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Suggest Treatment For Low Back And Coccyx Pain

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Posted on Tue, 11 Nov 2014
Question: I had a Ct Scan done the other day because of ongoing low back and Coccyx Pain. My Ct Scan report says Posterior Disc Bulge at L5-S1 indents the Ventral Thecal Sac. Small Right foraminal Disc Extrusion which extends into the end aspect of the right L5-S1 neural foramen. Anterior angulation of the Coccyx which is likely developmental.
What does all this mean? If I had no pain in the area of my Coccyx and then I had a fall where i landed directly on my Coccyx, could that fall have caused the anterior angulation and if so could it cause severe pain when i sit to long. Can you see anything else in the images that could cause pain in my low back and Coccyx??
doctor
Answered by Dr. Indu Kumar (1 hour later)
Brief Answer:
Your symptoms suggest coccydynia.

Detailed Answer:
Hello XXXX

I have gone through your query in detail.

Your symptoms suggest coccydynia.Coccydynia is a type of lower back pain felt around the last bone at the base of the spine (known as the coccyx).
Anterior angulation of the Coccyx may be due to developmental reason or dislocation.
It is mostly managed conservatively.For pain in coccyx region,a cushion with a hole at the back under the coccyx is recommended.For prolonged cases,anti-inflammatory medications such as NSAIDS may be prescribed.Local nerve block injection is also helpful.You should avoid lifting heavy objects and concentrate on proper body posture.
Surgery may be required in refractory cases.

CT scan report suggests minor lumbar disc prolapse.It may be due to trauma or age related degenerative changes.Most likely lumbar findings are due to trauma.

1.At L5-S1 level,there is disc bulge in posterior direction which is indenting(touching)the thecal sac.There is small disc herniation in right side which is extending to lateral neural foramen.
3.Anterior angulation of the Coccyx may be due to developmental reason or dislocation.

Majority of the cases of disc prolapse are benefited by physiotherapy.Since your have minor findings,so physiotherapy should be tried first.
Surgery should be the last option.

Treatment can be planned after consultation with neurologist.

Get well soon.
Hope i have answered your query.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indu Kumar (43 minutes later)
Thank you very much for your response. So disc extrusion means it is herniated??

I am a Police Officer and i've been doing it for 17 years. I had two major car crashes early in my career that caused low back problems. I had a fight with a suspect about 7 years and blew out my lower back. The most recent accident was the fall from a shelving unit and i landed on my buttocks. My pain has lasted for over two years now and i have used up all my sick time and now they are putting me up for a disability Pension. If a police officer can't perform 100% of his job then he/she shall be retired. With the injuries i listed and for how long they have lasted would you say someone should be able to perform extremely physical activities??
If i wnated to give you a tip for answering my questions can i do that??
doctor
Answered by Dr. Indu Kumar (10 hours later)
Brief Answer:
Please find detail answer below.

Detailed Answer:
Hello XXXX

Yes,extrusion means herniation.
You don't have very major findings that demand retirement.You will definitely be able to deliver your job 100%.
You are rightly given steriod injections.You need proper evaluation by a orthopedician.Dislocation of lower coccygeal segments may be one of the possibility.You may need reduction under anesthesia after evaluation.

Don't be worried.You will be fine soon.This is a curable condition.
Thanks for considering compliments.It is not necessary.Thanks again.

Get well soon.
Hope i have answered your query.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Indu Kumar

Radiologist

Practicing since :2004

Answered : 6729 Questions

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Suggest Treatment For Low Back And Coccyx Pain

Brief Answer: Your symptoms suggest coccydynia. Detailed Answer: Hello XXXX I have gone through your query in detail. Your symptoms suggest coccydynia.Coccydynia is a type of lower back pain felt around the last bone at the base of the spine (known as the coccyx). Anterior angulation of the Coccyx may be due to developmental reason or dislocation. It is mostly managed conservatively.For pain in coccyx region,a cushion with a hole at the back under the coccyx is recommended.For prolonged cases,anti-inflammatory medications such as NSAIDS may be prescribed.Local nerve block injection is also helpful.You should avoid lifting heavy objects and concentrate on proper body posture. Surgery may be required in refractory cases. CT scan report suggests minor lumbar disc prolapse.It may be due to trauma or age related degenerative changes.Most likely lumbar findings are due to trauma. 1.At L5-S1 level,there is disc bulge in posterior direction which is indenting(touching)the thecal sac.There is small disc herniation in right side which is extending to lateral neural foramen. 3.Anterior angulation of the Coccyx may be due to developmental reason or dislocation. Majority of the cases of disc prolapse are benefited by physiotherapy.Since your have minor findings,so physiotherapy should be tried first. Surgery should be the last option. Treatment can be planned after consultation with neurologist. Get well soon. Hope i have answered your query. Further queries are most welcome. Take Care Dr.Indu XXXXXXX