit or lie on hard chairs or the floor.
I once read a medical column that suggested such symptoms are often misdiagnosed as bone spurs or sciatica, but they could actually be due to coccydynia, or pain from coccygeal myofascial syndrome, which radiates to the buttocks and legs.
Possible causes include poor posture, kyphosis, sports injuries, falls, perineal or rectal surgeries, and postpartum changes.
I wonder if my condition could be related to coccydynia.
Additionally, I often experience knee pain without redness or swelling, and after doing household chores like cooking or cleaning, my lower back becomes stiff, and I have shoulder pain and wrist pain.
I am currently receiving treatment from a traditional Chinese medicine practitioner, but there has been little improvement.
Should I consider seeing an orthopedic specialist or a rehabilitation physician? Thank you for your response!

Celia, 30~39 year old female. Ask Date: 2001/08/13

Dr. Ye Qingnian reply Orthopedics

Coccyx pain is often associated with a history of trauma, such as a fall, leading to injury of the coccyx.
While this can cause pain, it typically does not affect walking.
Pain in the back and buttocks that is characterized by a limping gait may be due to myofascial inflammation in the back or buttocks, requiring further diagnosis and treatment.
Pain in the back, shoulders, and wrists caused by household chores is also mostly due to myofascial inflammation.
Traditional Chinese medicine may not be effective; rest, heat therapy, and medication are recommended.
Please consult an orthopedic clinic.

Reply Date: 2001/08/13

More Info

Post-abortion pain, particularly in the coccyx area, can be a complex issue that affects mobility and overall quality of life. Your symptoms, which include pain in the pelvis, buttocks, and thighs, along with difficulty sitting or lying down, suggest that you may be experiencing coccydynia, or coccyx pain. This condition can arise from various factors, including poor posture, trauma, or even the physical changes that occur during pregnancy and childbirth.

Coccydynia is characterized by pain in the coccyx, which is the small bone at the base of the spine. The pain can be exacerbated by sitting, standing, or moving in certain ways. In your case, the pain radiating to the thighs and buttocks may indicate that the discomfort is not isolated to the coccyx but could involve surrounding muscles and nerves. This is often referred to as referred pain, where the source of pain is not necessarily where the pain is felt.

The fact that you have been experiencing these symptoms for three months post-abortion is concerning. While it is common to have some discomfort after such a procedure, persistent pain warrants further investigation. The symptoms you describe, such as the inability to sit on hard surfaces and the feeling of tightness or pain in the lower back and legs, could be indicative of underlying issues such as muscle strain, ligament damage, or even nerve entrapment.

Given your history and the nature of your symptoms, it would be prudent to consult with a healthcare professional who specializes in musculoskeletal disorders, such as an orthopedic surgeon or a physical medicine and rehabilitation specialist. They can perform a thorough examination, which may include imaging studies like X-rays or MRIs, to assess for any structural issues in the coccyx or surrounding areas.

In the meantime, there are several conservative treatment options you can consider to alleviate your pain. These include:
1. Pain Management: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help reduce inflammation and relieve pain. However, it's essential to consult with a healthcare provider before starting any medication.

2. Physical Therapy: A physical therapist can design a tailored exercise program to strengthen the muscles around the pelvis and improve posture, which may help alleviate some of the discomfort.

3. Coccyx Cushions: Using a cushion designed for coccyx pain can provide relief when sitting. These cushions are typically contoured to relieve pressure on the coccyx.

4. Heat and Cold Therapy: Applying heat or cold packs to the affected area can help reduce pain and inflammation. Heat can relax tight muscles, while cold can numb the area and reduce swelling.

5. Posture Correction: Being mindful of your posture while sitting, standing, and walking can significantly impact your pain levels. Ergonomic adjustments in your workspace or home may also be beneficial.

6. Alternative Therapies: Some individuals find relief through acupuncture, chiropractic care, or massage therapy, which can help address muscle tension and improve circulation.

7. Gradual Return to Activity: While it’s essential to rest, gradually returning to normal activities can help your body adjust and strengthen over time.

If conservative measures do not provide relief, further interventions may be necessary, including injections or, in rare cases, surgical options. It’s crucial to communicate openly with your healthcare provider about your symptoms and any changes you experience.

In conclusion, while your symptoms may suggest coccydynia, a comprehensive evaluation by a specialist is necessary to determine the exact cause of your pain and develop an appropriate treatment plan. Don't hesitate to seek help, as addressing these issues early can lead to better outcomes and improved quality of life.

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