Coccyx problems and removal

Lisa -

Posted 2008-05-25

I fell from a horse over 8 years ago but my big problems didn't come to the surface until 2 years ago. Over the years of riding I blamed my sore coccyx on new saddles, taking a jump badly, dismounting on unlevel ground, etc. It wasn't until April 06 when I got a new horse and was riding everyday that the pain became increasingly bad. I was also suffering from feet and ankle pain. Getting up from the sofa, or out of the car after driving was so painful and sleep at night was becoming very limited. Laying on my back was impossible and my whole life centred around the pain from my coccyx area and although I was 35 if felt 70!!

After being referred to a skeletal consultant by my GP for the severe pain in my feet and ankles and lower back pain, I was told I had 3 main problems with my feet, including planta faschitis and Achilles tendonitis and that I had ruptured my pelvic floor. They blamed the pelvic floor rupture on my lower back pain and coccyx pain but couldn't explain why it had ruptured, I have no children and have ridden all my life.

After 6 months of physio I was eventually referred to an orthopaedic surgeon because my coccyx and back pain had extended up to my neck and shoulders. I saw him in March '07 and after a very embarrassing and painful examination and x-ray's, I was told the coccyx was not broken or dislocated, I needed an MRI. This showed nothing and I was diagnosed with coccydynia, but I was told to carry on riding, I would do no harm, and I would be referred to the pain clinic for la/steroid injection into the coccyx.

After 2 months I was in such pain, riding was impossible even for 5 minutes, I made the decision to see a private coccyx expert in London that I found on this site. I saw him early Sept '07. He x-ray'd me from a different angle, the NHS x-rays were straight on, these were side on and it was easy to see the backward dislocation of the last 2 sections of my coccyx and a small crack higher up that could be a birth defect but would cause lower back pain. He then gently examined me, whilst lying on my tummy and again it was easy to feel the dislocation. The NHS surgeon had examined me on my side and the MRI scan would never show a backward dislocation. The private guy attempted manipulation and invited me back but advised it was a long road of 18 months to 2 years manipulation. It was a long way to travel, meant a lot of time of work and was very expensive. Because it was such an old injury the muscles were holding the dislocation out of line.

I went back to my GP for further advise. He was horrified that I had been advised to continue riding after being diagnosed with coccydynia and after seeing the private x-ray advised me to seek a second opinion urgently with a consultant who would see me privately but treat me on the NHS.

In late October '07 I saw Professor Dowell in Chelmsford, Essex (see Doctors and specialists in the UK). He suggested a manipulation under general anaesthetic, an MUA. This was carried out on Xmas eve as a day case, a cancellation appointment but I couldn't turn it down!. I was injected with local anaesthetic and steroids whilst I was under. However, the point of entry for the manipulation was extremely painful for the next 2-3 weeks. Without going into to much detail, everything became more difficult and I feel the MUA made things worse. I needed 6 weeks off work and have not been able to get comfortable since!! On the review in Feb '08 it was decided to perform a coccygectomy.

This was done on April 10th. I was advised I would be in for 2-5 days and need 6 weeks of work. However, I was thrown out the day after it was done. I had to be catheterised after the operation and needed the emergency doctor to attend for a bladder infection 12 hours after I was home. I was saddened at the lack of aftercare provided by the hospital. Advice was sadly lacking and my GP and district nurses (who I contacted off my own back) have been great. I was tottering about within a week, albeit only with in the house, after 2 weeks I could get up the garden for 5 minutes and 3 weeks I was back in clothes, having proper showers and walking more upright than I have for the last 18 months. I feel I have been very lucky in my recovery and it has been much quicker than I thought but going to work is not an option unless they strap me to a roof rack!!!

I would strongly recommend memory foam mattresses to anybody suffering coccyx or back problems. I have one on my bed and also brought a single to put on my sofa as I spent the first 2 weeks sleeping downstairs and it is the only place I can rest comfortably.

I am now 5 ˝ weeks after the op and due for my check up next week. I take no pain killers apart from 1 x diclofenac before bed. I probably should take more but I find they mask the pain and then you over do it so I prefer to potter about at my own pace. Sitting is possible on my memory foam mattress but only for up to 10 minutes. I have brought a coccyx cushion but it compresses too much to be able to use it as yet. I have not driven or been out in the car and sitting would be too uncomfortable and although they are not given to you by the hospital… I use crutches if I walk too far, just as the support helps. The hospital provided me with a toilet raiser and this was a great help as the lower you sit the more likely you are to split the wound.

My wound is completely within my butt crack, if you excuse the expression. Only my closest friends will ever be able to see it and although I have had some bleeding, it has all been controllable with high standards of hygiene, gauze placed between the bottom cheeks and common sense. My wound has healed even though it is still uncomfortable and a bit itchy.

I think it is important to stress if you have this op, the surgeons only gave me 50% of being pain free, however, a 50% chance of being in any less pain than before was of a huge benefit. I feel so much 'lighter' after the op. The pain in my neck/back/shoulders is gone, the band of pain across my lower back is negligible and I don't think you realise how much it drags you down. Also, the constant playing with drugs to get some relief, messes with your body and its so nice to not be on any drugs!!! I put a lot of that down to the memory mattresses though!!

I hope to get the all clear next week to try and get back in the saddle. As long as there is no health risk, the pain can be coped with, I hope. I know I have a long way to go before I know to what degree I have improved, but having the op has already relieved me of a lot of secondary pain. It turned out that my feet/pelvis problems were also all related to the original coccyx dislocation that was done 8 years ago. Everything is almost gone now; just have problems with the planta fasciitis and the operation site, but its still only 5 weeks down the line.

I hope my experience may help others to understand not only the secondary problems that coccydynia can cause but the lack of understanding of the condition from the NHS. There is a definite lack of advice and aftercare but this site has a lot of helpful advice on it.

If I can help or advise anybody else in any way please do not hesitate to email me.

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