Cortisone injection seems to be helping

Colin - colinthom@shaw.ca

Original posting, 2003-02-16:

I'm a 42 year old male. I'm fit, and not overweight. I developed coccydynia in the middle of 2002. It came on relatively suddenly, though I could not trace its origin to any particular trauma. Oddly, I noticed the pain when dismounting my mountain bike, not when I was actually riding it. Getting off the bike, and standing up straight thereafter, really hurt. I did have some pain when sitting, but I think the pain from biking came first, emphasis on "I think". All this said, I do recall 2 instances of trauma, but they were both many years ago, which may or may not mean anything. I stopped riding my bike 4 months ago, not being able to think of anything else to stop doing. I use a fairly wide saddle, that is padded, and has a recess at the back-end to make life for the tailbone easier.

I consulted my GP, and subsequently had an ultrasound to look for a pilinoidal cyst, which turned up negative. I had dynamic and static X-rays, which my doctor prescribed after I directed him to your website. I also had a bone scan. Nothing. The dynamic X-rays indicated a flexion of 13 degrees. This is within what is called a normal range in the documentation on your site. So, no real news here. Too bad.

In early January, I started a 3-week program of oral anti-inflammatories, and they were working. 2 weeks into this treatment, I spent 4 hours one day doing trail work in the mountain bike park. This consisted of trail clearing and lots of bending and standing, but no trauma or sitting down. That night, and the following day, my tailbone felt like it did 4 months ago - really bad! The balance of one week of anti-inflammatories did nothing to alleviate the pain. The good news is that they had helped a bit, so there was hope.

This took us to a cortisone injection, which I had 2 days ago. My initial reaction to this is that it has had a noticeable effect. I didn't do my usual morning sit-ups and push-ups yesterday, the day after the injection, but did do them today. I do sit ups on my back, with my calves on a bed, and my thighs perpendicular to the floor. I do crunches really and not sit ups. I feel no pain in my coccyx area when I do these, and am confident that I'm not bending my coccyx in the process. My hunch is that the push-ups, and their attendant flexing of my butt muscles, are the problem. That said, I feel a bit worse today, than I did yesterday. So, I'll lay off the morning exercises for a few days to give the cortisone a chance "soak in". Off the cuff, I'd say that I'm 40% better, already. I see my GP in another 2 weeks, and will ask for another shot of cortisone.

Update, 2003-04-06:

The cortisone injection I had in February made a huge improvement. I'd say my pain went from an 8 to a 3 in about 3 weeks. I had a second injection 2 days ago, and am hopeful it has the same impact as the first. I'm feeling worse today than I did immediately before the injection, but this is normal.

Update, 2003-08-03:

I had my 4th cortisone injection on July 11, after the 3rd which was in May. I had the 3rd in a slightly different location, since another area of pain seemed to have been uncovered by the first 2 injections. The first location hurt more than the "new location" so I think that the first 2 injections while taking care of the first location, allowed the "new location" to be revealed. The initial location is now pain free, and the "new location" which was treated for the first time with the 3rd injection has improved substantially. Overall, I'd say I'm 85% improved over where I was before I started all this back in January. It's a bit soon to tell since the most recent injection was only 8 days ago, but if the 4th injection is as effective as the first 3, which I think it will be, I hope to be more or less recovered in another month or two.

A comment for those considering Cortisone: It can take a couple of weeks before you start to feel the effects of the injection, and up to 4-6 weeks before you feel the full effects of the injections. You'll likely need a few injections, typically 8 weeks apart. It's a treatment regimen that can take several months, and it's been known to not work for some people. But hey . . . what do you have to lose?

Update, 2003-10-19:

Well, bad news troops. I had my fourth cortisone injection in July. The first 3, every 2-3 months starting in January, resulted in progressive improvement. I was about 85% better when I went in for the 4th, thinking that would be the end of it. Sadly, the 4th made things worse, and I'm back to where I started. Big Bummer.

I had a neural or medical acupuncture treatment, which involves an injection of freezing (Lidocaine 1%) into the acupuncture points, but results (none) indicate that further treatments will not help me. This is too bad, because I've responded very well to acupuncture treatments for other ailments. So, the last un-turned stone is Prolotherapy, about which I have my doubts and then I guess surgery to remove the thing needs to be considered. Groan. My doc's making an appointment for me with the Prolotherapy doc, and I'll find out whether this guy's had success treating coccydinia before. I'll keep you posted. It's now been a year since I rode my bike!!

Update, 2004-01-18:

Well . . .you may remember that my 3 cortisone shots worked like a charm . . . and the 4th blew me out of the water. The 4th was in July of 2003. I went to see a prolotherapist about 6 weeks ago. I was encouraged by the fact that this guy was a well accredited orthopedic surgeon, and not some fringe medicine freak.

After a VERY thorough examination, including INTERNAL manipulation of my tailbone, he gave me a cortisone injection. I did not exhibit symptoms of weakened or damaged ligaments that he usually sees, and since cortisone worked before, he thought it worth trying again. It really made a difference. I was 70% better after about a month.

I saw him again last week, and had a prolotherapy injection, the thinking being that cortisone's benefit is often temporary, and the prolotherapy would only serve to help the ligaments. I've had continued improvement, to the point where I'd say I'm 80% better. This is monumental news, given that I've been living with this for 18 months now.

I see the guy again next week for either a booster, or to tell him that I'm better and don't need another shot....I'll keep you posted.

Kind Regards, Colin Thom

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