Coccyx Pain and manual treatment


Posted 2016-12-11

My experiences with coccyx pain began in early 2011. It started with a gradual realisation that the "square bum" feeling I got if I sat down too long was becoming a rather painful and regular occurrence even when sitting down for a short time. In fact, sitting down for any length of time was becoming more and more uncomfortable.

I mentioned this in passing when visiting my GP on another matter. Although he didn't laugh out loud his reaction was dismissive, as much as if to say there was nothing that could be done for that!

At work, which is desk-based in an office, I began to experience a sharp, stabbing pain in my coccyx when getting up from my chair. When at home on the sofa I would sit sideways, shifting from one buttock to the other to relieve my discomfort.

In early 2012 I moved house and changed my GP. I made an appointment and was seen by a young lady doctor who took my problem seriously - and by this time my problem was much worse. She referred me to hospital for an X-ray.

Imagine my horror when I arrived at the X-ray department and saw the crowds in the waiting room, the impossibility of "settling myself in" for a long wait and then my surprise when my name was called 5 minutes later! "Sorry, we don't X-ray the coccyx", I was told.

I returned to my GP and saw the same doctor again. This time she gave me a link to an NHS website, on which I would be able to make an appointment with a choice of three hospitals. The first hospital had no appointments available, the second had a waiting list lasting months, so I chose the 3rd option which meant waiting only weeks. Although this 3rd hospital wasn't really local it was relatively easy to get to.

There I met physiotherapist Helen, with whom I had regular appointments. Her first suggestion was to rub Voltarol on the skin near my coccyx. When that didn't help, she recommended that I try a certain treatment, the name of which I can't remember. It consisted of lying face down on a bed for 15-20 minutes while a machine was pointed at my bottom. I was to have four weekly sessions of this treatment and if it didn't work they would try a few sessions of acupuncture.

Realising that I was going to need time off work once a week for some time to come, I spoke to my manager about my pain and the treatment I was going to have. Immediately he advised me to make an appointment with my company's OHS. A representative came to my office, discussed my pain with me, assessed my requirements and recommended that I be given a height-adjustable desk at which I could stand and a coccyx-friendly chair. (I still use them to this day)

My treatments began - but all to no avail. Helen's next suggestion was a steroid injection. This actually appeared to work. My pain was reduced but only for a few months. I was given an appointment for another steroid injection a few months later.

I met the surgeon before the procedure. He was extremely positive about the procedure, it was sure to give me great relief, and he even said that I would be able to repeat the injection every 6 months indefinitely. (I had previously been led to believe that there was a limit to the amount of steroid injections you could safely receive).

However, things did not go to plan. There I was, lying over a triangular-shaped contraption, my bottom unceremoniously stuck in the air waiting for my injection. Suddenly the surgeon's optimism seemed to dry up - he couldn't get the needle in where he wanted to. That location of my spine was fused.

I think he stuck it in somewhere, but suffice it to say it didn't work. He left the theatre and I never saw him again. On my next appointment with Helen she made it clear that there was nothing more they could do for me. My options were either to get my GP to refer me to a spine surgeon to have my coccyx removed or to go on a Pain Management Course. I opted for the Pain Management Course.

I was given an appointment with another physio, whom I will call Jane. We discussed my pain and the treatments I had had. She explained the principles of the Pain Management Course. I began to form an impression that the course consisted of sitting in a room with a lot of depressed people and taking a lot of pain killers. Although I didn't say so out loud I didn't want it. But in the end, it was Jane who said that she thought the course wasn't for me - she thought I was much too positive! To be honest, I was relieved.

And although I was positive, and I still am, I went back to my GP and asked to be referred to a spine surgeon. I didn't relish the idea of having my coccyx removed but I did think that maybe a spine surgeon would be more of an expert and might have some other ideas that would help me.

This brings me to February 2014. After suffering for three years I'd got to the point of planning to never sit down again. I would think - "I'll get rid of my car and go to work on the bus - I can stand up on the bus - I can stand at work all day with my standing desk - I can eat my meals standing up - and then I can lie down when I go to bed".

I can't remember when I first discovered I occasionally looked at it to read other people's experiences and get advice about chairs, etc. It was there that I read recommendations for Dr Michael Durtnall of Sayer Clinics (see Doctors and specialists in the UK, London).

So, it was with much nervousness and trepidation that I decided to phone Sayer Clinics and make an appointment to see Michael. He did the one thing the NHS should have done in the first place - he took an X-ray. He diagnosed my problem then and there and immediately knew how to treat it. My sacro-coccygeal joint was dislocated and almost fused solid and my gluteal muscles were in permanent spasm as protection against the coccyx pain. I began receiving treatment from Michael and I have made 95% improvement. He also gave me exercises to do and showed me that I was sitting incorrectly. I now have to make sure that I sit forward on my back thigh muscles, not slouch backwards on my bottom. I also receive massage treatment from Marta Dias de Oliveira.

I can highly recommend both Michael and Marta. I had no reason to be nervous; they are kind, friendly and patient and they are experts!

If you are suffering with coccyx pain don't mess around with the NHS for years like I did. Try Dr Michael Durtnall first. The people at the NHS seemed to want to help me but they were treating my symptoms without knowing the cause. The Voltarol, the machine, the acupuncture and the steroid injections were all a waste of time. They were never going to cure me. In fact, the first steroid injection may well have made things worse because it enabled me to sit down in my bad slouchy manner without pain and likely exacerbated my problem.

Incidentally, my GP did refer me to a spine surgeon but nobody ever contacted me. Happily, I don't need that now, thanks to Michael and Marta.

Update, 2018-06-24

Before writing this update I re-read my own experiences posted on 2016-12-11. It brought back memories that I think I would have forgotten if I hadn't written them down. Some of it made me laugh and I realise that I've forgotten the pain I was in. I must have been experiencing intense pain for me to keep on searching for a solution.

I had an appointment today with Dr Michael Durtnall and also with Marta Dias de Oliveira. My last appointments with them were over four months ago. I wanted them to check that I wasn't reverting to my previous state.

Although my bones were slightly stiff and my muscles slightly tense, they loosened up quickly and both Michael and Marta said that there was no pressing need to see them again unless I feel that I need to, or that I can come back again in a few months if I like.

Additionally, my stiffness is probably due in a large degree to the fact that I don't do enough exercise.

I'm very happy with the treatment I've received from Michael and Marta. I highly recommend them. I'm still at 95% improvement, so I haven't deteriorated. 100% would be good, but then I might be tempted to slouch on the sofa and, according to Michael, that isn't good for anyone.

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