Tailbone pain diagnosis

Tagged: Coccyx pain

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Ren24
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November 25, 2015 at 7:49 am

Post count: 21

#20839

Hi. I have been searching for a diagnosis for most of this year as to why I have had suck severe pain at my tailbone and sacral site. Finally went to UPMC Presby in Pittsburgh and a very good neurosurgeon saw me and was willing to help. When I told him how severe my pain was and where it was he told me he though I had a fractured coccyx. I had s fall relief this year hanging a curtain in my bedroom which was most likely what caused this. Afyer a CT. Scan to confirm it I am scheduled for surgery on December 1st. Somehow I dislocated just the tip of it and as I there is no way to repair it he will eemove the tip of my coccyx. I was hoping this would be read by you and others and help someone else since I have suffered so long and it’s was so difficult to find help. The pain is terrible and I spend most of my time laying on one side or the other. Standing up from a sitting position seems to cause the absolute worst pain. It feels as if someone is stabbing s knife or needles into the area right at the top of my gluteal fold I would also like to ask your opinion on my neck. I did have a discectomy with posting and fusion at C5-6 in July of 2014 and removal of said hardware in June of 2015 due to numerous issues I was a having from the hardware. U fortunately my problems continue. Why were they I a me to diagnose my throat problem until the hardware removal? I have esophageal dysmotility with spasm and a hiatal hernia The same problem for almost s year and nobody could catch it until the hardware came out after 3 esoohagrams ??? Also I am having severe severe spasms in my neck with aching pain in my neck. Shoulders and I to just upper arms. The aching pain was so bad I take pain meds. Muscle relaxers and lay on heat pad and it was t touching it. Being in a certain position seems to ease it slightly laying on left side with pillow and heat pad pressed tightly against my neck and shoulder on the left. It is the same kind of pain I felt when I blew the first disc. Is it possible I ruptured another disc or does this sound more like something pinched ? I haven’t been able to work since November s year ago because of all these problems and I am trying to figure it all out so I can try to get back on my feet. This neurosurgeon is sending me to s pain doc on his end for ‘injections’ and evaluation. Honestly all thes shots are just a temporary holdover as I am newly diagnosed with DM to add to my issues I can’t keep having all these cortisone shots. The last one caused my sugars to remain high in 170-180 range anyway please please guide me with this neck thing. I lost my job and my ability to do much of anything as cannot bend. Twist. Or lift or carry the smallest item without setting off all these psi. Issues. I do have mildly hemodynamically u stable retrolisthesis st c2-3 and and stable anterolisthesis at c3-4 with discovering diseas at c2-3. C3-4. C4-5 and c67. Nobody makes any big deal out of this. Oh. It’s mild. No big deal. Just like they did for my C5-6 that ended up suddenly extruding and ruining my quality of life forever is this all caused my what’s going on in there now or is it nerve damage from the previous surgery at c5-6. Thanks for your time

Donald Corenman, MD, DC
Moderator

November 27, 2015 at 6:00 am

Post count: 8660

#20852

First-the tailbone pain. Coccyx pain can originate from the coccyx but there are other sources that can refer to this region. There is a condition called pudendal or sacral neuropathy which is a subset of peripheral neuropathy and explanation can be found on this website. This is a condition where the nerves themselves are “sick”. Rarely, disc hernation in the lower lumbar spine can also cause radiation of pain to this region.

For the record, it is extremely rare to have a coccyx fracture. The coccyx is a series of small bones hooked together by ligaments. You really don’t “fracture” the coccyx but “sprain” the coccyx by tearing some of these ligaments.

I have removed exactly 3 coccyx’s in my 30 years of being a surgeon so this is an extremely rare procedure. I make sure the coccyx is the pain generator by having the patient undergo a diagnostic block of the coccyx (see pain diary). If there is no immediate relief that lasts 2-3 hours, I question if the coccyx is really the pain generator.

I am surprised that your disorder of “esophageal dysmotility with spasm and a hiatal hernia” took so long for diagnosis. Barium swallows and esophageal scopes generally will diagnose these conditions.

You need a complete work-up of your neck to determine your diagnosis of continuing neck and shoulder pain. This would entail a complete history and physical examination and new imaging studies of which could be X-rays, CT scan and MRI.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.

Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
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Donald Corenman, MD, DC

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81 reviews

Eric S

Sep 26, 2021

by Eric S on Donald Corenman, MD, DC

Successful pars repair at 46 years old

Back in November of 2018 (at 46 years old) I came from Vancouver BC to have a pars repair done with Dr. Donald Corenman at the Steadman Clinic in Vail Colorado. I'm finally posting this review nearly three years later in late 2021. The reason I waited so long was I wanted to know the final result before I posted my review. Unfortunately in that time Dr. Corenman has retired. Nevertheless, I want to post this review of Dr. Corenman and his staff at the Steadman Clinic in their excellent treatment of my L5 pars interarticularis.

I fractured my pars at age 42 back in 2014 when rolling on the gym floor, and was denied treatment by the Canadian healthcare system, probably due to my age. First my GP told me there was no surgical option for a pars defect, which was quite incorrect! I tried to live with it, but the symptoms worsened (periodic random spine slippage and weeks of resultant pain after just bending over to tie my shoe, so I eventually learned to mostly squat and hardly bend). When I finally consulted with Canadian spine surgeons, I was told they believed my pars defect had been congenital (since birth). This was absurd, considering I had done extreme martial arts (including jiu jitsu) for years prior, as well as 5 years of reinforcing steel full time in my 20s, probably the hardest job on the back you can find. No pars defect like mine would possibly have allowed this--ergo it was impossible that I had had the defect since birth. I did however have an asymptomatic congenital spina bifida occulta that made me more susceptible to a pars fracture. In 2014 in one instant, I went from having the strongest back people I knew said they'd ever seen, to being unable to safely bend over and tie my shoe without a non-negligible risk of my spine slipping randomly (which would lead to weeks of pain after each occurrence). This was due to the unilateral L5 pars defect, otherwise known as spondylolysis. It was when lying in pain on the floor 4 years later after maybe the 6th spine slippage event post injury, that I had had enough, and resolved to have surgery. If Canada's "universal health care" said no, I would make lemonade from lemons, and find the very best surgeon in the world at pars repairs. That was Dr. Donald Corenman. Dr. Corenman back in 2018 ran a website https://neckandback.com/ that dedicated many pages to the science of every aspect of pars repairs, from eligibility (good discs on MRI), to best surgical techniques (minimal open compared to minimally invasive), best imaging to use (i.e., O-Arm with Stealth imaging vs. older fluoroscopy), the ideal amount of BMP to use and why not use too much or too little, and much more, all to do with pars repairs, pages upon pages of his site just on the pars, with scientific references and his own extensive expert opinion. As a health research statistician, I was very impressed with this. It was in stark contrast to the websites of other spine surgeons which barely gave the pars a word or two, focusing almost exclusively on fusions. I had found the best surgeon in the world for pars repairs, and so after Dr. Corenman personally screened my MRI to ensure my discs were healthy, I booked the surgery.

Being 46 years old at the time of surgery in 2018, with a 4-year-old pars fracture from 2014 combined with a congenital SBO meant my pars fragment was somewhat atrophied, but it was "very solid", said Dr. Corenman in the operative report. Nevertheless, it was challenging with two things to fix, the pars and SBO, and OR time was around 4 hours. Recovery over the following months was guided by a very clear "Spine binder" from the Steadman Clinic with strict rules of "no BLT" (no bending, lifting or twisting), and illustrated physiotherapy guidelines. They even warned patients to avoid fish oil supplements, which could excessively dampen inflammation and hence slow bone healing. They answered many questions I had during months of recovery, with responses coming from the very supportive Lori Fugate (then director of Dr. Corenman's practice), and Ehrich Bean (then physician's assistant at the practice), as well as a couple calls with Dr. Corenman himself after two of the CT scans. Ehrich Bean offered great advice for taking the spine binder conservatively due to the nature of pars repairs vs. fusions. The final post-op CT scan I had was a couple weeks ago at 34 months post-op, and Dr. Corenman had retired, but I got a very positive and informative call from Eric Strauch (current PA at the Steadman Clinic under Dr. Corenman's replacement there, and who had also worked with Dr. Corenman previously). The staff at the Steadman Clinic were extremely supportive all the way through the process. I should mention, the local Canadian spine surgeon did offer me very good post-operative support including antibiotics as needed to deal with a mild surface incision-site infection early on, booking numerous x-rays when I felt something was amiss, as well as booking all four of my post-op CT scans. I am very grateful for that support also.

My final result shows plenty of solid bone across the pars and a healed SBO, with my vertebral body now a solid bone ring instead of being broken at two places as it was pre-op. Does my spine hold up in the real world? You bet! I have recently dug and moved several yards of dirt and sand and gravel by myself (shovel and wheelbarrow!) to fix our water main, pulled roots from the yard, moved several "portable" (these are HUGE) air conditioners up several flights of stairs my myself, and lifted weights. I now run 2 miles (3.2 KM) several times weekly with a hard 100 meter dash in the middle. I bend deeply before each run I go on, with no spine slippage. My spine feels amazing. I can bend over to do exercise, or real word tasks, with no risk of spine slippage.

My sincere thanks to God, Dr. Donald Corenman, Lori Fugate, Ehrich Bean, Eric Strauch, and the Steadman Clinic, as well as the Canadian spine surgeon who offered me excellent post-operative care back in Canada. You have all given me a new lease on life.

Sincerely,
Eric S

Robert S

May 11, 2021

by Robert S on Donald Corenman, MD, DC

Back Fusion Surgery

I had my entire lumbar spine fused in November of 2018. I had scoliosis , with pinched nerves that were so painful I could hardly walk - and standing for more than a few minutes was impossible. Even sitting was painful.
The fusion surgery produced immediate relief! And the recovery was much easier than I expected.
To this day I can do all the activities I love from hiking, to standing in a stream fly fishing to riding my bike long distances - or just walking down the street with my wife.
Kudos to Dr. Corenman and his staff, (including the two Erics) for taking such good care of me!

Leslie R

Jul 9, 2020

by Leslie R on Donald Corenman, MD, DC

TLIF

I had my TLIF surgery on 6/24/2020 by Dr. Corenman, I can not say enough good things about the Dr or his staff. I was always treated with respect and explained everything throughly, that made it easy for everyone to understand. I highly recommend Dr. Corenman and the Steadman Clinic.

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