Coccydynia: Pain Management After Tailbone Injury

Q: Coccydynia: Pain Management After Tailbone Injury

Hello： For a general coccyx contusion, apply ice without pressure and avoid prolonged sitting. <br>Rest for a week and normal pain medication should help improve the condition. <br>If the contusion is more severe, it may take one to two months to heal. <br>Whether the coccyx is f

Coccydynia

Hello doctor, three days ago I fell and my coccyx hit the edge of the stairs.
When I went to the emergency room, the doctor said there was a fracture, but it was unclear whether it was congenital or acquired.
Later, I visited a nearby orthopedic clinic, and the doctor said the coccyx was not fractured, just bruised.
Both doctors advised ice therapy and gradual recovery at home.
I underwent shockwave therapy at the nearby clinic, and initially, I felt better with less pain, but afterward, I experienced increased pain.
The doctor advised against massaging the painful area, but during the shockwave treatment, a device was applied directly to the painful spot (is this okay?).
I sometimes feel a heaviness near the perineum, and there’s an odd sensation at the junction of my right buttock and the back of my thigh.
Lying flat causes pain, but sleeping on my side or stomach is fine.
After the shockwave therapy, I experienced significant pain while using the toilet (sitting), and I felt like I couldn't fully relieve myself, which took a while to resolve.
Is this a normal situation after an injury?

A Jiu, 20~29 year old female. Ask Date: 2015/05/22

Dr. Wang Shouji reply Orthopedics

Hello: For a general coccyx contusion, apply ice without pressure and avoid prolonged sitting.
Rest for a week and normal pain medication should help improve the condition.
If the contusion is more severe, it may take one to two months to heal.
Whether the coccyx is fractured or not, the treatment principles remain the same, differing only in the duration of treatment.
My recommendation is that shockwave therapy is not necessary.
Pain from prolonged sitting is a normal phenomenon in the short term.
Thank you!

Reply Date: 2015/05/22

More Info

Coccydynia, or tailbone pain, can be a challenging condition to manage, especially following an injury like a fall. Your symptoms, including pain in the tailbone area, discomfort when sitting, and sensations in the perineal region and thigh, are common after such injuries. Understanding the nature of your injury and the appropriate management strategies is crucial for recovery.

Understanding Coccydynia
Coccydynia is often caused by trauma to the coccyx (tailbone), which can result in pain due to inflammation, bruising, or even fractures. In your case, the initial assessment indicated a possible fracture or contusion, which aligns with your symptoms. The pain can be exacerbated by sitting, standing, or moving, as these activities put pressure on the coccyx and surrounding tissues.

Pain Management Strategies
1. Ice Therapy: Applying ice to the affected area can help reduce inflammation and numb the pain. It's typically recommended to ice the area for 15-20 minutes every few hours, especially in the first few days after the injury.

2. Pain Relief Medications: Over-the-counter pain relievers such as ibuprofen or acetaminophen can be effective in managing pain and reducing inflammation. Always follow the dosage instructions and consult with a healthcare provider if you have any concerns.

3. Avoiding Pressure: When sitting, using a cushion or a doughnut-shaped pillow can help alleviate pressure on the coccyx. It's essential to avoid hard surfaces and to change positions frequently to minimize discomfort.

4. Physical Therapy: If pain persists, physical therapy may be beneficial. A physical therapist can provide exercises to strengthen the pelvic floor and surrounding muscles, which can help alleviate pain and improve function.

5. Avoiding Certain Activities: Activities that put additional strain on the coccyx, such as prolonged sitting or heavy lifting, should be minimized until healing occurs.

Concerns About Treatment
Regarding your experience with shockwave therapy, it's essential to communicate openly with your healthcare provider about any discomfort you feel during treatment. While shockwave therapy can be beneficial for certain conditions, it should not cause significant pain. If you experience increased pain during or after treatment, it may be worth discussing alternative therapies or adjustments to your treatment plan.

Normal Recovery Process
It’s not uncommon to experience varying levels of pain and discomfort during the recovery process. The sensations you describe, such as the feeling of heaviness in the perineal area and discomfort in the thigh, may be related to muscle tension or irritation of the nerves in that region. These symptoms can take time to resolve as the body heals.

When to Seek Further Medical Attention
If your symptoms worsen or if you experience new symptoms such as severe pain, swelling, or changes in bowel or bladder function, it’s crucial to seek medical attention. These could indicate complications that require further evaluation.

Conclusion
In summary, managing coccydynia after a tailbone injury involves a combination of pain relief strategies, physical therapy, and lifestyle modifications. While recovery can take time, most individuals see improvement with appropriate care. If you have ongoing concerns about your treatment or symptoms, don’t hesitate to reach out to your healthcare provider for further guidance. They can help tailor a management plan that suits your specific needs and monitor your recovery progress.

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