Tailbone pain persists seven months after complicated delivery of my baby - coccyx removal successful!

Margaret

Posted 2006-09-24

First, I want to thank Jon and the other contributors to the website for providing a wealth of good information and moral support for those of us suffering from this seemingly obscure problem. The information provided has helped me to evaluate whether I am getting the proper care. I have also bought a couple of the "tush cush" cushions featured on the site to help me cope with the pain when at the office and in the car.

Like many other women who posted their story, my tailbone was seriously injured during the complicated delivery of my son last winter. My son is now 7 1/2 months old and the pain is worse then ever. It was a terrible delivery -- I developed acute and severe pre-eclampsia after I went into labor which caused my blood pressure to rise to 170/110, and I had the most severe pain I have ever experienced in my life in my low back and tailbone. It turns out the baby was facing the wrong way and it literally felt like he was trying to blast his way out through my tailbone. The anesthesiologist made me wait 3 hours for the epidural. Those 3 hours were the most heinously painful hours of my life as each contraction continued to force my baby's head against the tailbone he had already broken or dislocated. I had constant pain in my low back even between contractions. After a very long and difficult labor, a vacuum extraction was necessary in order to avoid an emergency c-section. I hemorrhaged after I had him and had to have a blood transfusion a few days later.

Needless to say, in the mist of the various and serious complication my physician (OB) was managing, the tailbone injury was not the focus of my treatment. My OB did a great job managing a very difficult delivery and really got after the anesthesiologist to give me the epidural. She even paged the nurse anesthetist to come back and give me a "piggy back" on the epidural to further address my pain. She was very apologetic afterwards for the terrible pain I had endured and sent me home with Percocet because of the extensive tearing that had occurred.

My tailbone continued to ache in the following months and I assumed it was "bruised". I fell on the ice two weeks after that horrible delivery and landed on that poor bone so I joked to my sisters that I now had a 360 degree "bruise". I didn't think there was much anyone could do for it so I would just have to wait it out.

Finally, when my baby was 5 months old, a friend at church suggested that I get it checked out because she thought the pain had gone on too long. I went back to my OB who was very sympathetic and explained that sometimes the bone is broken during deliveries, but that normally it heals well. She said in my case, it obviously had not healed properly and she said that the tailbone felt "mobile" to her. She referred me to an orthopedic surgeon for cortisone shots and explained that very occasionally they have to remove the tailbone. My OB turned out to be far more helpful than the orthopedic surgeon.

The surgeon gave me a Novocain/cortisone shot which helped for a few weeks. She recommended against the surgery and said I could come back in a couple of months for another shot if I needed one. She didn't do the sit/stand x-rays to evaluate whether the tailbone was moving. A couple of months later, I am now in terrible pain. I went back yesterday to ask for another shot, but the surgeon now says she will not give me one. Instead, she referred me to a spine surgery clinic for a surgical evaluation, but the clinic says they "don't do tailbones" and can't see me for at least 6 weeks, anyway. Meanwhile I am trying to work full time and take care of a baby.

Fortunately, a co-worker's wife runs an orthopedic surgery research clinic at a different hospital. She recommended a spine specialist associated with the hospital who is already treating one of her friends for the same problem. I am going to see him next week. Based upon what my OB said (the tailbone is "mobile") and based upon how the pain feels to me, I believe that the tailbone needs to come out. In the meantime, a Novocain/cortisone shot would hopefully at least relieve the pain temporarily so I can continue working and caring for my baby. I plan to ask him about doing a sit/stand x-ray or MRI.

The website has been very helpful to me throughout this process. It helps to know I am not the only one with this very strange problem and it has helped me to evaluate the care I have received to make sure that it is correct. It has been a long and difficult ordeal. While many men do suffer from this problem, it is a condition that is particularly unique to women who have given birth. Like so many health issues affecting women, there seems to be very little known about this problem. Most orthopedic surgeons apparently don't "do tailbones" even though I have heard from the x-ray tech at the orthopedic surgeon's office that he has seen a number of women in the office with the same problem.

I am hopeful that the doctor to which my co-worker's wife has referred me will be more helpful. In the meantime, I am taking a lot of ibuprofen and some percocet which I have left over from the delivery. I am going to get a massage tomorrow to try to address the muscle pain that is spreading up from the tailbone into my low and midback.

I will write again to let people know how it goes and whether this next doctor is more helpful. Thanks again.

Margaret

St. Paul, Minnesota, USA

Update, 2006-10-01

As I mentioned at the end of my last posting, a co-worker's wife referred me to a specialist. His name is Mike Wengler and he is an orthopedic surgeon specializing in spine surgery associated with Hennepin Faculty Associates in downtown Minneapolis, Minnesota (USA).

He was friendly and more helpful than the general orthopedist I saw. He said I was a good candidate for surgery. He said he has only done four other such surgeries. He claimed that all of the surgeries improved the patientsí conditions, but one patient developed an infection which he was able to treat. I asked for another cortisone/Novocain shot to tide me over while I decided when and whether to do the surgery. He referred me to a group of diagnostic radiologist who do the injections under fluoroscopy. He believes that when the injections are done this way, they can be more effective and that the x-rays from the procedure will provide him with more information for any potential surgery. The procedure was very painful (although nothing hurts as much as the pain I had when I was in labor) and lasted almost an hour (the radiologist was very thorough!), but they did locate the point in my tailbone from which the pain seems to be originating. It took several days for the cortisone to take effect but I am finally now sitting more comfortably and feeling much better. These injections, however, were more effective at relieving more of my pain than the last injection I received. I found that having them done under fluoroscopy by someone specializing in that type of procedure is more effective.

The procedure also provided us with some additional information. Only the top two vertebrae in my tailbone showed up on the original x-rays conducted by the general orthopedist I first consulted. The radiologist who did the cortisone injections under fluoroscopy located two additional vertebrae below those which were pointed inwards (which is why they did not show up on the x-ray) and are "fused". The focal point of the pain appears to be in the fused joint.

Now I have to decide when and whether to do surgery. As far as I can tell, Dr. Wengler is the only physician in the Minneapolis/St. Paul area who is qualified and willing to do the surgery. I am reluctant to do the surgery, but I know that I will most likely find myself in overwhelming pain again in a month or two when the cortisone injections wear off. Even with the cortisone injections, I still cannot sit normally or put any weight on my tailbone, and I do still have some pain and throbbing in that area. I am leaning towards having the surgery because I would really like to get this whole chapter behind me and get on with my life. And as my sister pointed out, it will not be any worse than the horrible delivery I had last winter.

I am concerned about how long the recovery period will take. He says he can have be back to work in one to two weeks. He said it will really just be a matter of getting the incision to heal. I am worried that it might take longer than that. I am not in a position to take a lot of time off work at this point but do not want to delay the surgery.

I will write in again after the surgery to let others know how it went in case anyone else in the U.S. upper midwest area is looking for a specialist.

Margaret

Update, 2007-01-28

I had my coccyx removed on November 17, 2006. The surgery really was not too bad. The surgeon said that my coccyx was literally covered with bone spurs! Because my sacrum had a bit of sharp angular bend to it above the coccyx, the surgeon opted to shave it down, also. There is no way to know for sure whether my sacrum had been broken at some point and then healed in that odd shape or if it had always been like that.

For me, the recovery took a little less than two weeks. By 3-4 days post surgery, I was having to forego taking any vicadin for certain periods of time so that I could drive my son to day care and drive myself to the doctor. It was very uncomfortable, but you do what you have to do!. If, however, you can manage to take a full two weeks off and avoid having to drive during that time, I would recommend it. I took only a little over a week off work, and that really was not quite long enough.

By two weeks, post surgery, I stopped taking any painkillers at all, including ibuoprofen. I think that my recovery time would have been even shorter if I had not had my sacrum shaved down. Compared to the horrible delivery which caused the coccyx problem, the surgery did not seem so difficult!

Two months post surgery, my sacrum is still a bit achey, but it continues to improve, and I do not find it necessary to take any painkillers for it. The incision area is healed, but sometimes still a little tender. I can feel some scar tissue there, also.

On the whole, I am substantially better off than I was before the surgery. I expect that over the next few months the slight lingering discomfort I have will further diminish. By about a month post surgery, I could already sit on chairs without a cushion for the first time in months! It was amazing!

The surgery was definitely the best treatment for me. It is so nice to have the pain virtually gone! My surgeon was Mike Wengler at HCMC in Minneapolis Minnesota. He did a good job.

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