Coccyx pain with calcification, spicule, and associated pelvic floor muscles dysfunction

Tina From Madrid - coccigodinia@gmail.com

Posted 2009-11-29

I have been suffering while sitting since September 2008. Pain has been increasing progressively. I had already suffered from lumbalgia since January 08 till August 08, due to a disc protusion at L4-L5, my left leg was numbed from time to time. Once the lumbalgia went away and all muscles stopped being contracted (and no problems in my left leg), I still kept suffering in the bottom area while sitting. This pain progressively increased up to the point that I had to get a sick leave 3 months ago.

Gammagraphy showed bilateral sacroileitis and I was sent to see a rheumatologist. First they thought it would be spondilitis/arthropathy, but doctor Emilio Martin Mola (a well-known doctor in Madrid) finally discounted rheumatic disease. I was HLB27 negative and not enough signs were found at tests to prove a rheumatic disease.

My therapist realised that I had pain in my coccyx. Nobody had touched my coccyx before!

Dr. Maigne in Paris examined my coccyx in September 09, with dynamic x-rays and found out one calcification in one coccyx vertebrae (this shows a chronic inflammation process) and a spur at the end of my coccyx. My coccyx was not flexible, which made my spur more painful while sitting. He injected me anti-inflammatories with no visible results after 3 weeks.

I went back to Paris in October 09, I had an IRM prescribed by Dr. Maigne, very well done, it showed lots of inflammation and one bursitis close to the big spur. This all matched. He injected cortisone again. The pain did not really go away. But I must point out that Dr. Maigne is a professional Dr. when it comes to coccyx issues. He diagnosed my coccyx problem and made the reasons more concrete. If anyone suffers from this, I strongly recommend visiting him first (see Doctors and specialists in France). He prescribed internal massage and I had the first internal massage. It was not horrible as people can think so do not worry about that. He suggested that I have this kind of massage in Spain. A girl informed me that the osteopath François Ricard performs this kind of massage in Madrid. Inconvenient: big waiting list! (two months)

In the meanwhile I am visiting one chiropractor, dr. Chad Liggin, the has studied my case professionally with lots of care, comparing all tests, pointing out that my sacroiliac joint is not well aligned, and that my L5 S1 has become worse since last year (...in spite of all rehab!!). Since I have pain in both coccyx and sacroiliac joint, he suggested I start with a treatment in the sacroiliac joint as he said the bad position of my sacroiliac can be having an impact on my coccyx again. I am still on treatment with him.

I have been told that Ariel Joselovsky also has experience with internal massage and with sacroiliac joints. I am still in the waiting list, but I would like to try! He works in Madrid.

I have been recommended as well the Centro Médico Leonor Sacristán in Madrid, by a person that suffered from severe coccyx issues. I have not tried this clinic yet.

Update, 2010-01-03

During November-December I kept going to the chiropractor, he would move my sacroiliac joint and some times it did help for a couple of days but after two days the pain kept coming back. Anyway, it does look like my sacroiliac position does have an impact on my coccyx pain!

I met some girl (friend of a friend) that suffered from coccyx and hip pain a lot, she was in huge pain for several years and she got it finally cured thanks to a therapy called "aponeurotic surgery" at a medical center in Madrid. I recently started the same therapy... let's see if it does help! Even though the name o the therapy includes the word "surgery" there are not any cuts... only injections and a strong sort of massage.

I have also started to feel pain in my ears and I have found out that this is common among coccyx sufferers... I wonder if my lovely coccyx can have something to do...

Update, 2010-05-23

I am still following the same "aponeurotic therapy" at the Leonor Sacristán medical center in Madrid. It is based in a sort of massage and results so far are:

- Referred pain to left gluteos has significantly decreased

- Pain is much more concentrated at my coccyx when I sit. It hurts more in a soft surface because my coccyx is very short therefore it receives more direct pressure when I sit in a soft surface.

- I repeated the dynamic x-rays which according to my doctor showed that my sacrum was not flexible while seating (not only my coccyx) so L5-S1 seems to have something to do with all this mess. Sacrum not moving well while seating means that the coccyx does not move forward well either, as a result the spur at the end of my coccyx keeps hurting. I have tried to pressure the sacro-coccygeal joint with my fingers while sitting, and when I do this it almost does not hurt. X rays also showed that the coccyx has signs of inflammation, which matches the first tests.

- I am 1 cm higher than I used to be. Believe me, I am 31 years old and I have been keeping track of my height since the age of 10. I never reached 1,70m before, not even when I was younger. Maximum was 1,69m which I still measured last year. My doctor says this is good news. Maybe this can compensate from the fact that I can not wear heels anymore!

I think that the treatment is going well little by little.

Update, 2010-09-05

I am still unable to sit, but the diagnosis is quite clear now: my sacrum was inflamed after a very long back pain period in 2008. Because the back spasms took so long to cure (1 year), and I kept working all the time, the weight of the body was mostly supported by my sacrum and hip, inflaming the tissue around my sacrum and explaining the sacroiliac inflammation. This tissue around my sacrum would have stuck to the bone making it unable to bend while sitting, as shown by the dynamic x-rays. Coccydinia started to appear right afterwards because my coccyx was not bending either, and it was supporting so much weight. The spur in my coccyx would only make the situation worse creating a big bursitis around it. My doctor is now trying hard to separate all this stuck tissue and I can feel how the sacrum starts to bend little by little, although I am still unable to sit.

Update, 2012-01-08

Went through surgery in March 9th 2011. Great experience thanks to Dr. Jean Yves Maigne and Dr. Doursounian (see Doctors and specialists in France). Calcification was the main reason for being considered as a good candidate, although Dr. Maigne did not like sporadic perineal pains. I also had a spicule in coccyx. Only last vertebrae with spicule was removed.

10 months after the operation I can sit down for lunch and dinner 20 minutes in my cushion and sit up with no pain, like magic. It is a slow recovery as compared with other patients but I am happy I went through this surgery. 40 minutes a day is infinite % more than before, so it is something... My recovery is very slow, I had lots of infections in the summer (cystitis, candida) that provoked perineal pain and pelvic floor tightness. This did not help. I am very weak and my buttocks have weak muscles now. I am working on treating the infections, avoiding sugar and alcohol, and I have learned that there is a direct influence in muscle tightness, pain and infections.

This book is helping to diminish perineal pain: Bob Anderson: Stretching. The leg chapter is very helpful.

The main doctor that helped me with pelvic floor diagnosis and treatment is Dr. Eric Bautrant in Aix en Provence, France - (see Doctors and specialists in France). He diagnosed a Pelvic Floor Myofascial Syndrome and prescribed botox injections that released tension and diminished pain a little bit.

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