This story does indeed have a happy ending.
I injured my coccyx while mountain biking almost four years ago, when I got into an awkward position while trying to stabilize my bike and came into jarring contact with the tip if the saddle. I had done the same thing 7 years earlier, and it had taken about 3 months of staying off it to heal. Not this time. After 12 months of trying to stay off of my tailbone, as well as acupuncture, anti-inflammatories, cortisone injections, cold laser therapy and an unsolicited blind side of chiropractic treatment, I had not improved at all. During this time I had two MRI's and one CT scan. An abnormality showed up on only one of the MRI's, referred to as a small edema located on the tip of my coccyx, which was where I perceived that all of the pain was coming from. I received another cortisone injection, aimed directly at the edema, but felt no improvement. Shortly afterwards, I found coccyx.org and this extremely helpful forum.
As I read through the various stories, I began to consider surgery to remove my coccyx, and scheduled a consultation with a surgeon experienced in performing coccygectomies, Doctor Jeffrey Donner in Loveland, Colorado (see Doctors and specialists in the USA, Colorado). During the consultation, I received direct and candid answers to my questions. With a clear understanding of the risks and rate of success, I asked Doctor Donner to perform the surgery to remove my coccyx. The surgery itself went smooth… no complications, pain was much less than I was bracing myself for, and the incision healed quickly. In my own mind I was confident of success, and I circled a date eight weeks after the surgery as the target that I could expect relief. That date came and went with minimal improvement. Although the pain I had experienced at the tip of my coccyx was gone, the pain in the immediate vicinity remained, and it felt identical and just as intense as the pre-surgery pain….. frustrating phenomenon. As time went on, it was difficult to tell if things were improving because things would seem better for a while and then I would have a setback.
Eleven months after surgery, (two years after the initial injury), I received another MRI, but it revealed nothing. In a follow up visit, I received a series of steroid injections from Doctor Donner, into 5 separate locations as directed by me. After 3 days of additional soreness, (most of which was likely due to bruising caused by the ample needle….. holy bayonet, never look at the needle!), I did feel a bit of relief, which lasted for about a month and then most of it wore off. Another set of multi-location injections resulted in more initial soreness, lasting longer. A bit of relief did follow though. I did feel that I had experienced some gradual improvement since the surgery, however it was at a glacial pace, and my quality of life continued to be significantly compromised. Spending way too much time horizontal on my stomach in order to recover from trying to perform competently at my job. Another crossroads: whether to continue injections or try something else.
I decided to try something else. I had definitely not lost hope, but my optimism was being brutally tested. I scheduled a session with a highly regarded Functional Manual Therapist, Jen Shepherd of Whole Body Integrative Therapies in Golden, Colorado (see Doctors and specialists in the USA, Colorado). I didn't know it at the time, but I had just found the one who would find the connections that would lead to sweet relief. Jen Shepherd approached my condition with Functional Manual Therapy, as developed by the Institute of Physical Art. In my case, she supplemented the therapy with recommended exercises primarily aimed at strengthening the muscles in the immediate vicinity of where my coccyx used to be, the primary muscle being the pelvic floor. At the beginning of FMT treatment, we discovered that engaging my pelvic floor muscle resulted in only a weak-ass unsustained flicker, and that I needed to get to work strengthening it. Also the gluteal muscles, which I had been working on at Doctor Donner's suggestion, needed more attention. Another part of the FMT treatment involved 'going internal', which turned out to be only slightly more terrifying than it sounds. But dang, was it effective. In addition, a book was recommended that proved to be a super-valuable supplement and resource: Taming Pain by Cheryl Wardlaw. This book was most effective in identifying foods that cause inflammation, as well as foods effective in fighting inflammation. After five sessions of therapy spanning seven weeks, I experienced a colossal breakthrough, in which 75 percent of my pain was eliminated. A beautiful place to arrive at after a journey with so many dead ends... finally able to function normally. I made it a priority to continue with the exercises and nutrition, had some follow up FMT sessions, and consistently improved. I am now pain free. As if the injury never happened. Hard to believe that I would ever get to this point. I will never take the simple act of sitting for granted again.
If you're reading this, you are likely in significant discomfort, and have had some dead ends of your own. I have learned through this website and from personal experience that there's no such thing as a typical coccyx injury, and perhaps no universal treatment. What does seem to be a common thread is the temperamental, un-responsive, un-cooperative nature of the pain magnet, inflammation haven, design flaw of evolution that is the coccyx. If I had to go through it again, I would obviously start with what worked for me; manual therapy by someone certified specifically in Functional Manual Therapy. I would spend as much time on the recommended exercises as possible, and I would pay attention to anti-inflammatory nutrition. And if it came to it, I would still be receptive to cortisone and steroid injections, as well as surgery to remove.
Don't give up.
Note from Jon Miles:
I emailed more than a year after this story was posted, to ask for an update, as the long-term outcome of treatment is of great interest. In this case I did not get a reply.