1. < Spine Health

Tail bone pain: What can I do?

Posted by suerc @suerc, Sep 13, 2022

Any one have terrible pain in the tail bone. I shattered my l4 in a boating accident 4 yrs ago. I have had terrible tailbone pain. Have done PT. Pool therapy now they want to try caudal injections. Please anyone tell me more.

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Moderator
Amanda Roe | @amandajro | Mar 19, 2023
In reply to @mrm098020 "Chronic Pain in Coccyx Region Thought I'd share my experiences with chronic pain of the coccyx..." + (show)
@mrm098020

Chronic Pain in Coccyx Region
Thought I'd share my experiences with chronic pain of the coccyx because no doctor I've been to has seen chronic pain develop this way.

How I developed the pain:
Around age 22 I developed a sensitivity in my tailbone region after using a metal fold out chair for a 3-4 years as my main desk chair. 5 or so years later when getting my motorcycle license I sat on a saddle type seat for 12 hours over 2 days and the constant pressure made my sensitivity explode into full on debilitating pain. From then on I could not escape the pain except when lying prone in a very specific position.

Medical Treatment:
No broken bones or any kind of structural damage was done. X-ray and MRI show nothing wrong. I was able to get it under enough control by taking Gabapentin and Venlafaxine at the around maximum dosages and using a u-cushion while sitting. I still feel it if I sat or lay on my back. I went the route of trying caudal epidurals which ended up only giving temporary relief for around 2 weeks. After that did not help I had a neural stimulator (nevro senza) implanted which gives me addition comfort and gives me the ability to relax further and longer while sitting. The pain I feel now is somewhat dull. Almost like someone is just pushing on my tailbone with ramping intensity. It builds and reduces based on constant pressure. I am now 30 and I am still looking for more ways to remove pain and reduce side effects from the anti-depressants that I take. The side effects that I struggle with is large reduction in sexual sensitivity and labido. My doctor does not know what else I can really do other than mix around medications that I use to get the best result with the least side effects. I am now trying acupuncture but I am not really seeing huge results. My next step is going to be to take an addition medication with the hope of counter balancing the side effects of the others. Yoga does not help and I've been told PT is not an option for the coccyx because it is not a region that can really move. I have dabbled in marijuana but I didn't notice much help and I generally do not like the feeling of being high.

My life now:
When it comes down to it I am very fortunate to be able to be able to function and more or less live my life the way I used to. Even in a bed I cannot lie on my back for long (20 min) without pain developing. My only big limiting factor is how long I can sit for before I need to lie on my stomach/stand/walk and give my coccyx time to rest. Long distance commuting is very difficult on me.

Tips and advice for others:
Medications like Gabapentin and Venlafaxine do most of the work in reducing my pain.
The neuro stimulator is great because there aren't any noticeable side effects but its pain reduction is not as effective as medication in my case. They are expensive but if you can afford it I would suggest giving the trial run a try.
I have a topical pain killer (ketamine based) that I can use to control the pain even further if it gets to be too much but it does not do much more than temporary relief.

My questions:
- I have never seen a neurologist because I have been told that they focus mainly on genetic conditions and not pain related symptoms. Other than this chronic pain I do have quite a few other issues (knee pain, wrist and elbow tendonitis that comes and goes, gastro/heartburn, plantar fasciitis ) but no test has shown that I have some greater condition. Should I still see a neurologist?
- Does anyone have a similar story in how they developed their chronic pain?
- How have others with coccyx pain handled theirs?
- Has anyone been successful at combatting sexual side effects and how?
- Any other avenues that I can try that I have not yet?

I'm happy to answer questions and delve further into my experiences.

Thanks!

Jump to this post

Hello @mrm098020 and welcome to Mayo Clinic Connect. It is impressive how you could keep track of and trace your specific pain back through your journey and also that you have been able to find some key ways to reduce your pain.

You will notice I have moved your post into an existing discussion with others experiencing pain in the tailbone region. You can find your post here:
- Tail bone pain: What can I do?: https://connect.mayoclinic.org/discussion/tail-bone-pain/

Members like @repairgirl @suerc and @melinda7 have shared and may have more they can share with you.

Has your sexual side effects just become more noticeable?

REPLY
1 reply
jmd5 | @jmd5 | Mar 20, 2023
In reply to @mrm098020 "Chronic Pain in Coccyx Region Thought I'd share my experiences with chronic pain of the coccyx..." + (show)
@mrm098020

Chronic Pain in Coccyx Region
Thought I'd share my experiences with chronic pain of the coccyx because no doctor I've been to has seen chronic pain develop this way.

How I developed the pain:
Around age 22 I developed a sensitivity in my tailbone region after using a metal fold out chair for a 3-4 years as my main desk chair. 5 or so years later when getting my motorcycle license I sat on a saddle type seat for 12 hours over 2 days and the constant pressure made my sensitivity explode into full on debilitating pain. From then on I could not escape the pain except when lying prone in a very specific position.

Medical Treatment:
No broken bones or any kind of structural damage was done. X-ray and MRI show nothing wrong. I was able to get it under enough control by taking Gabapentin and Venlafaxine at the around maximum dosages and using a u-cushion while sitting. I still feel it if I sat or lay on my back. I went the route of trying caudal epidurals which ended up only giving temporary relief for around 2 weeks. After that did not help I had a neural stimulator (nevro senza) implanted which gives me addition comfort and gives me the ability to relax further and longer while sitting. The pain I feel now is somewhat dull. Almost like someone is just pushing on my tailbone with ramping intensity. It builds and reduces based on constant pressure. I am now 30 and I am still looking for more ways to remove pain and reduce side effects from the anti-depressants that I take. The side effects that I struggle with is large reduction in sexual sensitivity and labido. My doctor does not know what else I can really do other than mix around medications that I use to get the best result with the least side effects. I am now trying acupuncture but I am not really seeing huge results. My next step is going to be to take an addition medication with the hope of counter balancing the side effects of the others. Yoga does not help and I've been told PT is not an option for the coccyx because it is not a region that can really move. I have dabbled in marijuana but I didn't notice much help and I generally do not like the feeling of being high.

My life now:
When it comes down to it I am very fortunate to be able to be able to function and more or less live my life the way I used to. Even in a bed I cannot lie on my back for long (20 min) without pain developing. My only big limiting factor is how long I can sit for before I need to lie on my stomach/stand/walk and give my coccyx time to rest. Long distance commuting is very difficult on me.

Tips and advice for others:
Medications like Gabapentin and Venlafaxine do most of the work in reducing my pain.
The neuro stimulator is great because there aren't any noticeable side effects but its pain reduction is not as effective as medication in my case. They are expensive but if you can afford it I would suggest giving the trial run a try.
I have a topical pain killer (ketamine based) that I can use to control the pain even further if it gets to be too much but it does not do much more than temporary relief.

My questions:
- I have never seen a neurologist because I have been told that they focus mainly on genetic conditions and not pain related symptoms. Other than this chronic pain I do have quite a few other issues (knee pain, wrist and elbow tendonitis that comes and goes, gastro/heartburn, plantar fasciitis ) but no test has shown that I have some greater condition. Should I still see a neurologist?
- Does anyone have a similar story in how they developed their chronic pain?
- How have others with coccyx pain handled theirs?
- Has anyone been successful at combatting sexual side effects and how?
- Any other avenues that I can try that I have not yet?

I'm happy to answer questions and delve further into my experiences.

Thanks!

Jump to this post

Have you tried stretching your piriformis muscles in your hip area? I have tail bone pain and I have to stretch that area on both sides before getting up in the morning.

REPLY
1 reply
mrm098020 | @mrm098020 | Mar 20, 2023
In reply to @amandajro "Hello @mrm098020 and welcome to Mayo Clinic Connect. It is impressive how you could keep track..." + (show)
@amandajro

Hello @mrm098020 and welcome to Mayo Clinic Connect. It is impressive how you could keep track of and trace your specific pain back through your journey and also that you have been able to find some key ways to reduce your pain.

You will notice I have moved your post into an existing discussion with others experiencing pain in the tailbone region. You can find your post here:
- Tail bone pain: What can I do?: https://connect.mayoclinic.org/discussion/tail-bone-pain/

Members like @repairgirl @suerc and @melinda7 have shared and may have more they can share with you.

Has your sexual side effects just become more noticeable?

Jump to this post

Thank you for getting my post in the proper thread.
No, the sexual side effects always correlate to the amount of of medication I am taking. I know that it is pretty common to have these side effects with anti-depressants: Gabapentin, Venlafaxine, Pregabalin.

REPLY
mrm098020 | @mrm098020 | Mar 20, 2023
In reply to @jmd5 "Have you tried stretching your piriformis muscles in your hip area? I have tail bone pain..." + (show)
@jmd5

Have you tried stretching your piriformis muscles in your hip area? I have tail bone pain and I have to stretch that area on both sides before getting up in the morning.

Jump to this post

I have tried similar stretches in the morning before and I think they were helping. I need to get back making these a habit. Thanks for the reminder 🙂

REPLY
pamperme | @pamperme | Mar 23, 2023

I have pelvic pain for many years. I think they originally thought it was prostatais, then someone said pudendal nerve but I have some of your symptoms. The book a headache in thePelvis by Dave Wise discusses this and how it is diagnosed many ways. I have trouble sitting due to pain and have to sit on a doughnut. This is one of the symptoms of pudendal nerve issues. One thing they say can cause pudendal neuralgia is cycling.
My pelvic pain of sitting was much worse after I had a prostatectomy( I would not sit) and I had pains from the sphincter muscles and had incontinence. The urologist told me to go to a pelvic therapist. I did and they were able to find trigger points to my sitting pain and I felt better after the therapy but the pain came back. They stopped me from doing Kegels and had me do pelvic stretch exercises. My sitting pelvic pain got better. I do not know if this is what caused it to get better, but it might have helped. I still have sitting pain and my external sphincter muscle has pain making me feel I have to go all the time. The urinary incontinence is secondary to me, I can manage the incontinence by using protection but the pain I can not manage.
I have learned stress can contribute to pain also since it makes you tense your pelvic area causes muscle tension. When I was diagnosed with prostate cancer last year I was extremely stressed and the pelvic pains became very bad. It appears I may need to get less stress to help also
My pains in the pelvic area comes in waves and can radiate out.
I take Cymbalta for pain and when I take it I can not get to orgasm. I am almost 70 now and after the prostatectomy last September this is less of an issue since I have errecticle dysfunction too and shrinkage.
I have had heavy antibiotics, blood test, surgery in the pubic area for the pelvic pain in the past with no success. I learned to accept the pain and live with it(I had no choice). The problem is that it has now progressed and given me more pain and incontinence. I am at the point that I am going the route of continuing pelvic stretching and try to lower my stress. The book I referenced above has a Wise protocol which can be taken to teach you how do trigger points and relaxation if you take their course. I am looking t it but it s expensive and I would like to hear from other people who have taken it. The pelvic pain you have is not easy to get rid of, I wish you luck, I have read how many people have tried many things with few successes
Wishing everyone happiness
Tim

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