Yesterday I had my second physiotherapy session.
The physio is confident she can help, which helps me to feel confident. Although, I am realistic about my expectations- show me a Dr, Consultant, Chiropractor or other Healthcare Professional who does not try and instil confidence in their ability to help.
My physio started with internal manipulation again, but this time for longer as the initial consultation was more of a history taking exercise. With my consent, she felt around until she found sore and uncomfortable areas, then applied pressure and/or massaged them. Some areas seemed to relax and 'give' fairly quickly, others took a minute or more. It was a very strange sensation actually feeling these areas relaxing. At the end, everything inside felt a lot less tense and pulled.
Then she moved onto outside, applying pressure with her thumb to painful areas. These tended to be on the buttocks around the knicker line. Again, application of pressure relaxed these areas.
We went through relaxation techniques again. I am learning to relax my pelvic floor- this flies in the face with all I have learnt as a Nurse regarding pelvic floor exercises. I have to take two slow, normal breaths then for the third one, sniff into my stomach. I hold one hand on my rib cage and the other on my stomach, the air should be felt as if I have a third lung in my stomach/pelvic area that I am filling, my ribs are meant to stay still. Then I have to hold my breath for a good few seconds, and breathe out slowly, whilst thinking of the areas relaxing. It is REALLY hard! This apparently relaxes the pelvic area. Also during the day I have to think about relaxing that area, to stop tightness building.
I can see the logic of all this. Muscle dysfunction/contracted muscle fibres are causing contraction knots in this area. These are also known as myofascial trigger points. They are common in muscles such as the levator ani, sphincter ani and coccygeus muscles. For me, this has been building up for several years. It can be understood therefore that tenseness in these muscles would pull the coccyx out of position. If treatment can therefore extend and relax these muscles it will allow the coccyx to return to it's normal position. An initial coccyx injury which is unresolved can go onto cause chronic pain with over sensitised nerves. The initial injury may no longer be the cause of the pain, but the pain is still there and still very real.
At the moment I am allowing a week between sessions. I have seen no improvement as yet; but really only had one session. Also- as discussed as my coccydynia has been present for over five years I am not expecting a magical quick cure.
Some practitioners use external manipulation, some do manipulation through the vagina or anus. Having tried all (!) I can confirm that none are particularly pleasant, but none are particularly painful.
I do not profess to know much about the science behind pain as it is extremely complex. My understanding is that in the presence of continued stimulation caused by my initial injury/acute pain my nervous system is now oversensitive, it has pathologically altered. Initially pain hypersensitivity was a good thing as it helps me to avoid further damage to that area. Prolonged sensitivity provides no benefit at all!
Next appointment next Friday. Wish me luck!
Nurse who suffers chronic tailbone pain
- Pain in the arse
- I am a Registered Nurse who has suffered with tailbone pain for over 8 years. Like all chronic pain, it is essential that sufferers get the correct support, diagnosis and treatment appropriate for them as an individual. This blog follows my journey with chronic pain, it expresses my personal opinions and thoughts. It is not intended as a replacement for advice or treatment from your normal Healthcare Provider.