I know that I have mentioned causes of tailbone pain before, but feel it my be a good time to revisit this.
Gp's I have worked with have told me they see coccydynia patients as 'heart sink' patients because they are 'notoriously hard to treat'. They do not seem to take the condition as seriously as it should be taken. More often than not patients are given pain relief, and told to go away, and that it will improve over time. Well- maybe for a lucky few it might. I would argue that for the majority of us it doesn't.
Coccydynia patients I have known and heard about have to fight for investigations such as X-rays. They have to fight for their Gp to do an onward referral. Getting a referral to the correct specialist is an additional battle.
I would argue that coccydynia patients need to be taken more seriously. How can they get the correct treatment if they do not have the correct diagnosis? Prompt and correct diagnosis, referral and treatment could save us years of pain, grief and frustration.
NHS Choices causes of coccydynia
The NHS Choices website says that coccyx pain is due to the coccyx or surrounding tissue becoming damaged. It also states that one in every three cases has no obvious cause. Coccydynia can often develop gradually over time, with symptoms that become fairly well established before it is bad enough for sufferers to seek help; known in the medical profession as an 'insidious onset'.
Cited causes include- Childbirth, injury, repetitive strain injury (RSI), poor posture, being over or under weight, ageing, and cancer. Women are more likely to suffer as their pelvis is broader, meaning that sitting will place more pressure on the coccyx; our pelvis is also rotated, so the coccyx is more exposed to injury.
As mentioned in my previous blog entry, my coccydynia was of insidious onset. I was not sure exactly how or when it started. I have been told it was an old injury (possibly from being kicked as a child), that was then aggravated by spin cycling. I was at one time going 3-4 times a week. Spin cycling would come under RSI as it involved continually leaning forward, stretching and putting strain on my muscles and ligaments around my coccyx. These muscles were then permanently damaged and unable to hold my coccyx in the correct position.
The physio that I have been seeing has always maintained that my coccyx is not my current problem, and that the pain is from the surrounding muscles and ligaments that have had years of holding my coccyx in the wrong position. They have overcompensated, trying to protect an old injury, as well as being subjected to bad posture whilst spin cycling. Obviously ongoing bad posture and sitting both at work and home have aggravated this.
I am without doubt that the treatment she has done has helped. She has applied pressure to internal and external pressure points, as well as internal and external massage, on both surface and deeper tissue. I have had in excess of eleven sessions now. I am due to see her again on the 27th, but am thinking the need to keep going has lessened, and it's becoming more of a psychological crutch now than actually having the potential to improve things any more. Obviously I will discuss this with her.
Additional possible causes of tailbone pain that I have explored have been to remove my Mirena coil. I am not sure if this has made a difference or not, but at least it's out of the equation now. I have also had an ovarian cyst which has now gone.
Added to these possible causes, following a laparoscopy, my surgeon has told me that I have pelvic varices (varicose veins in my pelvic area) which can present with a dull aching, sometimes sharp pain, usually worse on one side- like mine is. They can also cause low back ache. Any activity that increases venous pressure can apparently exacerbate these symptoms- such as sitting (or standing). He described it as chronic pain that is unresponsive to conventional treatment. All of this ties in with my coccydynia.
He also found that I have a 'significantly' distended bowel. This, I was told is so large and dilated that it is resting on my coccyx, and the surgeon is in no doubt, also contributing to my coccydynia. It stands to reason therefore that this will aggravate my pain, especially if I become constipated.
The gynaecological surgeon has told me that there is nothing he can do for the pelvic varices. He says a bowel specialist may be able to help in regard to my distended bowel, but feels it is unlikely. Both he and my GP have told me that any bowel surgery would potentially mean removing part of my bowel and possibly a bag for a while (or permanently) and there are no guarantees it would work anyway.
So to summarise- possible causes known to me are-
Childbirth, injury, repetitive strain injury (RSI), poor posture, being over or under weight, ageing, cysts (not always ovarian), a coil, a distended bowel or anything internally that may be pressing on ligaments, structures and nearby nerves.
I still get uncomfortable sat for any length of time. I still have to consider long journeys- planes, trains and cars. I have to consider hairdressing and dental appointments. The option to spend the whole day sat in front of the TV is not open to me. Things so many people take for granted- I cannot do without consideration, or potential suffering. I know I am better off than many, and for that I am thankful. The residual pain I am left with- whether it is my coccyx, varices or bowel I am going to have to live with. So my journey with my coccydynia continues.....for now.
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.