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[RC] Tailbone Pain - Bruce Weary DC

I would have to guess that a fall like the one you described would have contributed significantly to your disc degeneration. There are lots of paradoxes in the treatment of back pain. For example, your x-ray findings most often do not correspond with symptoms. You can have ugly x-rays with lots of arthritis present, and be symptom free, and you can have clean looking x-rays but be in agony. Many people who have a tailbone injury presume they "must have" fractured it, but confirmed fractures of the coccyx are actually pretty rare. The pain that seems to be coming from the tip of the tailbone is often actually from the ligaments that attach it to the pelvis on either side. When you take a hard fall on the tailbone, much of the force is absorbed by the sacroiliac joints above. The good news is that most tailbone pain can be eradicated with manipulation to the sacroiliac and hip joints, and deep massage to those ligaments I mentioned. Along with proper treatment, riding sometimes helps this pain, because it causes intermittent stretching and relaxing of those ligaments, which is therapeutic. Riding by itself may aggravate it, so get treatment first.
Your thin disc possibly isn't the main cause of your low back pain. Discs deteriorate for various reasons, but the thinning deterioration process is basically a painless one, unless it gets so thin that there is inadequate spacing for the nerves of the area. Most back pain is from the mechanical malfunction of the 100-plus joints of the spine and pelvis that results from daily living--the influence of gravity, injuries, sedentary life (not us, right?) sitting in school for 10-15 years, sitting at work, dinner, movies, TV, driving, lack of exercise, standing on hard surfaces....the list goes on.
Over 60% of Americans have disc herniations and don't know it.We know this from all the MRI's that have now been done, and inadvertantly detected them. So when symptoms arise, we can't presume that those symptoms are caused by disc defects that are then found on examination. There are very clear clinical signs for when a disc may be the cause of your pain. The most important skill your doctor can have is a talent for diagnosis. Once we have the right diagnosis, most doctors agree that giving the appropriate treatment is like falling off a log.
I want all my patients to know this: Don't presume that alleviation of symptoms is the same as eliminating the underlying cause. Many people try to treat their back pain (which has other factors involved than the pain itself) with meds, ice/heat and time. When their symptoms improve, they breathe a sigh of relief, pat themselves on the back, and move on. Until the next time. Four or more recurrences of back pain put you at greater risk of damage and or chronic pain. IMO, it's better to fix it right the first time. As I tell my patients: "I'm like the undertaker. I'll see you sooner or later."
Dr Q world renowned tailbone expert


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