Coccyx dislocated backwards

Posted 2024-05-26

Summary: If you have a dislocated coccyx (especially a backwards dislocation) get sit-stand or dynamic imaging and see an expert. Manipulation from Dr. Stephen Sandler (see Doctors and specialists in the UK, London) gave me relief.

For the full story: I'm an American man around 30 based in London. I have a family history of hypermobility. I used to skateboard, but was pretty conscious of falls, padding and risk. In July 2022 I had a strange skateboarding fall. I fell about a foot onto a metal ledge, directly on the left side of my coccyx. I could tell that something was wrong right away, although nothing felt broken. Sitting was immediately painful. An NHS doctor didn't take x-rays but examined me and found no abnormalities. My GP recommended a tailbone cushion, physical therapy and a non-steroidal anti-inflammatory.

After two months, I had significant sitting pain even with a cushion. The pain was in the tailbone and to the left and below it. Pain from sitting to standing or on the right side didn't appear until later, possibly because the dislocation worsened. The NHS speculated that I had a micro-fracture. A standard x-ray and a later MRI were unhelpful. I started swimming and avoided sitting, using a standing desk. Imran Riaz, an excellent physical therapist, recommended I see a specialist.

In December, dynamic x-rays showed that my coccyx was dislocated backwards from the second joint. Coccyx manipulation was recommended. I flew to the U.S. for the holidays. This was incredibly painful, even with painkillers and two coccyx cushions. An orthopedic surgeon there confirmed my diagnosis. He was not hopeful, was unconvinced about coccyx manipulation and surgery, recommending pain management. I took another painful flight back to the U.K. in January. I tried manipulations and exercises. They helped but didn't provide permanent relief.

In May 2023 I tried low level laser therapy with helpful osteopath Philip Rossiter at Leigham Practice. The treatment gave me noticeable pain relief. I traveled to Paris to visit Dr. Jean-Yves Maigne (see Doctors and specialists in France) in June. He was kind, incredibly knowledgeable and hopeful about my coccydynia. Dr. Maigne took x-rays and gave me a steroid injection. My tailbone was still dislocated. He said that my coccyx's position while sitting could have been a problem later in life anyways. Dr. Maigne recommended avoiding long flights and bicycling essentially forever. I was happy with my visit, but unhappy with the prognosis. The injection alleviated the coccyx pain, but I still had pain in nearby areas. I had stopped the laser treatments, since one treatment was pro-inflammatory and the other was anti-inflammatory. After two months, Dr. Maigne recommended another injection. I was dealing with an unrelated minor health issue, so I waited.

In the fall I tried the laser therapy again. It provided less relief than before. I had a virtual consult with Dr. Jerry Hesch, who gave me useful self-manipulation techniques which he said might not be effective given how long I had been suffering. I got another MRI thanks to Darren Chandler, who used to do coccyx manipulations, but no longer does. He was very considerate, and sat with me for an hour, going over the results, recommending a nerve block. I considered more injections or surgery to reduce the dislocation. A doctor friend recommended a coccygectomy.

I contacted osteopath Dr. Stephen Sandler in January 2024. I wanted another opinion. At this point, I had seen a number of specialists, gotten x-rays, MRIs and tried multiple treatments. I hoped this would be my last treatment. Dr. Sandler thoroughly reviewed my medical history, and put me at ease. He then performed a coccyx manipulation. It wasn't painful and it didn't last long. I felt a "pop" and Dr. Sandler believed that the dislocation was corrected. I left his office uncertain, but I could actually sit, and improved rapidly. I could swim strokes that used to hurt and sit longer. After a week Dr. Sandler said I would be fine. I'm 70% better. The pain is a nuisance, before it was life-changing. I'm hoping to improve more. If I'm not 100% better in a year, I'll consider other treatments. Thank you to the medical professionals who helped me, the moderator of coccyx.org and its contributors. My advice is to see experts and trust your gut. Take care!

*Since writing this I fell slightly backwards onto my left hip while wearing padded shorts. The fall wasn't bad, but I worry it may have knocked things out of position, although I hope not. I've had some improvement since, but I'll contact Dr. Sandler if it doesn't improve more.*

Note from Jon Miles:

I emailed more than a year after this story was posted, to ask for an update, as the long-term outcome of treatment is of great interest. In this case I did not get a reply.