Pain Concern
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Do you feel like you've been kicked in the coccyx?!

For the last year I have had nauseating pain around my coccyx when I get up from sitting in any chair. I had physio and was diagnosed with degenerative tendinopathy, as I also get some pain in my right hip but the pilates exercises ended up giving me nerve pain in my right leg to the point where I could barely walk, and made no difference to the coccyx pain. I have had an MRI which shows wear and tear of my facet joints and recommends pilates!

The only time I don't have pain is when I'm laid down flat. I ache at night and it hurts to lie on my right side.

I had tramadol and was very ill with it and it didn't touch the pain, so am just taking paracetamol, which also does nothing for the pain. I have discussed the possibility of it being menopausal tendonitis (I am 48) and will be trying HRT in the new year. Does anyone have any experience of my particular pain?

8 Replies

Hi, I don't have the same medical cause as you but i do have pain where the only thing that doesn't irritate it is lying down flat on my back. With me it helps having my legs slightly elevated to relax the abdominal and back muscles. I don't know if this will help you but I've been working on a way of exercising that doesn't irritate the pain. Pretty much everything I do irritates it including breathing so it's a compromise but...I've developed a system of micro exercises that have really helped. let me know if you are interested and I'll try and explain it. It's taken me years to find a system that works so I think it's worth certainly won't make it any worse.


Hi, that's very kind of you, thank you. I did find it comfortable when I had a 'leg pillow' during the MRI. I would love to hear about your exercises. I'm sorry you've been in pain for so long.


ok then, this will be interesting as I've never had to think about communicating it before.

So, to start with I find it important to start from a neutral physical posture, which for me is lying flat on my back with my legs slightly's important to be physically aware of how this posture feels, this involves moving various parts of your body thus, assuming the neutral posture to start with...start at your feet and move you toes up slightly, ideally this is a very gentle tiny movement...just enough for you to be physically aware of the movement...(this isn't about strength or sweating and all that nonsense, it's all about the sensation). Repeat this movement two or three times at the end of each section scan your posture for any tension and regain your neutral posture.

Then move on to the next which is opening your toes width ways, again it's all about feeling the sensation of movement in a very gentle and sensitive way, do this 2 or 3 times and regain your neutral posture, then move you toes downwards. Once these three movements are sensed do the same thing with the main part of your foot.

Very gently move your feet up and down. try and limit this movement to your feet rather than involving you ankles in this. this movement comes from the middle of your foot, for instance if you were standing up and gripping your carpet with your toes your foot moves in a very particular way, try and mirror this very gently and slow movements, do this 2 or 3 times, returning to the neutral posture at the end of each section from now on.

Next is the ankle, the ankle can move 360 degrees so for this i use the poles north, south, east and west which will give the full range so gently sense your feet moving north (up) a few times, East (right), South (down) and West (left). work your way up your body thinking about the range of movement that each part is designed to make and see what is comfortable for you to do and what isn't. Do what you can.

If you find anything hurting stop doing it.

Once you get used to the sensation of the relaxed posture throughout your body you will become more aware of where you are carrying unwanted muscular tension, in the areas where there is tension think about the muscles melting away.

For me, because my pain is abdominal and in the right side of my body I find this technique really useful, it's amazing how much tension we carry around without realizing it. You can also try timing your breathe so you relax on the out breathe for an even deeper relaxing effect.

With all the exercise programmes I've come across it's always about straining or stretching or sweating etc, none of which is any good for me, by just shifting the emphasis over to the sensation of a slow and gentle muscle twitch it's made a huge difference. I base my routines around the sensation of twitching each muscle or group in a way that uses the absolute minimum of movement in a slow and controlled manner. The slower the better and never strain. I know it sounds obvious but don't do what you can't do, and don't listen to anyone else about what you 'should' be able to do, listen to your body in it's relaxed neutral state. For me, the most important thing is being aware of the muscular tension in my body and releasing it. The more you do this exercise the more you will be able to do, i think it develops a real efficiency of movement as well as a great bodily awareness for where you are feeling the stress.

That's it really, i hope it helps. I'd definitely be interested to see what you make of it.

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Hi again, thank you so much for your advice. I'm now much better able to manage my pain by using your technique. The things you say that particularly resonate with me are about carrying unwanted muscular tension and listening to my body in its relaxed neutral state. I can be in a state of feeling that I have widespread pain, but if I take time out to mentally wander around my body, I can usually pin-point an area of tension, which when relaxed, will significantly reduce, or remove the pain.

I have also found that my mental state has a great effect on my muscles. If I get agitated, my leg immediately starts to hurt, which can lead to a negative spiral. I certainly don't get any benefit from straining or stretching, as you mentioned. While the medical profession is still guessing what is wrong with me, I will continue using your method and ignore their advice if I don't trust it.

Many thanks



sounds like sacroiliitis. Thats the hallmark for ankylosing spondylitis or spondyloarthritis generally (inflammatory spinal arthritis), and along with it a lot of folk with spondyloarthritis also have significant and sometimes widespread enthesitis - which is inflammatory at the point where tendons join onto bone. Not surprised tramadol doesn't do anything for it. You could try NSAIDs as they are antiinflammatory meds. if they work better than anything else, especially if you can get them prescribed at full doses (more than the over the counter doses), then thats a pointer that its inflammatory back pain. Check out this website to see if you think it might be inflammatory pain

The bad news is that it can be incredibly hard to get a diagnosis - especially if you are female, and over 40 (it occurs a bit more in men than women, and usually shows up before the age of 30), and there really aren't any conclusive tests until it gets to the point where permanent damage is showing up on xray or MRI.


forgot to say that "degenerative tendinopathy" could be a misdiagnosis of enthesitis


I have it and can't really sit, just told it was arthritis.

there are cushions with that bit cut out to relieve pressure.

this might make you chuckle - I was told this by a physio :-

a man says to his physio

"my hip hurts when I walk, do you think putting a finger in my bottom might ease it?"

"maybe" says the physio " it'll be ok in here, but they won't like it in tesco's"


Facet Joint injections would help you tremendously. It's used as a tool

to diagnose back pain.


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