Intense Tailbone Pain, Done MRI, Dessication Of Lumbar Invertebral Disc, No Stenosis, No Nerve Root Compression

Posted on Tue, 2 Oct 2012

Question: my father has had a very high intense pain for 3 moths so far in the tail bone area he says i think in the tip of tha tailbone it causes a lot of pain for him he did do mri recently also his mri report says dessictaion of the lumbar intervertebral discs with exeption of L4-5 L3-4 very minor disc bulge a posterior degenerative change L5-S1 tiny central disc protrusion and some prosterior degenerative change no central stenosis or nerve root compression lession doctors said not enough to cause pain but he feels it can you please kindly help

Answered by Dr. Shiva Kumar R (29 hours later)

Hi,

Thanks for the query.

Inflammation of the bony area (tailbone or coccyx) located between the buttocks is referred to as coccydynia.

Coccydynia is associated with pain and tenderness at the tip of the tailbone between the buttocks. The pain is often worsened by sitting. It can be due to infection, Sciatica, pilonidal sinus or fracture of the bone. The IVD dessication may not be related to this tail bone pain. Some times herpes can cause pain and later on manifest with rash over the bottocks. MRI in your father does not show any evidence for lumba rcanal stenosis or sciatics. No fracture seen. But you have not mentioned about any infection or sinus or falls over the buttock. I suggest to rule out infection at the local site or sinus by physical examination by your local doctor. I can even suggest you to get a rectal examination done to rule out rectum problems which are common.

If no reason found then can be treated as coccydynia of uncertain cause. Pain can be avoided by using a well-padded seat when sitting and avoiding long periods of sitting if possible. If it becomes more trouble some it can be treated with local steroid injections like cortisone. Antiinflammation and pain medications can be used to relieve pain.

So let me know if he has a fall or infection of the skin or sinus around the tail bone. If not present then go ahead and try steroid injection to relieve the pain.

Hope I answered your question.

Wish you Good Health.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shiva Kumar R (21 hours later)

Hi no no infections he has had the gp take a look already and blood tests urine tests all clear just this pain he said before he could at least walk a little now even he cant walk he cant sleep on left side or right side only flat looking up at the ceiling can this coxcyc diagnoses you said it could be graduate in pain like this he hasnt fallen or bruised that area as well thats why i am at a lost i hope this helps you to confirm what you said and if is what you said the gps here they dont want to give him injections because they said they havnt confirmed a diagnoses so they dont want to inject him it is very frustrating to watch him like this please reply all the best

Answered by Dr. Shiva Kumar R (18 hours later)

Hi,

Thanks for getting back to me.

It is only a diagnosis of exclusion of other serious problems which you have already done. I cannot confirm a diagnosis without physically examining him just with narration of symptoms, hope you understand this. If he has unbearable pain then that is the only option left out. If he does not respond to the cortisone injections then he may require surgery to relieve his pain. But this will be the last option.

Do discuss this with Neurosurgeon or Spine specialist and confirm the same. Meantime you can speak to the GP there to give him good pain killers and make him comfortable for time being.

Wish him Good Health.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar