American Journal of Physical Medicine and Rehabilitation
2010 April; 89 (4): S32-3.
Patrick M. Foye, M.D., Evish Kamrava, M.D., Renee Enriquez, M.D., Sean Sanderson, M.D., Jason Smith, M.D.
Tailbone Pain Center, UMDNJ-New Jersey Medical School, Physical Medicine and Rehabilitation, 90 Bergen Street, DOC-3100, Newark, NJ, United States, 07103. Phone: (973)972-2802. Fax: (973)972-2825. tailbonedoctor.com/.
To assess whether patients with coccyx pain (tailbone pain) tend to rate their pain mainly with affective (psychological) descriptors versus sensory (physical) pain descriptors.
Retrospective chart review of patients with a chief complaint of coccyx pain, all of whom had completed a Short Form of the McGill Pain Questionnaire (SF-MPQ). The SF-MPQ includes 15 descriptors (4 affective, 11 sensory) which are rated by the patient.
We reviewed 110 charts of patients with a chief complaint of coccyx pain, all of whom had completed a SF-MPQ. The patients included 72 females and 38 males, with an average age of 43.6 years (range 18-74 years), an average symptom duration of 47.6 months (range 1-413 months). We used the previously published protocol for assigning numerical values to the severity of each pain descriptor as follows: 0 = none, 1 = mild, 2 = moderate or 3 = severe. On average, these patients with coccyx pain rated their sensory (physical) pain descriptors as follows: throbbing 1.1, shooting 1.1, stabbing 1.3, sharp 1.5, cramping 0.3, gnawing 0.7, hot burning 0.8, aching 1.8, heavy 0.5, tender 1.6, splinting 0.5. On average, these patients rated their affective (psychological) pain descriptors as follows: tiring/exhausting 1.1, sickening 0.5, fearful 0.4, punishing/cruel 0.7. On average, the patients rated their sensory (physical) pain descriptors with an intensity of 1.0 and rated their affective (psychological) pain descriptors with an intensity of 0.7. Thus, on average, the physical pain descriptors were rated 43% higher than the psychological pain descriptors [i.e., (1.0-0.7) ÷ 0.7 = 43%].
On average, in this population of 110 patients with coccyx pain, the patients rated the intensity of their pain descriptors such that their physical pain descriptors were rated 43% higher than their psychological pain descriptors. To our knowledge, this is the largest study of coccydynia patients to have analyzed the patients' physical versus psychological pain descriptors. The results imply that coccyx pain is primarily due to physical pathology, rather than just a manifestation of underlying psychological pathology.