Success with physical therapy in Ohio

Matt

Posted 2010-10-03

In the summer of 2009, I began experiencing tailbone pain that was mild when sitting but that sharpened when I was in the act of standing up or when I sneezed. In October my family and I drove from Cincinnati (my hometown) to North Carolina and back, and afterwards, the pain was stronger and more persistent. I went to see my primary care physician, who said that he was unused to seeing pain that low in the back. To rule out more serious illness, he ordered X-rays, which came back negative, and then put me on a regimen of anti-inflammatories and weekly physical therapy.

While I was on the anti-inflammatories the pain nearly disappeared, but two weeks later, when my prescription ran out, it returned as strong as ever. Over the next month, I went to physical therapy dutifully, and although I felt that the various stretches and exercises seemed a bit too generic, too tailored to common lower back pain rather than to my specific tailbone ailment, I remained optimistic that the treatment would help to heal me gradually over time.

In late November, before a driving trip to Massachusetts. I asked my PCP to refill my prescription of anti-inflammatories, hoping not to need them. I lasted about two hours into the first-day's drive before taking one, and ended up taking one every day of the trip that featured a drive of longer than 30 minutes. When we got back, I found that I could no longer drive at all without considerable pain, and I came to dread just taking my kids to and from school.

On December 8th, my wife and I went to a movie, and I was in too much pain to sit through it. A few days later I went back to my PCP, who admitted that he didn't know what could be wrong with me or how to treat it, and referred me to a spinal surgeon. On December 18th, I went the spinal surgeon's office. I spent about twenty minutes in the exam room with one of his residents, relating every detail of my experience in the hopes that one of them might trigger some insight into my condition. After consulting with the resident and reviewing the X-rays that my PCP had ordered two months earlier, the spinal surgeon came in and told me that I had coccydynia, that the condition was chronic - untreatable except by corticosteroid injections that were effective only in the short-term and by surgery that had a high risk of failure and complication—and that I needed to learn to live with it. He wrote me a prescription for a donut cushion, a device that does not actually relieve pressure on the tailbone, from a medical supply store that does not actually carry them.

A few days after seeing the spinal surgeon, I flew with my family to Florida for Christmas, and at some point on that journey—on the plane, during the long car ride from the airport, on the hard wooden seats at the restaurant where we ate dinner—I worsened the damage to my tailbone. The pain, which had previously existed only when sitting or when I was transitioning from sitting to standing, became constant. At every moment of the day I felt as though a shovel blade had been inserted into my lower back so that the tip of the blade touched the inside of my navel. The only way I could sit for even a few minutes was to tuck the calf of one leg under the thigh of the other, which caused the calf to fall asleep almost immediately. I became unable to sleep. On one day of the trip my wife and kids and I went to Disney World with my in-laws, who we were visiting, and it was all I could manage to go on a single short ride. I'd been looking forward to riding a roller coaster with my daughter and sitting beside my son as he steered his first go-kart, but I couldn't do it—I had to lean against the railing and watch while others took them on the rides. It was a horrible feeling, and I came back from vacation deeply depressed.

From Coccyx.org, which I read comprehensively while I was in Florida, I knew that I didn't need to accept the finality of the spinal surgeon's diagnosis. I was fairly positive that I hadn't fractured my tailbone, because I had no memory of injuring it, because there was no evidence of fracture on the X-rays my PCP had ordered, and because the onset of my coccydynia was gradual. I suspected that my years of poor posture working in desk jobs were the culprit, and that my tailbone had gradually become misaligned or destabilized over that time.

To know for sure, I decided I needed to find someone to give me the sit/stand X-rays I'd read about on Coccyx.org. However, as I was in extremis by this point, I didn't want to wait several weeks to see someone who might (but probably would not) know how to give me a proper diagnosis, but to go directly to someone who would.

So I turned to the index of health care providers on Coccyx.org, with a special eye on those whose recommendations were accompanied by personal stories. That's how I found Jean McConnell, a physical therapist in Youngstown, OH, and Dr. Vernon Patterson, an orthopedic doctor near Cleveland, both of whom had been had been recommended by patients multiple times, including several who reported that their gradual-onset coccydynia (like mine) had been cured completely in a single session using only therapeutic means (see Doctors and specialists in the USA, Ohio). I actually wrote to one of the patients who'd seen Dr. Patterson, to see how her "instant" cure was holding up three years down the road, and she wrote back to say that she was still fine, and that Dr. Patterson remained the only doctor she'd ever sent a Christmas card to.

I arranged to see Ms. McConnell on the afternoon of January 20th, and then Dr. Patterson, if necessary, the following morning. I wanted to schedule them both together because their offices were only about ninety minutes apart, and because I wasn't sure my tailbone could handle one long car trip (four hours each way), let alone two. On the morning of January 20th I gathered the various ice packs and pillows that I'd learned to use to make driving bearable and headed to Youngstown. After spending a few minutes with Ms. McConnell, it became obvious that she was far more familiar with coccydynia than anyone I'd yet seen, and I understood why people traveled from other states to see her. She didn't cure me that day, but after my examination she told me that my problem was likely caused by ligaments that had been overstretched, probably due to my years of bad posture, and advised me to seek a pelvic floor specialist versed in the trigger point work of Janet Travell. She also recommended that I continue with my plan to see Dr. Patterson, to get his opinion and to get the dynamic X-rays to rule out other causes. So I did. My sit/stand X-rays showed no trauma to, excessive range of motion of, or misalignment of my tailbone, and Dr. Patterson concurred both with Ms. McConnell's judgment that the ligaments in that area had been overstretched and also with her prescription for treatment.

When I got back to Cincinnati, I contacted pelvic floor rehabilitation specialists and asked them if they had successfully treated coccydynia using the trigger point work of Janet Travell. And that's how I found the wonderful physical therapist Kathleen Novicki of the Center for Pelvic Floor and Core Rehabilitation (see Doctors and specialists in the USA, Ohio). I've been seeing Ms. Novicki for seven months now, and I'd say I'm 95% cured. I can drive moderate distances, go to movies, and dine out with friends without pain. My life is pretty much back to what it was.

I’d also like to recommend the Boppy (nursing) pillow, as others on Coccyx.org have done; I found it dramatically superior to any of the more “official” wedge cushions I tried.

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