Injections gave temporary relief, manipulation making progress

Steven, UK -

Posted 2013

My coccyx pain began without any obvious cause and took approximately a month to turn from mild discomfort in certain positions to acute pain, particular on standing after sitting in my office chair. I saw my GP who was sympathetic but not very helpful in a practical sense. He spoke about special cushions and drugs that would help, particularly Diclofenac. He advised that this was a stomach irritant and should be used with another drug, Omeprazole, to counter this. He also agreed to refer me to see an orthopedic specialist at the hospital. In the meantime, the coccyx pain became consistently worse and I had to take the drugs just to keep going.

I tried the cushion solution but it did nothing. I changed my office chair and was very careful about seating and posture. Hard, flat surfaces such as a wooden stool or chair, were the least painful. However, the drugs made me feel ill (tired and lethargic, pre-flu like) and upset my stomach with bouts of IBS type symptoms every few days. They took about 50% of the pain away so I persisted with them. I had also been referred to a physiotherapist and when my appointment came up I was told that there was nothing physiotherapy could do for my condition. The NHS also treated my new IBS symptoms separately and I eventually had to have a colonoscopy which fortunately proved to be clear. I then decided to stop taking the medication, apart from when my coccyx was particularly bad. The IBS symptoms gradually went away.

When I saw the orthopedic specialist after about a four month wait he was not interested in x-rays and said it was not possible to clearly image the coccyx area. He offered me a manipulation and cortisone injection under anaesthetic, which he said was successful in many cases. I had this done by the NHS which involved me checking in to the hospital and leaving the same evening. The procedure gave me about 2 months pain free. However, because it masked the pain I was no longer as careful about my sitting and posture and the pain gradually returned. I went back to the orthopaedic specialist who offered me another try, saying that the second time was often more successful. With approximately one year between treatments, I had the second manipulation and injection under anaesthetic. This time I continued to be very careful regarding sitting and posture and the pain went away for 11 months and requiring no medication at all. However, it then began to creep gradually back. I was offered a third (and final) manipulation, which I declined, now realising that the cortisone was probably doing more damage than good in simply masking the condition. I spoke with the surgeon about coccyx removal and he thought that in my case I had between a 70% and 75% chance of some degree of improvement, but also a chance that it would either do nothing or even make the condition worse. Given the area, there is also an increased risk of infection. I declined.

At this point I made an appointment to see the chiropractor, Dr Michael Durtnall of the Sayer Clinic (see Doctors and specialists in the UK, London), having read the information on this site. Dr Durtnall was friendly, knowledgeable and enthusiastic as he listened to my case history and then took two x-rays. Within minutes we were able to clearly see an image of my coccyx on his computer monitor. The images showed my coccyx to be fused at the first joint at too upright an angle, and also dislocated at the second joint, where it was tucked under and to the left. Precisely where my body and pain was telling me. It also appeared to be abnormally long and the joints showed signs of long term calcification. After such vague and impersonal treatment through the NHS it was a tremendous relief to finally have an image and diagnosis of my coccyx condition. Why the NHS cannot do this is beyond me.

Dr Durtnall explained that this was a tough case and he would do his best to get it sorted. My treatment involves manipulation of the coccyx externally and massage. He also works on my spine higher up as needed and has used acupuncture on one occasion. The treatment sometimes feels strange but is not painful. In addition, I have exercises to perform at home. So far I have had four treatments, spaced once every two weeks. The Dr thinks I may need around 10 or 12, although the average number for this type of condition is actually seven. On the third treatment my coccyx finally began to move and I felt this as a strange creaking sensation in the days after. It is now becoming gradually more mobile and the relief I experience following manipulation is lasting longer each time. I have no acute pain on standing any more, although the coccyx is still painful in certain positions and I often have a dull ache throughout that region. My treatment is still in process and at quite an early stage, and so far my progress has been better than expected. I have not needed any medication whatsoever for the last month.

I will update this report as my treatment with Dr Durtnall progresses.

What is coccydynia? | Investigation and diagnosis | Treatment | Coping with coccyx pain | Find a doctor or specialist

Medical papers | Personal experiences | Links to other sites | Support groups | Site map