Physical Medicine and Rehabilitation
2009 Sept; 1 (9): S177
Patrick M. Foye, M.D., Evish Kamrava, M.D., Renee Enriquez, M.D.
Coccyx Pain Service, Department of Physical Medicine and Rehabilitation, UMDNJ: New Jersey Medical School, 90 Bergen St., DOC-3100, Newark, NJ 07103-2499. Phone: (973)972-2802. Fax: (973)972-2825. tailbonedoctor.com/.
OBJECTIVE: To report on recreational water slides as a source of tailbone injury in patients with coccydynia (coccyx pain). The waterpark industry reports more than 1000 waterparks in North America, with an attendance of about 78 million per summer season, with further growth expected. To our knowledge, no prior case series has ever described waterpark injuries in association with causing or exacerbating tailbone pain.
DESIGN: Retrospective chart review of 200 patients with a chief complaint of tailbone pain.
SETTING: Academic-based physiatric outpatient pain management practice with a dedicated Coccyx Pain Service.
PARTICIPANTS: Records were reviewed from a population of 200 patients with a chief complaint of tailbone pain.
INTERVENTIONS: Interventions: Not applicable
MAIN OUTCOME MEASURES: Medical record documentation was sought regarding water slides as exacerbating or initially causing coccyx pain.
RESULTS: Of 200 outpatients with coccyx pain whose records were reviewed, 2 patients had reported that their coccygeal symptoms had either originally started while sliding down a water slide, or that prior (pre-existing) coccyx pain had been exacerbated by this activity. One patient was a 42 year old female with a 3 year history of tailbone pain of non-traumatic onset, which had improved 75% via a combined ganglion Impar and corticosteroid injection. Months later, she was doing well enough that she went down a water slide on a family vacation, resulting in exacerbation of her prior tailbone pain. The other patient was a 37 year old male with no prior tailbone pain until going down a "bumpy" water slide. His tailbone pain persisted for almost a year prior to presentation for PM&R pain management. His imaging studies revealed substantial listhesis at a coccygeal joint that matched his most painful site on palpation, as also confirmed via fluoroscopy.
CONCLUSIONS: Based on the clear history of direct trauma to the coccyx in each case followed by the prompt onset of coccyx pain, these cases support a causal relationship between water slides and coccyx pain. The cases demonstrate that coccygeal trauma on water slides may either exacerbate pre-existing coccyx pain or provoke new onset coccyx pain in previously non-symptomatic patients.