Dynamic x-ray showed unstable/hypermobile coccyx

Anonymous - rleepac@gmail.com

Posted 2009-02-22

I'm a 37 year-old female Physician Assistant. Married to a wonderful man and we have a 7-year-old daughter. I am 4' 10 1/2" tall and weigh 105 pounds. I had gastric bypass surgery a little over 18 months ago and I started getting tailbone pain after losing about 60 pounds. After losing the remaining 35 pounds and being at my goal for over a year (yay!) the pain has been unbearable for about the last 6 months (boo). I cannot recall any specific trauma to my tailbone - not even childbirth as I had a C-Section.

My pain is primarily when sitting - leaning back in a chair is torture and sometimes I actually feel a "pop". Then getting up from a sitting position is extremely painful. The pain is more like an ache when standing or walking. Driving more than 15-20 minutes is miserable. I can shift from "cheek" to "cheek" but then my leg falls asleep and my low back starts to hurt.

I've tried over-the-counter meds (except NSAID's that I can't take because of the bypass surgery), prescription pain meds, pillows, ice, heat, electrical stimulation, manual manipulation - all NO HELP. My primary care doc shrugged her shoulders and said "try gaining a few pounds". Hmmmmm...no thanks...I'll keep searching for another solution.

So, about 4 months ago I went to an orthopedic spine specialist for treatment. He looked at my x-rays (not dynamic films) and decided that my pain was from losing all my padding. He offered a cortisone shot which I was more than willing to try. It hurt like #$^^$%^$%&& and the pain was worse for the first few days but then became at least tolerable. The pain never went away completely. The effects of the shot wore off after about 3 weeks. I went back for another injection. Same scenario, same results. Went back for a third shot. He told me it was the last one he could give me for a while and when I had 3 weeks to take off work to come back and see him and he'd surgically remove the tailbone. So I got the 3rd shot and hoped for the best. Nope - only partial relief for about 3 weeks.

The pain is worse now than it has ever been and it even hurts to lay on my back. At night I cry out in pain when I roll over and I have modified my office to accommodate my need to stand most of the time. But, those examination stools that I have to sit on when I see patients are a killer!

Anyway, before I went back to the ortho I did some research and found coccyx.org - I'm so happy that I'm not alone! I was also very interested in the dynamic stand/sit x-rays and I went back to the ortho armed with the details. He said he'd heard about them but had never done any but he was willing to give it a try. The x-ray tech was great and we got some good shots. When he put them up on the light box he was astounded at what he saw. The normal coccyx flexes no more than 25 degrees when sitting. My coccyx flexes well over 50 degrees creating about a 90 degree angle with the sacrum. Wow! No wonder I'm in so much pain.

So my official diagnosis is unstable/hypermobile coccyx. He thinks that I might have torn a ligament for it to be bending so much but no matter...the treatment is to do a coccygectomy. He gave me a Fentanyl patch (12 mcg) for pain. It's not really helping but I need to be able to function so I'm not going to ask for anything stronger. The doc has requested authorization from the insurance and I wait...in pain...

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