Coccydynia with right-sided angulation of the distal coccygeal segment

Posted 2026-08-16

I am Ashwin, 21 years old from Mumbai. My coccyx pain started around March 2025, most likely triggered by prolonged sitting and general carelessness with posture at the time, though there was no specific fall or injury. From May 2025 I started using a cut-out cushion and restricted long sitting and any heavy activity involving the tailbone.

In July 2025 I had an internship that made things significantly worse — despite using the cushion throughout, the sheer amount of sitting aggravated the pain. After that I stopped all physical activity and have been trying hard to recover since.

I was on medication (pregabalin, NSAIDs, muscle relaxants, among others) from around the start through October/November 2025, before giving up on that line of treatment. I consulted more than 10 doctors across major city hospitals, most of whom asked me to simply wait it out. X-rays and CT scans came back undetected, but an MRI eventually showed a finding — the report noted that the distal-most segment of the coccyx was slightly angulated to the right side, with minimal faint hyperintensity and no adjoining abnormal soft tissue suggestive of oedema. The sacrum, rest of the coccyx, and sacro-coccygeal joint were all reported normal, with no fracture or lytic/sclerotic lesion.

Based on this, in February 2026 I underwent external manipulation. It didn't help - if anything, after about a month I was back to my pre-treatment baseline or slightly worse, so I suspect the practitioner may not have been adequately qualified for the procedure. I restarted medication around this point too, as the pain had picked up again.

A few weeks after the manipulation, I tried physiotherapy — TENS, SWD, and hot water bag application, three times a day. It gave some relief and felt slightly different, but wasn't sustainable long-term since it caused pain with each session.

Currently, I'm managing with just a cushion, hot water bag a few times a day, and diclofenac gel when I need to sit longer — mainly during exams or important occasions. I try to avoid the gel otherwise since it causes sweating and can worsen pain with repeated use.

The pain has been genuinely disabling. I'm a student in a field that demands a lot of physical presence, socialisation, and sitting, and I've had to work twice as hard just to keep up. I now sit only when essential — eating, studying, or similar — and stand the rest of the time, including on buses and trains, which often feels awkward when there are empty seats around. I've barely been able to attend lectures, even with the cushion, since most run an hour long. Internships have become difficult too, since very few places offer standing desks. Beyond academics, I've had to give up sports, the gym, travelling, and long trips — all the things I used to be actively involved in.

My biggest fear is simply never being able to sit normally again.

I'm currently waiting for the right time to go ahead with manual manipulation and a corticosteroid injection, and hoping this next step brings real relief.