I am a 39 year old woman who never had any trouble with coccyx pain until last May 2017. It started as a dull ache after sitting for extended periods, and then progressed to constant nagging pain.
My first step was an x-ray with my primary care doctor in August (3 months after onset). The image showed the coccyx was pointing in the wrong direction, facing out instead of curving inward. The doctor did not know if I was born that way, or if a fall had caused it to grow in the wrong direction. He suggested a three month regimen of an anti-inflammatory medication called Meloxicam, and sitting on a pillow. I went through a few different pillows before finding one that made driving bearable (doughnuts are a waste of money). Here is the one I liked: ComfiLife Gel-Enhanced Non-slip Coccyx Memory Foam Seat Cushion
I followed the doctors orders, but the pain became worse to the point where it was disturbing my sleep, especially when I rolled from side to side. I could not tolerate sitting in a theater, dentist's chair, or pedicure chair. Driving, even with the pillow, was not something I could do for longer than an hour at a time.
I went to an orthopedic spine specialist, who recommended I have the coccyx removed due to the position of it and how much it was protruding backward. He gave me a steroid injection in the tailbone to provide some relief and buy me some time while I did my research. That injection was the most painful thing I have ever experienced. Worse than childbirth. I thought there is no way I can have one of those a year for the rest of my life.
The pain was worse after the injection for nine days. After that, I was able to sleep again without pain, but sitting was still a problem. The ache had dulled, but I could tell it would come back. It was just a matter of time.
My next step was to see a physiotherapist since I still could not wrap my head around how I was suddenly in pain from something that had never bothered me before, especially when I had not fallen recently or had any type of injury. I had fallen off a swing when I was 13, slipped on ice at 17, and had two kids, but all of those things happened long before the pain started.
The physiotherapist specialized in pelvic floor dysfunction, and claimed she had helped many people with coccyx pain avoid surgery. The problem could be tight muscles pulling the coccyx in different directions. We did one treatment together, which involved internal massage (kind of awkward), but ultimately she could not help me because my problem was a mechanical one, not muscular. If you are in Florida and want to consult with them, it was Gina Parsonis, Foundation Physical Therapy: (see Doctors and specialists in the USA, Florida).
I then went to Orlando to see Dr. Scott Katzman of Advanced Orthopedics (see Doctors and specialists in the USA, Florida). He was listed on coccyx.org as helping others with their pain. I saw his associate, who looked at the x-ray and identified what two other doctors had not: the coccyx was fractured. He also recommended having it removed, and said Dr. Katzman was the best surgeon for the job because of how many he has performed (about 500 - he does on average 50 a year, sometimes 2 a week!).
I read up on Dr. Katzman, had a phone consult with him, and then scheduled the surgery for December 8, 2017. Because there are horror stories online about infection and slow healing, I did some homework on how to have the best possible outcome. I am happy to report my surgery was a success. Of course, credit goes to having a fantastic, experienced surgeon, but here is what I thought I could do to help have a great end result:
Surgery itself was quick! 30 minutes outpatient procedure. I had general anesthesia and was intubated so throat was sore for about three days afterward. I was able to walk the first day and sit on the toilet to pee without a problem, although it was a little sore. I took antibiotics for three days, and percocet for about a week. I also started the postoperative vitamins, but that with percocet made me nauseated so I had to stop until I was done with percocet (one week post surgery then moved on to tylenol).
I continued the low residue diet for five more days, but perhaps I shouldn't have. I did not have a bowel movement for 6 days, which was not ideal when it finally did happen. I was taking a stool softener twice a day since the surgery, but percocet is severely constipating so that first BM was pretty awful. On one hand, I'm glad I didn't go before then since it takes about 5 days for the incision to close up and I was super worried about infection, but I leave the decision up to you.
I do not recommend using Hibiclens anymore after the surgery. I did and it gave my skin a rash from where the tape from the operation was stuck to it.
I also do not recommend getting shampoo in your stitches once you can take a shower. It made them super itchy. I do recommend taking an antihistamine like Claritin to help with the itch, and have someone put Vaseline on the skin to help relieve the desire to scratch.
So here we are one day after my stitches were removed. I am walking 10,000 steps a day, can drive, although I wouldn't want to do a long road trip right now, and I can sit without pain. My surgeon said when they went in, they found multiple fractures (CRAZY!) and the tailbone sticking out so much it was almost protruding through the skin, making my case "unique". Overall I am very happy with my outcome and look forward to getting better every day. By three months I should be as good as new! I hope sharing my experience will help you, good luck!
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.