I'd had sitting pain for years. I thought it was because I had a tiny heinie and getting older. It got much worse after a 2003 bus ride of an hour stuck in traffic (hard plastic seats). Suddenly, I could not sit down.
I was misdiagnosed for over a year. They thought I had piriformis syndrome, then herniated disc, the SI syndrome. And the treatments I had were awful: VAX-D where you're stretched on a rack (which destabilized my spine); then Ozone injections (which was like pouring oxygen on my inflamed buttocks); then Prolotherapy (no help for sitting pain); and Trigger Point injections (more fun with needles and totally useless). I've got to say Graston Technique did rid me of the hard Trigger Points on thighs I developed from my problem but I could not get a diagnosis, not from over 20 doctors I saw around New York City. I'd gone to all the best specialists.
In desperation, I flew to Paris to see Dr. Maigne (see Doctors and specialists in France), having been impressed by his medical papers I read on the net. (I was so desperate for a diagnosis I was reduced to reading medical papers.) I never realized it was my coccyx until Dr. Maigne diagnosed me. He not only told me it was my coccyx (not my back) he told me exactly what was wrong with it - a spicule or bone spur on the end.
Back in the USA I had an anesthetic block test to tip, cortisone injection, and MRI of just the coccyx. All proved pain was coming from coccyx tip. Coccyx MRI showed the deformity; if you get MRI of the pelvis, the coccyx image isn't big enough and they say "it's not your coccyx".
Happy ending: Coccyxgectomy July by neurosurgeon Dr. James Campbell at Johns Hopkins (see Doctors and specialists in the USA). He let me take my coccyx home where I boiled it and bleached it to show the bone with a hook and spike on the end. At 13 weeks post surgery I'm doing fine, everything's smooth down there, and expect a full recovery.
Dr. James Campbell at Johns Hopkins has done dozens of coccyxgectomies. He's a neurosurgeon and Chair of their Pain Department so he examines you and looks for things like if it's PNE instead. I had idiopathic coccyxdenia; he performed a entire - not partial - coccyxgectomy. Dr. Campbell does not like to do partials, even though my problem was at the very tip. Got to say I'm getting along fine (at 13 weeks post-surgery) and expect a full recovery. I'm thin but nothing is sticking me in the butt anymore. He does a smooth job, shaving everything down. Johns Hopkins social workers can get you inexpensive hotel rates nearby. I'm glad I went to Johns Hopkins, rented a SUV and got myself hauled back to Manhattan. He's at 410-955-2058.
Finally Sitting Pretty in Manhattan
Posting to tell you that I'm recovered. No more pain in the butt. No problems with the surgery. I can now sit on hard surfaces, even park benches. But, it took over a year of healing to get here. I had surgery a year and 4 months ago. If you decide to have surgery, you'd better carry around your tush cush for a year, like I did. And don't push it. If you sit on a hard chair for dinner with friends 5 months after surgery (as I stupidly did) your PITA will return with a vengeance and it'll take you weeks for it to get back to the way it felt before you sat down on hard chair. Don't do hard chairs even with tush cush! For the year you are healing you must Baby Your Butt.
I disagree with surgeons who tell healing patients to sit soon after surgery to toughen up the surgery site. I did no sitting for 10-12 weeks after surgery. Totally glad I had the surgery.
Good luck, everyone!