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Natalie - nat_the_rat@hotmail.com
Posted 2010-02-21
I sustained a coccyx injury during childbirth last year and had a lot of trouble finding someone to treat it successfully. After 5 months of no improvement, my doctor arranged X-rays & CT scans which showed nothing. I found that physio was of little help - she just did heat therapy using the ultrasound device. She did recommended getting a special cushion with a semi-circle cut out at the back (where your coccyx would be) and that did assist in avoiding any further aggravation to it when sitting (especially with breastfeeding when you are sitting a lot).
I did some research online and read about a myotherapist who had treated someone with this problem, Carissa Stewart (see Doctors and specialists in the Australia). Went to see her and she did trigger point therapy and some stretching on the area and gave me exercises to do at home, and also urged me to use a heat pack for 15 mins every night on the area (and you really do have to do this). It took about 3 treatments with her (on the 3rd one is when she does it quite firmly) to see improvement but it would have been about 30% (by this time, about 6 months after the birth). After another 2 sessions, about 70% better which brings me to now (9 months after the birth). Rather than being in constant pain as I was before the myotherapy, I now only really notice the pain when I have been sitting for long periods, which is much better than always feeling it!
She also has some adhesive heat pads that stick to your undergarments which helped me on a 8 hour car trip and last up to 12 hours. They can only be used once but were only a couple of dollars each.
Posted 2011-07-24
Whilst I did have some success through the myotherapy, the relief was only short lived. I have since seen three more physiotherapists before deciding I needed to see someone more serious, and this is when I decided to bite the bullet and try cortisone injections. If it didn't work, at least it was something else I could rule out. I should add first that one of the physios that I saw practiced internal massage of the muscles around the coccyx. As you can imagine this is a fairly intrusive procedure, one I wasn't particularly fond of. She did find that my muscles were incredibly tight and knotted, and did what she could to stretch them out. Again, just short term relief. She also recommended having regular massage particularly around the glute muscles, as whatever was wrong with my coccyx was causing them to be incredibly tight. Keeping on top of this definitely helps.
So I had my first appointment with a specialist who deals in musculoskeletal pain on 15th February 2011 and he discussed my options. He said the only thing that could really be done was cortisone (and various other injections such as glucose), and if all that fails, a coccygectomy. I was a bit shocked that I would have to consider something so drastic, but on the other hand it was coming up to 2 years since the injury and it was clear it wasn't going to heal up on its own. He convinced me to have a cortisone shot whilst I was there, so I did. It is done with a local anaesthetic. Needless to say it still hurt, but sitting down straight after didn't. I was to keep a record of my pain level (out of 10) for the next 6 hours and then daily for 2 weeks. Once I got home though, my pain shot up to an 8/10 which I wasn't expecting – I guess the local wore off. Unfortunately it was like that for the next 48 hours, and I really regretted having it. However after the 48 hours the pain decreased rapidly, and got as far as a 1/10 (I would estimate I was a 4-5/10 before the cortisone). The effects lasted about 6 weeks in which I went back for another, except this time I felt no initial pain (but still the coccyx pain), and it took a good 2 weeks for the cortisone to set in.
Once that wore off, my specialist suggested performing a cortisone injection under x-ray guidance a) to get a better and more accurate result and b) to have a look at the coccyx at the same time. Whilst under x-ray, he said there was no obvious problem with the coccyx such as it pointed the wrong way or something – that is, it was straight. But when he tried getting the needle into the joint (where my pain is), he could not. He said it was as if something had fused over the joint. I asked what that meant and he said he didn't know. He proceeded to inject the cortisone all around the joint, as it was the best he could do. Needless to say I was a bit alarmed. I was hoping that after 2 years I might actually have some concrete answers. All he could say was that I should give it two weeks and get in touch with him and report on the pain level. He said 'I wouldn't remove it at this point – I can, but I wouldn't yet'. I don't want to have it removed, but if that's what's eventually going to happen I'd rather do it sooner rather than later. It's now been 1 week since that injection and the pain is still a 6/10, so I am going to give it one more week and then call him.
We were hoping to be pregnant with our 2nd child by now (needless to say I am going to have a caesarean!) but we have put those plans on hold. I don't fancy being pregnant and having the baby pressing right down onto the coccyx constantly. At the moment I get relief when standing but being pregnant, that wouldn't be the case. Also if I plan to go down the path of surgery, I will need to get that well and truly out of the way before becoming pregnant.