Hatrack River Forum: Removal of the tailbone

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Posted by beverly (Member # 6246) on :

Does anyone know anything about the removal of the tailbone? How crucial is this bone to movement, sitting, posture, etc?

I broke my tailbone years ago and it has bothered me on and off since. I never knew for sure that it was broken. But it has been bothering me again--not just hurting, but it has started getting in the way. I have checked, and I can feel that it veers out to the side. So now I am certain that it was broken and healed wrong.

It isn't horrible or anything, mostly just annoying, but I am wondering if having it surgically removed might be a good idea--if not now, then later on down the road.

I really don't like the idea of it being broken and then re-set. As far as I know, it serves little to no functional purpose. But I thought I would ask here if anyone knows. Would I miss my tailbone if it were gone?

Posted by Ryuko (Member # 5125) on :

I'd think it would be necessary, or it's possible that your butt padding would be right up against your spine, which would probably be BAD. I think the only alternative would be breaking and re-setting it, sorry. But I'm no medical expert.

Posted by beverly (Member # 6246) on :

>.<

Having it broken and re-set sounds... unpleasant. [Frown]

Posted by Pythian (Member # 7080) on :

o.O, [Frown]

, sounds painful, what did your docter suggest(or did you ask him?)

Posted by Annie (Member # 295) on :

Too bad you don't have an actual tail. That would solve a lot of problems and look cooler.

Posted by quidscribis (Member # 5124) on :

Oooh! Tail!!!! Can I have one, too, please?

Posted by Tullaan (Member # 5515) on :

People occasionally will have it removed. Usually the bone that is removed is a tiny peice. I'm not aware of any major muscles that attach to it, so movement shouldn't be an issue.

I've even heard of it done in the office. However, if your tail bone has reset it may require more 'work' to remove it(if it needs to be done). More 'work' might require general sedation.

I'm not an expert at this kind of stuff though (better at the drug kind of thing).

Tull

Posted by Hobbes (Member # 433) on :

Just so you know Annie, you'd look sexy with a lot of different things on you, but a real, live tail is not one of them.

Hobbes [Smile]

Posted by mackillian (Member # 586) on :

There was an episode of the x-files about tails...

Posted by Annie (Member # 295) on :

Not even a cute little rooster tail? [Frown]

Posted by rivka (Member # 4859) on :

Hobbes, are you telling me you are anti-tail? [No No]

Posted by Boris (Member # 6935) on :

Heh, real pain in the butt ain't it. (Sorry)

Posted by Jonathan Howard (Member # 6934) on :

Put it this way, bev, it was what evolution gave you. I think that if you can remend it somehow, do it; otherwise, I can't tell you what consequences might be.

Jonny

Posted by aspectre (Member # 2222) on :

Coccydynia treatment and coccyx removal

Posted by Sara Sasse (Member # 6804) on :

quote:
I'm not aware of any major muscles that attach to it, so movement shouldn't be an issue.

Au contraire.

There are several ligments and muscles of the pelvic floor which attach to the coccyx (or "tailbone"). These include:

- ventral sacrococcygeal ligaments
(two sheet-like structures that form part of the hammock-like pelvic floor, constituents of the pelvic diaphragm which provide support for the rectum)

- coccygeus muscle; aka the levator ani and the piriformis
(supports the dorsal organs of the pelvic floor so that they don't extrude downward during forced bowel movements or sneezes)

- sacrotuberous and sacrospinous ligaments
(alignment of lower vertebrae and dorsal support for the gluteus maximus muscle)

- the tendon of the sphincter ani externus
- the anococcygeal raphe
(maintains continence)

I'm sure there is surgery available to help correct pelvic floor problems if one were to lose one's coccyx, but I'm betting that resetting it would be less involved. The problem is that the coccyx is both a site of attachment for many muscles and ligaments that get tugged while supporting the pelvic floor through day to day activities and can't really be splinted because of its position.

So, healing after a coccyx break is long and painful. [Frown]

I sympathize, beverly -- I bounced down 3 iced wooden stairs directly on my coccyx one Urbana winter and snapped it, and it was agonizing. So much pain I couldn't even cry out. Took years to get back to a normallish state.

Maybe your physician (GP or esp a gynecologist, I'd think) could give advice about whether physical therapy might be helpful.

[ December 17, 2004, 06:05 AM: Message edited by: Sara Sasse ]

Posted by Sara Sasse (Member # 6804) on :

From aspectre's link, looks like there is some controversy about removal of the coccyx, that patient selection is important, and most professionals who do this recommend a trial of steroid injection treatment first.

quote:
From a few surgeons (?probably) who have written in, mostly from Europe, as far as I can tell):

"As a consultant treating coccydynia regularly I have read your site with interest. Few doctors seem to recognise the altered mechanics of the sacro-coccygeal joint or coccyx joints when sitting compared with standing. Conservative treatment should be multi-disciplinary. I use a combination of oral NSAIDs, regular ice packs, pelvic ligament stretching exercises, manipulation of sacro-iliac joint and coccyx, back school training and a special wedge shaped cushion for sitting on. The treatment does not work for all, but the majority demonstrate improvement with the cushion alone. The course of the condition is usually chronic and recovery slow. Injection therapy should be reserved for those who have been through a conservative course of treatment lasting 3-6 months or for those in acute pain.

Another:

During my orthopaedic training, I was told never to excise the coccyx as it seldom cured the patient; most of them were female and neurotic anyway. I saw at least one patient who had had pieces excised on 2 separate occasions and still not cured, and was in fact worse. This tended to reinforce my teachers' point of view.

Then I did 1 or 2 operations myself (because patients begged me to do something) and the patients were some of the most grateful I have ever treated. I have now done around 14. Most but not all have been female. I must admit 1 or 2 of them still seem a bit flaky. But all got some help from the procedure. None would say they were made worse.

It seems careful selection and counselling are the keys to a good result. You must avoid surgery in a patient with a complex medical history. I do usually advise steroid injection as a first measure. This can be done in outpatients but is not very pleasant! Can also be done under anaesthesia which gives an opportunity for a good manipulation. Injection works best if the symptoms have not been present for too long ([less than]3 months). Less reliable if a long standing problem. The operation is NOT particularly difficult but experience does reduce the collateral damage to soft tissues and adjacent nerves. My patients seemed to recover in weeks rather than months.

And another:

Treatment. For me, the first treatment is an anti-inflammatory injection (steroid) in the affected joint, as demonstrated by the dynamic films. This can only be done under fluoroscopic control. The result occurs within one week and provides a two to four month relief in 60 to 70% of the patients and full recovery (at one year) in 30%. Despite there is a theoretical risk of local infection, I have performed more than 500 injections in 8 years without any problem. In 10% of the cases, there is a marked post-injection pain for a couple of days.

We have completed a study (not published yet) comparing three manual treatments (manipulation, massage of the pelvic muscles and stretching of these muscles) with a placebo. These treatments work in only 20% of the cases and are actually more efficacious than the placebo.

The last specific treatment is surgery. We have also a study (submitted for publication) on this topic. Our success rate is 93% of good and excellent results, provided only patients with luxation or frank hypermobility are operated on. In other cases, the results are not so good. This is a very demanding surgery. It may take three to ten months for recovery.

Posted by beverly (Member # 6246) on :

Wow, this really does sound like a pain in the butt. [Frown]

I am fortunate that my problem is only a minor irritation. It could be so much worse.

Interesting to know that there are important things connected to the tailbone. Certainly makes me think twice about removing it!

Thanks for the info, all. [Smile]

Posted by ketchupqueen (Member # 6877) on :

I've had pain there since I had the baby. I didn't know anything could be done about it.

Thanks for the thread. If I ever get health insurance again, I'll talk to a doctor about it (although I don't want it removed). [Frown]