How to tell if you have a DISLOCATED TAILBONE (COCCYX DISLOCATION)

By: Patrick Foye, M.D., Director of the Coccyx Pain Service at New Jersey Medical School, Newark, N.J. (www.TailboneDoctor.com)

A DISLOCATED TAILBONE (COCCYX DISLOCATION)is one cause of TAILBONE PAIN. If you have tailbone pain (coccyx pain), you may want to know whether you actually have a tailbone dislocation (a dislocated coccyx). Some people may incorrectly believe that it is pointless to determine if the tailbone is dislocated because they incorrectly believe that there is no treatment available. In my medical career as a physician who has treated at least hundreds of patients with tailbone pain, I would disagree. In actuality, making a correct diagnosis can help everyone (such as the patient, physician, family, employer, insurance companies and others) to understand why the patient is having so much pain. Identifying the dislocation can also help everyone understand why the tailbone pain may persist for longer than it might if the tailbone had only been bruised or sprained. Documenting the tailbone dislocation can also have legal implications if the patient needs to prove that their coccyx was significantly injured during an accident at work or elsewhere. Documenting the dislocated tailbone can also help reassure the patient and others that the tailbone pain is due to a "real" and substantial injury (and that these symptoms are not just "all in the patient's head"). Also, there are treatments available for tailbone pain and tailbone dislocations. The steps below can help you and your doctor tell whether or not a dislocation is the cause of your sore or aching tailbone (painful coccyx, coccyx bone pain, etc.).

Difficulty: Moderately Challenging

Instructions

Things You'll Need:

• A physician
• Medical imaging studies (such as x-rays, MRI, or CT scan)

1. Remember if there was any trauma to your tailbone region. Tailbone dislocations sometimes occur because of blunt force that caused an injury at that location. Examples include falling on the tailbone (a fall onto the coccyx), sprains and similar injuries. Make a note of when the tailbone injury occurred and how it happened. Realize that sometimes even minor trauma or prolonged sitting may be all that can be recalled prior to the start of the tailbone pain.

2. See a physician. Tell the doctor about your tailbone symptoms. Ask the doctor to perform a careful physical examination that should specifically include checking to see if the pain is really coming from the tailbone are not. The doctor should know where the tailbone is and ideally should be able to tell you if that is your most tender spot or not.

3. Understand that relying solely on the symptoms and physical exam will rarely ever be able to confirm whether the tailbone is dislocated. Some injuries cause lots of tailbone pain and the coccyx region clearly shows that the overlying skin is bruised, but there may be no dislocation at all. Other tailbone injuries may hurt less and have less visible bruising, but may indeed have a tailbone dislocation. Thus, medical imaging studies are almost always needed to make a confident diagnosis of tailbone dislocation.

4. 
    
   Tailbone MRI

   Ask the doctor what medical imaging studies could confirm whether the tailbone is dislocated. Ask the doctor if they will give you a prescription (radiology orders) to have the tests done. Usually, the tests would be tailbone x-rays or MRI (magnetic resonance imaging), but CT scans (CAT scans, or computerized tomography scans) may also occasionally be needed.

5. 
    
   Web Search for Tailbone Doctor

   Consider going for a second opinion with a tailbone specialist, if your own doctor is not experienced at evaluating tailbone pain, or is not compassionate about your tailbone symptoms, or is unwilling/unable to order the proper tests, or seems uncomfortable interpreting the MRI results, or is not aware of non-surgical treatments to offer you. By searching on the Internet, you can probably find a physician who offers specialized care for patients with tailbone problems. Sometimes you may need to travel to reach such a specialist, but it may be worthwhile if you can get the answers, the treatment and the relief that you deserve.

Tips & Warnings

• For more information on Tailbone pain, please see Dr. Foye's other TailboneDoctor articles on eHow, or go to www.TailboneDoctor.com and www.Tailbone.info
• WARNING: This information is intended to be educational and is NOT to be considered as medical advice. This information is NOT a substitute for direct medical care from a physician who evaluates you in person.
• WARNING: coccyx pain can sometimes be due to very serious underlying medical conditions, so it is important to seek in-person evaluation by a medical professional.
• WARNING: Many physicians and other health providers have little or no experience in evaluating or treating tailbone pain or coccyx injuries. If you are not satisfied with the first physician you see, then seek medical attention from a specialist with experience in treating tailbone pain.

Resources

• www.TailboneDoctor.com
• www.Tailbone.info
• eMedicine chapter on tailbone pain (coccyx pain)
• Dr. Foye's Tailbone - Coccyx articles on eHow
• Dr. Foye's profile on eHow, TailboneDoctor
• Online images of the tailbone - coccyx
• Radio show on tailbone pain (coccyx pain)
• TAILBONE PAIN
• www.TailbonePain.net

[dsmith5259]

on 9/23/2009 Thank you for responding. How do I know which kind of bone scan was done. The report says NMbone Img mult HCPCS: 78305 shows on the anterior view, there is no abnormal uptake in the coccyx, but this i partially obscured by the bladder. Also, can you have foot pain from prolonged standing and walking Driving a standup fork lift. Worker's Comp denied claim stating contusion when Dr. diagnosed displaced coccyx.

[TailboneDoctor]

on 9/22/2009 To answer your question about bone scans... Bone scans are sometimes used to look for fractures (especially to confirm that a fracture is acute, meaning recent) and to look for certain types of cancers. Coccyx bone scans often need to be done with SPECT. A typical bone scan (without SPECT) fails to show the coccyx well, since the frontal view of the coccyx gets blocked by radionuclide in the bladder.

[dsmith5259]

on 9/22/2009 Is a bone scan used to find out about a dislocated coccyx? The dynamic x-ray showed 60% dislocated. It was a on the job injury.

[tailbone]

on 9/7/2009 Dr. Foye, I have an old Tail bone injury from about 7 years ago. I flipped my quad on stunt and landed on my rear which lead to a full year of pain. It took me a year to plateau to my so so recovery. I still feel pain when I sit for more than 30 minutes and in 5 minutes when sitting on the floor, which rarely happens. Recently I took a second job as a Transit Bus driver. I sat for about 3 hours straight which reignited my tailbone pain to lvl 8. I ordered a Coccyx cushion but I want a permanent solution as my 2 jobs hing on driving a transit bus. I live in Los Angeles. I read your articles and came to the conclusion the common remedy for coccydynia sufferers is a series of shots. Can you recommend anyone on the west coast? THANK YOU SO MUCH FOR HELPING US WITH OUR PLIGHT!

Kindest Regards,
M
[e-mail]

[TailboneDoctor]

on 8/30/2009 loosecaboose, I am sorry to hear about your tailbone pain (coccyx pain). While this eHow forum is not for actual medical advice, I sympathize with the pain you are having and with your frustration trying to find a doctor to provide focal treatment at the site of the tailbone pain, rather than just as an overall chronic pain. Many doctors tend to trivialize tailbone pain, which I think is largely out of ignorance for causes, tests, and treatments. Wishing you all the best. -Patrick Foye, M.D.