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Step 1
The best first step is to find out what is causing the tailbone pain. Ideally this is done by seeing a physician with experience in evaluating and treating a variety of causes of tailbone pain. Tailbone pain can be caused by many different conditions, such as: coccyx fractures (fractured tailbone, "broken tailbone", chipped tailbone, "cracked tailbone"), coccyx dislocations (dislocated tailbone), coccyx sprains (sprained tailbone), coccyx injuries from pregnancy (tailbone injuries while pregnant or from childbirth, labor and delivery), tailbone injuries from sports and other causes (bruised tailbone from trauma) and tailbone pain, aching, soreness or tailbone discomfort that began without any trauma or injury at all. By knowing the cause of the tailbone pain, the physician can give individualized advice or treatment to help decrease the pain without surgery.
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Step 2
In cases where the tailbone pain is caused by cancer (tumor, malignancy), surgical removal might be the best treatment, if recommended by your doctor. However, fortunately, the vast majority of cases of tailbone pain are NOT caused by cancer.
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Step 3
Web Search for Tailbone DoctorBefore considering tailbone removal surgery, it usually makes sense to first try non-surgical treatments for tailbone pain.
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Step 4
Non-surgical treatments available without a physician include using tailbone cushions (wedge cushions and/or donut cushions), taking over-the-counter (non-prescription) medications by mouth, and using caution to avoid exacerbations of tailbone pain (e.g., by avoiding sitting on surfaces that worsen the pain).
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Step 5
Non-surgical treatments available through a physician (medical doctor) include prescription strength medications (to relieve pain and/or decrease inflammation), either taken by mouth or applied topically to the skin over the tailbone. Also, a physician with experience treating coccyx pain can perform local injections at the tailbone region, such as nerve blocks and/or injections of anti-inflammatory medications (e.g., steroids similar to cortisone). Ideally, injections in the coccyx region are performed under fluoroscopic guidance (rather than "blind" injections), so that the physician can more precisely place the medication at the correct location (and avoid accidentally placing the needle into other pelvic structures). There are new/current injection techniques that were not available a few years ago.
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Step 6
Fortunately, the majority of patients with tailbone pain will get relief through the steps above. But for the small percentage of patients who have gone through the above steps yet still have severe tailbone pain substantially compromising their quality of life, it may be reasonable to consider surgery to remove the tailbone (coccyx removal surgery, coccygectomy).
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Step 7
Prior to proceeding with surgery, make sure to find a surgeon who has substantial experience in performing this particular surgery. Experience matters.
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Step 8
Make a list of questions to ask the surgeon, including asking about risks, benefits, and the surgeon’s experience and expected outcomes.
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Step 9
Consider the potential benefits of the surgery. Despite the multiple potential risks (including those noted below), if patients are properly selected and if the surgeon is experienced at performing this particular (uncommon) surgery, the tailbone pain is improved in at least 2 out of 3 patients who have the tailbone removed.
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Step 10
Make sure to consider all of the risks of the surgery. Current publications of medical research (since 2000) have noted that even after undergoing the surgery as many as 1 out of every 3 patients may have pain that is still not relieved. Also, almost 20% of coccygectomy surgeries may be complicated by infections (requiring repeat surgery in 15% of patients who have the coccygectomy surgery). Some patients have postoperative pain (pain after surgery) that lasts as long as one year. Patients may be at risk for prolapse (sagging) of the pelvic floor.
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Step 11
In summary, consider the medical advice often published by both surgeons and non-surgical physicians, both of whom often refer to coccygectomy as "a last resort." Specifically, tailbone removal surgery may indeed be helpful for the small percentage of patients who fail to get adequate relief from first trying all of the non-surgical treatments (including current injection techniques). Doctors often recommend coccygectomy for coccyx pain only if patients have first tried the spectrum of non-surgical treatments.
Comments
TailboneDoctor said
on 10/29/2009 Sorry to hear about your tailbone pain. Sit-ups can indeed cause coccyx/tailbone pain. While I can not give formal advice in this forum, I can say that in general patients with tailbone pain should have an in-person evaluation by a doctor with experience in evaluating/treating this. This might need to include xrays, MRI, injections, etc., and in a limited number of cases it may include surgical removal of the coccyx (coccygectomy). If you go to www.TailboneDoctor.com and enter your email in the yellow box it will sign you up for a newsletter that will give more info. than I can fit here.
rochesterguy507 said
on 10/29/2009 I got booted from the army about nine months ago. My tailbone got very sore when i was doing situps and i couldnt handle it anymore. I went to the army doctor and he said that my tailbone was deviated to the left.
I want to join a branch of the military, but am afraid it will happen again.
If i get surgery will i be able to join again, and be able to do situps without pain. Do most insurance plans cover this type of surgery?
itsrox said
on 9/17/2009 9/17/09 - I had the gastric bypass done almost 5 years ago... after loosing 214 pounds and having NO meat/fat around the tailbone the coccyx has ripped through the skin!
I had a doc that just fixed my hiatal hernia look at the area and said he has heard of the issue, has never seen the outcome until the day he checked me. He said I would need a procedure called a "coccygectomy".
I live in Phoenix, Arizona and I have called almost 40 doctors and not 1 of them do the procedure. I did however come across 1 that only does the procedure on children...
Do you possibly know of any doctors in Arizona that do the surgery? I am at my wits end... I am in pain and it seems I am going to have to stay this way because I cannot seem to locate a doctor that can help me.
Thank you for your time!
Roxanna
TailboneDoctor said
on 8/25/2009 (Continue, since it cut off my last post)... Lastly, as this forum is educational rather than medical advice, you should definitely discuss the risks/benefits with your treating doctor so that they can review with you at an office visit the specific considerations in your own specific/personal case.
All the best.
TailboneDoctor said
on 8/25/2009 Hi, Nate. Yes, there are some potential complications at the site of surgery when the coccyx (tailbone) is removed. These include infection at the surgical site (partly since it is so close to bacteria from the anus/stool), occasional need for repeat surgery to clean out infected tissue, occasional sagging (prolapse) of the pelvic floor (anus, rectum, etc.), prolonged pain after the surgery, etc.. A common issue is that the recovery time takes quite a while (e.g., no sitting at all for several weeks after surgery, and sometimes tailbone pain at the surgical site that can in some cases last for many months). In summary, to answer your question, there are a number of potential complications (these are just some examples). I have seen some patients do marvelously well with tailbone removal, and others who have not done well. Lastly, as this forum is educational rather than medical advic...