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Cough, pain in tailbone. Does this sound like a strain?

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Orthopaedic Surgeon
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About 5 years ago, I had a very severe cough, coughing from XXXXXXX within , and violently . I believe that I strained either muscles or ligaments in my tailbone area. The pain is still present, although not always. if I stand from a sitting position, I get debilitating pain in my tailbone , which will bring me to my knees. It will subside when I get into a lying- down position. After this happens, it doesn't take much to bring the pain on several times in a day. The pain may actually disappear for weeks, and then it comes back , sometimes worse than before. I told this to my doctor, an Internest, and he had no idea where to even begin. I'm writing now because I have had an unusually bad spell of intermittent pain the last 2 or so weeks, although I have been pain free a couple of days in between. Does it sound like a 5 year strain to you, or might something else be going on ? Again, this started during a severe coughing spell. I don't know how to proceed. I'm a male, now 58 years old, and weigh 217 since losing 25 lbs. On WeightWatchers. Thank you for any help a you can provide.
Posted Sat, 15 Sep 2012 in Bones, Muscles and Joints
Answered by Dr. Praveen Tayal 7 hours later
Thanks for posting your query.
Your symptoms are suggestive of coccydynia caused by inflammation of the coccyx bone. It is not likely to be due to a sprain happened 5 years ago. The symptoms are generally worse when sitting for prolonged periods of time, or with direct pressure to the tailbone area. You need a thorough evaluation by an Orthopedician for coccydynia. Your Doctor will examine you and suggest further tests like, lateral X-ray of the coccyx to rule any fracture of coccyx. He/she may also order CT scan or MRI scan if it is clinically necessary.

Once confirmed, treatment is conservative which involves Analgesics for Coccydynia along with Physiotherapy. Surgery is considered in severe cases.

Follow these measures for relief from the symptoms:

1) Avoid sitting down for long periods of time. When seated, sit on hard surfaces and alternate sitting on each side of the buttocks. Also, lean forward and direct your weight away from the tailbone.

2) Take adequate rest and apply cold compresses, avoid re-injury to the affected area and take some antiinflammatory and pain medications like ibuprofen(motrin) or diclofenac. Some severe cases with persistent coccydynia are treated with local cortisone injection and surgical resection of the coccyx.

3) You can also use a "doughnut" cushion or pillow to sit on. This cushion has a hole in the middle of it to prevent the tailbone from contacting the flat surface.

4) Also eat a high fiber diet foods to soften stools and avoid constipation.

I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Dr. Praveen Tayal.
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