Physician in Bend, Oregon

Mike Mason - Mike.Mason@rcis.com

Posted 2009-04-26

I have been suffering from coccydynia for almost 3 years. At first I was able to get relief by taking a variety of anti-inflammatory medications. The most effective was mobic. After about a year, that was no longer effective so I started seeing a specialist. He injected my joint and I would get several months of total relief.

However, I am now to the point that the effectiveness of injections lasts for less than a month if I get any relief at all. I saw my Dr. the other day and he's now talking about surgery. I have heard that the success rate isn't high. So I'm at the point where I either live with it or perhaps take the next step.

Unfortunately, my work requires extensive sitting either in my office or in my car. I have tried a variety of pillows and have gotten little relief. I just ordered a Roho pillow and am hoping that will be helpful.

Any suggestions on how I should proceed would be appreciated.

Thanks, Mike Mason

Update, 2009-07-19

I no longer am able to get relief from injections. I went back to my doctor this week. He took an new x-ray and it shows that I have some arthritis in two joints. Today I went back and an got another injection, only this time they used an x-ray machine to better target the specific joint. I did not get any immediate relief and the doctor indicated he didnít get as clear a picture as he would have liked. Said to give it 7-10 days and if no relief, they would send me to a different doctor who uses a CAT in giving injections. Apparently that improves accuracy. So Iím hoping I get some relief from todayís shot. It was quite painful, and I really donít want to do it again anytime soon. Both physicians Iíve been seeing indicate that removal will be next option. They are both skeptical about that option. Often doesnít work, but on the positive side, they both said surgery does not usually make it worse.

Update, 2010-01-10

After over 3 years of pills, injections, x-rays, bone scans & MRI's, my doctors have run out of options and consider surgery as my only remaining viable option. I was referred to a local surgeon who has performed this surgery several times. I visited with him in early Dec. and felt reasonably reassured when I left. First, this surgeon will not perform surgery unless there is some obvious abnormality to the coccyx. Both my bone scan and MRI show something???, but not sure what. Surgeon claims that his surgical success rate on individuals without obvious abnormalities, just pain, are less than 50%. He will not operate on those individuals. For those, like myself, who have an coccyx abnormality, success is nearer 80%. He emphasized No Guarantees which I totally understand, but he was reasonably confident he could help me.

So I am scheduled for surgery Feb 12th. Wouldn't you know it, that as soon as my butt knew I was thinking surgery, it started feeling better. Still hurts, but not near as bad. Very tolerable. I've been through this before where for some unknown reason the pain would subside, but it always came back with a vengeance. I haven't done a lot of long distance driving recently and I think that may explain it.

So I'm agonizing over having this surgery. My mind is playing games with me. Can I continue to tolerate the pain?? What will the recovery be like?? On and On! I just can't imagine having surgery on my butt, although most of the posts on this site from folks who have had the surgery indicate it really isn't that bad.

I have another pre-op appointment with the surgeon on Jan 20th, so I'll wait and talk with him. Also have a long road trip this week that will be a real test. Maybe that will make a difference. As always, I will keep you posted.

Update, 2010-03-07

Had my coccyx removed on February 26. My surgeon said it was totally detached. Did not know that going in. They thought it was a cyst. I think what looked like a cyst on the MRI was really an accumulation of cortisone from all the shots I've had. Since surgery, have been dealing with pain, muscle spasms in lower back. Taking Percocet for pain and it is fairly effective, although makes me feel like a space cadet. Surgery was same day.

Got home around 1 pm and by 4 pm I was in agony because I couldn't urinate. All the dope they had pumped into my system simply paralyzed my plumbing. So had to go back to hospital that afternoon and have a catheter put in. Much worse than the surgery. Dealt with that for two days and then had it removed. Everything is fine now and what a relief.

I'm actually able to sit a bit, as long as I put no pressure on the coccyx location. Otherwise, it's laying on the couch or in bed. I think that is messing up my lower back. Too many unusual positions. My goal is to be able to tolerate driving fairly long distances in 6 weeks.

Thanks for all the support from some of the folks sharing this website. Nice to have someone to talk to that understands what a pain in the butt this truly is.

Update, 2010-03-14

To recap my history. I started having coccyx pain back in the spring of 2006. To my knowledge, it was not triggered by any kind of accident. Just spontaneous. After 4 years of anti-inflammatory medications, numerous injections, MRI's, bone scans and much suffering, I finally had surgery on Feb. 26th 2010. Surgery is certainly not a walk in the park and should be a last resort option. My surgeon, Dr. Mark Maddox (now retired) is not an orthopedic surgeon. He is a Colon and Rectal Surgeon. He was adamant from the beginning that only patients that have an abnormality with their coccyx which appears on an MRI, X-ray or bone scan are good candidates for surgery. That was my situation, although the abnormality he thought he was going to find turned out to be different. My MRI indicated what appeared to be a cyst. In surgery, they determined my coccyx was totally detached. No idea what caused that to happen. What appeared to be a cyst was most likely an accumulation of cortisone they injected me with. So I got lucky. There was something far worse than a cyst. If a patient that comes to my surgeon with just pain and nothing shows up on any diagnostic test, he will not operate. Success is poor vs those with some kind of abnormality.

Returned to my Dr. on 3/10 and had my stitches removed. That felt good. No infection. Wound has healed up very well. No separation. He has asked me to return in a few weeks for a final check, really out of his own curiosity. I am able to sit if I am careful where the pressure is applied. I can sit in the car and did so for the 40 mile round trip to my Dr. It hurts, but the pain is tolerable and quite different that pre-op pain. I am nowhere near pain free and I realize it may be weeks or perhaps months until I am, but my Dr. is confident I will become pain free. Takes a long time to heal. The pain has not interfered with my sleep. I can lay on my back or sides with little or no discomfort. My goal is to drive 300 miles to a work related meeting 6 weeks post op. I think I will be able to do that. In the mean time, I am fortunate to be able to work from home and have lots of flexibility. My Blackberry makes that much easier in that I can email/text while laying down, which I still do for many hours a day.

While I realize some of you have had bad surgical outcomes, it is does not always have to be that way. I think the surgery decision should be case by case in consultation with a good experienced physician. I have appreciated the support of Donna and Yvonne who I met through this site. Both have had surgery and both are doing quite well post op. Their suggestions to help me deal with my pain, occasional depression and wound care was very important to me. If you are thinking surgery or have had surgery, feel free to contact me. I will continue to monitor the site and provide whatever support I can.

Update, 2010-04-05

Now 5 weeks post surgery and I am feeling great. Very little pain and it continues to be less and less painful each day. I have been driving hundreds of miles with no problem. Went to my Dr. today. He believes it takes a good 6 months before one can conclude if the surgery was successful or not. He has every reason to believe mine was and I agree. One issue I have is with my wound. It has not healed completely and now I have basically a hole that has developed with some bleeding. My doctor said that is not unusual and thinks it will heal over time. Itís a tough location for a wound. Wants to see me again in a month. Other than that, I am so much better off than I was for the last 4 years and very glad I had the surgery.

Update, 2010-08-15

Now over 5 months since my surgery. I am virtually pain free and have been for some time. I can drive hundreds of miles, fly thousands of miles and feel no discomfort. I am so thankful I found a good surgeon and had it done. I was afraid in the beginning, but found out there was nothing to be afraid of. If you have any kind of diagnosed abnormality of your coccyx, then you should seriously consider having it removed.

Mike

Update, 2011-05-01

I periodically look at the personal experiences on the site and occasionally reach out to some folks whom I can relate too. All too often it seems like I read very sad stories about misery and pain and lack of success with having the Coccyx removed. Thought it was time to share my positive experience.

After 4 years of pain and suffering I had my coccyx removed about 14 months ago by Dr. Maddox in Bend, OR. He was confident he could help me. My surgery was outpatient. Literally walked out of the surgery center. I was real uncomfortable for a couple of weeks. Had a problem with urination that lasted a weekend and required a catheter. Not fun. Once I got over that, it has been steady positive progress to the point I am now 100% pain free! I was fully functional within 6 weeks and all pain was gone after 6 months. So there is hope for us. I am so grateful that I know have a normal life.

Mike Mason

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