Broken T-Bone and surgery to come


Original posting: 2003-03-16

I am 25 years old and suffering from coccygodynia caused by my broken tailbone. I have fallen several times over the past few years and can't be sure when it actually broke, but the increasing pain led me to have X-rays taken by my doctor. During the last several years the pain would flare up again only if I sat for long periods of time (mostly at school or in the car). Occasionally I would experience pain after strenuous exercise More recently the pain has increased to a daily problem and continues to get worse. The X-rays showed my tailbone to be broken at almost a 90 degree angle which explained why so much pain! My doctor wondered how I had broken my T-Bone without knowing it, and I wonder myself. I do recall severe pain after a couple of bad falls but I just sat on a donut pillow for a few weeks and eventually it went away. My doctor prescribed pain killers and said I should "take it easy" for 6 months to see if I felt better. This was not an acceptable option for me as the pain was increasing daily and I did not want to be on medications the rest of my life. So I requested a referral to an orthopaedic surgeon and so began my journey of (hopefully) finding relief.

I saw the OS in November (2002). I was very disappointed with my visit as he was relatively unsympathetic to my daily pain (I think that being a young healthy female creates doubt in people's minds...) He did suggest a series of cortisone injections to try to ease the pain. However, I was concerned about the nature my problem causing trauma during pregnancy and childbirth as my angulated T-bone points directly to the birth canal (this possibility was pointed out by my family doctor, and I have read similar stories on your site). I am not pregnant BUTT my husband and I would like to start a family within the next couple of years so I wanted to take care of this "problem" ASAP! The OS sent me to an OB-Gyn before trying any pain therapy. She (also) was fairly unsympathetic to my condition and said that "it will probably just break again during delivery, but that kind of thing is fairly common". Okay, also not a good diagnosis!

Well, I didn't want to see the same orthopaedic surgeon again as he had terrible bedside manner and I felt he was very unqualified to treat my injury. (I called the office anonymously to find out if he had performed any coccygectomies and the receptionist said she "thought he might have done one in medical school!".) Well I began the quest of trying to find a new OS who had the right experience and finally found Dr. Benson at the UC Davis Medical Center (a spine specialist listed on this site). Not so easy to get my HMO to approve me seeing him though, as he is outside of my group. After (literally) several months of paperwork and dealing with the inefficient bureaucracy of an HMO I finally had an appointment scheduled 2-27-03. During this time I became very familiar with this site and I have to say it is so encouraging to read so many stories similar to mine! It is aggravating that many people don't understand the daily pain and disappointment as this has changed my life. I have spent the last several months at work standing or kneeling which has caused new pain in my back, legs and feet. The pain has increased so much I've had to start taking pain medications at work which prohibits me from driving (a daily part of work) and lowers my ability to concentrate. I work 10-11 hours a day and come home in so much pain I can only lay down on my stomach and use heat pads and ice packs to try to numb the area. My hips and thighs are so sore from sitting and laying on my sides that this pain almost overrides the butt pain. I usually do not leave the house on my time off and it has been months since I've been able to go to the movies or church or pretty much anywhere that requires sitting or driving longer than 20 minutes!

My visit with Dr. Benson was very painful but very encouraging. He pressed (very hard) on my T-bone to see if that's where the pain was coming from (I nearly went through the roof and lay there crying for several minutes.) He then decided to do an injection of cortisone, steroids and several anti-inflammatories of some sort which were supposed to numb me completely. Let me be very honest in saying that this injection was the most painful experience of my entire life. It seemed like an eternity of the worse burning pain you can imagine. I was bleeding and crying and it was terrible! They left me alone for a few minutes then came back in to see if the numbing had started (if it had it was a clear sign that my T-bone was the problem and that a coccygectomy was the right solution.) Well the pain was so bad it was hard to tell if there was any numbing BUTT I thought I could feel it. Dr. Benson decided a coccygectomy was the best solution. The staff were all very encouraging and promised me that I would soon find much relief! He prescribed me Vicodin as well as the Darvocet I was currently taking wasn't really helping the pain, then the nurse came in to schedule my surgery date (4-10-03). I was pleased to find that Dr. Benson has performed many of these surgeries (the nurse thought at least 200 or more) and has found almost all positive results. I left there feeling very encouraged and looking forward to my surgery ... then the pain set in even worse than before.

Turns out the injection only made things much worse. I now have a direct sharp pain in the coccyx whereas it used to be sort of residual pain from standing or sitting. I am told the pain is from the internal bleeding and bruising caused by the shot. If I sit the wrong way it's as if I have sat on a tack. My job has become unbearable as I wear high heels and am very active all day. The pain gets worse each day and I finally told my boss I could not continue working up until the surgery. He suggested I take a week off to rest and see if the pain diminishes, and if so suggests I return to work half days until my surgery. So ... that's where I'm at right now. One month until surgery. I look forward to it as it seems it should completely take care of the problem. But I am nervous after having read some horror stories. I am tired of living with pain on a daily basis though and eagerly awaiting a solution. I may not even return to work pre-surgery and just take some time to prepare for the down-time. If anyone has suggestions I would gladly take them. I have downloaded pictures of my x-rays and will send them to you if you want.

Well, wish me luck over the next month I will try to update after my surgery!

Best regards, Sharon

Updated 2003-07-13:

I had my coccygectomy April 11, 2003. I wanted to update my story sooner, as I have had a lot of people write to ask how I'm doing….but I guess I was just waiting to be able to share the good news. Well so far, not much good news to share. I am about 12 weeks post-op and still haven't returned to work. The pain isn't terrible anymore, so long as I don't sit, stand or walk for too long. But I am still on a regular dose of narcotics (Ultram) and Celebrex. My doctors aren't too sure why it's taking me so long to recover; I just still have a lot of inflammation and pain around the new tip of the coccyx.

The surgery itself went great. Dr. Benson at UC Davis performed the surgery (See list of specialists, he has done literally hundreds of coccygectomies!) When I came to in the recovery room the pain I felt was unbelievable. I was hyper-ventilating and trying to jump off the table. They quickly set me up with a patient-controlled morphine drip and that took care of me quite nicely. The first night I was very tired and got very sick from the morphine (they switched to a synthetic version, Dilaudid, and then I was fine). I was able to get up and go to the bathroom about 10 hours post-op. I ended up staying in the hospital 3 nights and 4 days. They attempted to send me home sooner but as soon as the Dilauded IV was removed the pain set in so badly I couldn't move. Finally they prescribed me a pill form and sent me home.

The first week wasn't too bad as long as I stayed on a regular routine of Dilauded (the first few days I had to take 2 pills every 3 hours, setting an alarm at night to continue taking it). I was severely constipated for almost a week but finally after many stool softeners and laxatives I was able to go with minimal pain. Walking was difficult, I couldn't go very far. In fact, the first couple of days post-op I could only lift my feet a few inches off the ground. Fortunately my husband was able to stay home with me and take care of me for the first week.

The next few weeks went along rather quickly. The incision healed very quickly, I never had an infection or any drainage. I improved with every single day and was able to do more and more. I was able to sit on my coccyx cushion for almost an hour at a time. I was still in a lot of pain though, and continued to take Vicodin on a regular basis. I couldn't really tell if the surgery had worked, the pain still seemed to be there. I was planning to return to work part-time around 6 weeks post-op.

Then, one day I overdid it. I had gone to the pool to try and swim and get a little exercise. That week (about 7 weeks post-op) I had been out of the house a lot, trying to engage in more interesting activities than laying around the house. I ended up having a total relapse of pain; I felt just like I did the first day after surgery with a screaming, burning pain in my behind. I had to take Dilauded again for several days. It was hard to walk and stand for very long, and sitting became absolutely out of the question.

I called the doctor's office and they said I had just really inflamed the area again, so it was back to bed for about a week. They prescribed me a new anti-inflammatory (Celebrex) and a new pain reliever (Ultram) as the vicodin was no longer helping the pain. Ultram has been a life-saver and allows me to be somewhat active.

So, I still haven't returned to work. I feel like I'm back to square one, and the pain is worse than before the op. I am scared to drive myself as each time I sit up straight in the car I get shooting pains (I'm afraid if I'm driving I'll swerve off the road or something). I am able to sit at the computer and do light housework for small amounts of time. I can ride in the car but have to recline the passenger's seat all the way and lay on my side. The pain really isn't terrible as long as I don't overdo it (which is actually pretty easy to do!). I am just waiting patiently for my butt to heal! Constant ice packs wedged between my cheeks really help the inflammation.

We've all read the horror stories of people who take months and months to recover, and I'm afraid I'm heading in that direction! I'm waiting for my health insurance to approve an MRI so we can see if possibly something else is going on.

Keep your fingers crossed for me and hopefully I can update again soon to tell you all how wonderful I am doing!


Note from Jon Miles:

According to the doctors who specialise in coccyx pain, the coccyx doesn't actually get broken. It is naturally in two or three segments, linked by ligaments. An injury can weaken the connections between these segments, or between the coccyx and the sacrum. Then if you sit down, that forces the weak joint apart, causing pain.

Doctors who are not experienced in treating coccydynia think that the coccyx must be broken, because medical textbooks wrongly say that the coccyx is fused into a single bone. When the doctor sees separate pieces on the x-ray, he or she assumes there must be a fracture.

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