No treatments are effective apart from regular exercise
Warwick, Melbourne, Australia
Posted 2021-06-27
I've had coccyx pain for many years, since about 2014. I first noticed it at work, where I sit a lot (programming). I've gradually become less able to sit for long periods. In 2020 it became so bad that I needed to take about 6 weeks off work. I've since learned that regular exercise seems to reduce the pain, and have returned to work. No diagnostics I have tried indicate that anything is wrong in the area of my tailbone. No treatments I have tried are effective at reducing the pain, apart from regular exercise. I am currently managing with constant low levels of pain. I worry that as I get older and/or get injured, I won't be able to exercise and the pain will worsen.
I am currently taking 50 mg of amitriptyline daily, which I am not sure is having any effect. The exercises I do regularly are focused on core, glute and hamstring strength. I go to the gym to do squats, deadlifts and associated assistance exercises. While in lockdown due to COVID, I did a combination of bodyweight HIIT sessions and regular running/jogging.
The general conclusion that I and some specialists I've seen have come to is that I have nerve sensitivity in the area. This sounds sort of right, since I have never been able to pinpoint a definite source of pain, and is sometimes feels more sore around the ischial tuberosities (sit bones) than the coccyx.
Brief history of pain, diagnostics and treatments:
- 2006: fell on sacrum while snowboarding. I had trouble moving for the next few days as a large bruise had formed. This is the only trauma in the area that I can remember.
- 2014: started noticing pain when sitting. I was cycling a lot at this time, and remember having lost around 5kg due to a change in diet.
- 2015: stopped cycling due to pain, started using a standing desk at home
- 2016-01: bone scan
- No abnormal tracer accumulation
- Degenerative changes in both sacro-iliac joints region (common at my age - 32)
- No focal activity noted to suggest fracture/facet joint arthritis
- 2018-09: blood scans, nothing abnormal
- 2018-09 to 2018-11: physio treatment, no improvement
- piriformis + glute stretches and strength exercises
- standing a lot at home, at work & on train
- 2019-01 MRI: degeneration of sacro-coccygeal joints, bone spurs
-image from Olympic Park imaging
- 2019-02: steroid + anaesthetic injection into joint, no improvement
- at Olympic Park imaging
- took naproxen for a couple of days, didn't seem to help, stopped
- 2019-05: 'triple injection' at Metro Pain clinic, Clayton
- ganglion impar block, steroid + painkiller injection
- reduced pain in the following hours, then pain returned within 24 h
- I am quite unhappy with the treatment I got here, given how much this cost. There was no follow up to see what other options I had.
- 2019-06: started going to gym, doing squats and deadlifts, among other exercises
- 2020-03: COVID, started sitting down a lot at home. Stopped going to gym.
- at this point I could sit for hours with only minor discomfort
- 2020-07-02: getting noticeably worse. Can't sit or stand for more than 30 min.
- taking time off work. Mostly lying on my side.
- taking oral voltaren, paracetamol, tapentadol, no noticeable effect
- 2020-08-08: some improvement, returning to work
- lots of exercise & stretching for past month. Mostly lying on my side.
- painkillers didn't work, stopped now
- still off work, starting half days next week
- 2020-08-13: saw rheumatologist. no specific recommendations. prescribed amitriptyline
- 2020-09-01: started amitriptyline 10 mg
- 2020-11-09: have been working full days for months, still getting better. Still exercising 3-5 days a week, currently on amitriptyline 50 mg daily. Not sure if that's helping.
