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Notes from the Practice of Harold Goodman, D.O.

Coccidynia: Tailbone pain in a pregnant woman.  Thursday, March 03, 2011

She called to say that she had been in excruciating pain for some time following a fall on her back.

At the time we heard from her she could no longer sit due to the pain. Since she was also many months pregnant she feared for the pregnancy as well as complications with labor.

When the patient finally came in she was miserable. She stood until she could be examined and then when I probed in the effected area she let me know how uncomfortable she felt.

The problem was that her tailbone, coccyx, the tiny bone at the end of the sacrum, had been traumatized during the fall. This is a very common and horribly uncomfortable problem since this area is well endowed with sensory nerves. In addition, there is a collection of nerves, called a ganglion, that is in the coccyx which has an effect on much of the autonomic nervous system. The result of such a trauma is that the patient may suffer apparently unrelated symptoms and go from doctor to doctor without much relief.

Most physicians including osteopathic physicians who are unfamiliar with osteopathic manipulation and diagnosis as the mainstay of their practice ( ie. over 95% of all American DO's) are unaware of how to diagnose and truly treat this problem.

On exam I noted that the coccyx was being pulled sideways, toward the right. Its normal position is sticking straight down the midline. Many of the soft tissues ( muscles, connective tissues) were also being pulled ( strained) in dysfunctional ways which were bound to create havoc in the system.

I gave her an extended dose of the homeopathic remedy, Hypericum ( St. John's Wort), which is a specific for coccyx injuries. This helped a bit but the real treatment lay in getting rid of all the trauma to the area and getting things back to where they belonged in relation to the rest of the body.

At some point we began intra-rectal treatment.

The gloved finger of the physician is inserted into the rectum and against the coccyx. The diagnosis of tissue pull is then not only confirmed but, with the aid of external aid from another finger, the coccyx is released along with all the other parts of the system that have been compromised.

It took several visits for this to be accomplished in full.

Since the first time this work was done the patient has reported more and more relief. Today she said that she no longer has any problems sitting and feels about 3% of the pain that she formerly did.

I was a bit surprised over how much additional release of the entire area we got today during the treatment. This leads me to believe that she will have not only a lot more relief of the coccidynia but also for all the back pain that often accompanies pregnancy.

I believe that this and attendant work we are doing will make her pregnancy much easier as well as bring about a safer and shorter labor than she otherwise would have had.

We are both very happy with her progress.

This is yet another example of osteopathy in action.

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