Long-term pain with no blunt trauma

Anonymous - ktoyo234@gmail.com

Posted 2010-11-07

I've been dealing with coccyx pain for 6 months, and the cause is still unknown to me. I am very interested in hearing stories or theories from people who have experienced similar things. Please email me at ktoyo234@gmail.com if you have any information. I am a 24-year old otherwise healthy male, and as a engineer, I do a lot of sitting. I will detail the whole story below.

Around 6 months ago, during finals week at my college when I was sitting many hours a day, I started to feel a very faint sensation at my tailbone when I would move from sitting to pushing my pelvic area strongly outward. It was so incredibly faint I could barely feel it for another week or two. After a few weeks, it became notable but still not painful. I started to get a bit concerned, but didn't think too much of it. By around 1 month since the feeling began, it start to legitimately hurt. Both sitting and standing were individually comfortable but switching between the two caused pain, especially later in the day. When I woke up, it felt healed for the most part. I decided to not sit at all for 3 days. I went to the doctor, who proscribed me anti-inflammatory medication and took an xray which showed nothing unusual. The anti-inflammatory medication appeared to have no significant effect.

After 3 days of not sitting, I felt nothing. I could sit for 1-2 weeks without feeling any ill effects, so I thought that it had gone away. But after a few weeks, it started to creep back. I attempted to sit sparsely, but when school started 3 months since the initial feeling, I was forced to sit. I attempted to sit on my right hip/butt cheek area to deflect the pressure from my tailbone. However, this made it worse - but only on the right side. I began to feel a sharp-ish pain coming from what felt like whatever attaches to the lower right side of the end of my coccyx. When this pain occurs, I can push on the area externally and feel the soreness. In addition, laying on my right side or on my back causes my actual coccyx (not the muscle attached to the right side) to feel sore.

I went to a physical therapist who told me I have weak glute muscles and gave me glute exercises and hamstring stretches, as my hamstrings were very tight. The stretches did not appear to have any effect but the glute exercises appeared to be helping the problem.

I dropped out of several classes and vowed not to sit for a single minute (which I have stuck to - I stand at my computer, lay in the back seat on car rides or lay with my laptop) until it is healed. For the last two months, I have been exclusively exercising, standing, or laying. While the problem has gotten better, and now I feel little pain most of the time, any sitting will bring back the problem very quickly. The only time I sat was for a 15-minute haircut which brought back pain for 2-3 days. Comfortable positions include standing, laying on one side for short periods, and laying on my stomach for short periods. Uncomfortable positions include laying on my back, sitting, and lifting heavy things or exerting large amounts of effort in basically any way.

I am at a loss as to what the actual source of the pain is. The localization to the right side makes me feel like it is a muscle or ligament problem, but the incredibly slow healing speed makes me think it may be something else. The healing process appears to be going slower and slower and I fear it will soon stop.

Thank you for reading my story. I will update if I make any significant progress and always appreciate emails.

Note from Jon Miles: Dr Maigne found that patients who had acute pain while moving from sitting to standing had a coccyx that partially dislocated or moved abnormally when the patient sat down. This was reported in the medical paper, Treatment strategies for coccydynia. The reason for the pain is thought to be that there are various muscles you use for rising which are also attached to the coccyx. When you go to rise, the muscles pull on the coccyx, pulling it out of position if the joint is damaged. Sally Cowell wrote: To avoid this pain, try sitting leaning forward a bit and hollow your back a lot. This got rid of pain going from sitting to standing for me.

Updated 2010-11-28

After reading R.K. Hennessy's post, I began doing the weightless squats, which I began nearly two weeks ago. I noticed results immediately. After a couple days, there was noticeable improvement, and I only felt pain from waking up after a night where I'd roll on my back or if I did something stressful like lift things around. I slept on the couch for a few days so I was forced to sleep on my sides the entire night, which was less stressful, and kept up two exercises:

1) Weightless squats, as suggested by R.K. Hennessy

2) The 'clam shell exercise' (detailed here about halfway down the page), which was recommended by my physical therapist and was also very helpful.

At almost two weeks of doing the exercises, I'm starting to feel back to normal. I just did a complete workout (bench, curls, squats, etc) with no discomfort at all, which has not been possible for a long time. I am still standing or laying down 100% of my day, and not sitting at all, however. I intend to ease into this gradually after I am confident I can do everything else (work out, sleep, etc) without any discomfort whatsoever.

From the the positive responses to weightless squats so far, I'm beginning to think someone's found a breakthrough. I'd like to give a big thanks to R.K. Hennessy for sharing their experiences, and to Jon for running the site. I will hopefully update in the future.

Clam shell exercise:

clam shell closed clam shell open

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