Any tips on what my next steps are?

Matthew -

Posted 2011-02-06

Hi there. I've had an issue with my coccyx area for nearly 14 months now. I woke one morning and went for a walk and noticed what felt like a bruise on my coccyx - I'd been out the night before but had not fallen over or done anything that would cause trauma. Then I remembered I had exactly the same thing about 8 years ago - back then the doctors didn't know what it was and it eventually disappeared after 5 or so weeks.

This time, however, it seems like it's here to stay. After 3 months of to-and-froing from the doctors they concluded they were stumped and sent me to physio. They couldn't be sure what the issue was either, but noticed that my glutes were extremely tight and would fire into spasm at the slightest touch. Maybe this was the I had 3 months of massage and stretching my glutes. Alas, even though my glutes loosened up, the problem remained, and a muscular pain (see below) seemed to develop as a result of this.

I then went to see a back specialist (since I was told there are no coccyx region specialists) and had an MRI scan to see what was what. The specialist suspected it would be 'normal' (ie: spine/coccyx ok) and I would therefore have 'tennis elbow of the bum'...coccydynia - and so it proved. He mentioned my options (injections/manipulation/butchery) but recommended I get back to the gym and see how it goes. During this time I tried about 8 sessions of acupuncture/deep tissue massage, which felt great but still has not helped either.

After 14 months of living with the different pains I'm convinced the problem is ligament-related - to be precise the two ligaments that run from the inside/top of the pelvic bone down to the coccyx, like struts. I can only assume they were damaged sometime in the past and have gradually got worse and worse until that night I went out. I generally only have discomfort when I sit - thankfully it doesn't prevent me from sleeping and I'm also ok when I standing.

I have 3 sets of symptoms - one of which will be with me for the day until they change shifts:

1. The most common is a muscular ache at the top of my buttock. Seems to emanate from the top/inside of the pelvic bone (the top of the ligament?) where there are several hard lumps which I feel compelled to press when I feel this ache - they feel sore and I usually end up bruising them. I assume these lumps are the connective tissue of the ligaments to the bone. I also feel as if I just need to stretch this tiny area. This occurs 99% on my right side.

2. If I don't have the aching I have the stinging sensation which encompasses my entire natal cleft, as if the whole region is aggravated.

3. Deep bruise. This only occurs if I sit down and totally relax - after about 30 mins I will feel a painful bruise running along either of these 'strut' ligaments. I never sit down that long anymore - well, if I have to I lock my core and thighs to 'raise' myself up and kind of float - very tiring! :o)

I'm continuing at the gym taking Body Balance classes as often as I can a week in the hope that if I can strengthen all the muscles in that region that will allow the ligaments to heal.

Has anyone else had similar problems and any tips on what my next steps are? I've read about prolotherapy (deliberately inflaming the ligaments in order to trigger healing) this something anyone else has experience of?

Posted 2012-07-29

Well, it's been nearly 18 months since I first posted on here, and I would say I am almost back to normal. I wish I could tell you exactly what my problem was, and that someone or something proved a clear turning point, but I can't.

Very soon after posting on here I started seeing Michael Durtnall at Sayer Clinics in Kensington (see Doctors and specialists in the UK, London). If you can get to London, I would recommend seeing Michael without hesitation - he knows what he's talking about, it's as simple as that. After the months of going to my GP, various physios and other medical experts, and wondering if there was anyone of earth who could understand, Michael was a godsend. My mind was put at ease after the first session - he x-rayed me and felt the area and diagnosed a 'subluxated coccyx'. However, my prayers for a quick resolution were dashed when he said it would take many months to heal because the entire area was rock hard with no movement at all - all the muscles had stopped working basically, and we needed to get them moving.

His solution was simple: do things that will get these muscles moving again. He gave me 2 very simple exercises to do and advised me take up tennis or something that would use these muscles.

After 4 months of just dong his exercises (a knee injury put paid to tennis etc) the muscle pains were as good as gone; I still could not sit for long without feeling the muscles starting to complain, though...which in turn would pull on my coccyx for the bruised feeling. Luckily I found a way to sit by sitting on a folded cushion at the top of my thighs whilst wedging myself into a chair with a cushion crammed into my lumbar region. This way, my bum was almost floating....I had minor leg pains from sitting on them all the time, but hey.

From months 5 to 9 months of seeing Michael I seemed to have plateaued; the muscle pains were gone, but I was stinging almost all the time. Seemed like the area around my backside had become hyper-sensitive. Michael didn't seem to know what it was, and it dawned on me that his exercises had cured my muscle problem months ago (or rather put the healing in motion), and this stinging was something else...maybe nerve-related. Anyway, I stopped seeing Michael soon after.

I then got into contact with someone from this site (Thanks, Sam!) who had seen Dr. Rajveer Singh (see Doctors and specialists in India). He had also seen Michael, but wasn't too impressed with the exercises. The exercises he got from Dr Singh did the trick for him, and upon reading about and then doing them, certainly made a lot of sense as they isolated the bum muscles that were affected. I believe if had these exercises to do along with Michael's from day one I may have seen a quicker progress...but who knows.

This takes me up to about 3 months ago. The stinging was still raging so I had a specialist take a look at my backside to check for a reason for it - I was having 5 days of discomfort with 2 days respite if I was lucky. He found there was nothing wrong, plus he pushed my coccyx around whilst internally examining me and I felt nothing. He gave me some cream and, to my amazement (having tried about 4 different creams in 4 months), the discomfort was reversed (5 days good; 2 bad). By luck I also found that using a Vaseline-like product called Epaderm cut the stinging even better....I've been on that ever since and I rarely flare-up now. God knows what it was...a skin problem? A nerve problem brought on by my main problem...?

So, that's me up-to-date. I'm not 100%. The muscles directly under my sit bones seem to have disappeared - feels like sitting on a pipe if I sit on a hard floor with my knees up, but I know I am gradually, and very slowly getting there. I can sit in the cinema comfortably enough and in the car. I hope that this time next year the muscles will have healed completely....maybe quicker now that my knee is better and I can start to play tennis.

If I had to guess what my problem was, I would say it is, as my back specialist said initially, 'tennis elbow of the bum'. The muscles either side of my pelvis that connect to coccyx got weak, or damaged somehow, and finally just gave up, pulling the coccyx out of position and staying that way for over a year until I started to see Michael.

So I'd like to thank Michael for his help and advice, and Jon for creating this wonderful website.

Hope this helps someone reading!

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