Question
Gerald,
        Thanks in advance for answering my question. I am a 43 year old man, 6 foot, 160 pounds. I workout out with weights regularly and I never had spinal surgery. MY question is this. For the past year or so I have been experiencing sacral pain after a bowel movement. The pain seems to be coming from an inch or so above the coccyx, on the anterior side of the sacrum. The pain usually lasts a minimum of 20 minutes but sometimes up to an hour. Posterior rotating my hips exasperates the pain. What do you believe is the cause?

Answer
Thank you for your question. Unfortunately, it is impossible for me to speculate on specific causes of your symptoms or to offer a diagnosis via the Internet. In general, however, coccygeal pain, or coccydynia, is more common in females than males (5:1 by some estimates) and is most often associated with complications of birth and injury or trauma. In males, coccyx pain may also be due to more serious medical problems such as fractures, dislocations, or malignant cancers, as well as due to mechanical stress and irritation such as prolonged sitting, or injury causing anterior displacement of the coccyx. Sometimes, the cause of coccyx pain is completely unknown. The condition may be temporary and transient, it may linger and be intermittent, or it may be chronic and persistent. Once serious pathology has been ruled out, usually by x-ray and sometimes followed by MRI or CT scanning, possible treatments may include manual manipulation of the coccyx by an appropriately licensed health care provider such as a chiropractic physician (unless otherwise prohibited by individual state law), an osteopathic physician or a medical physician trained to perform this procedure. Oral anti-inflammatory medications or nerve pain medications may be prescribed by a medical or osteopathic physician. Anesthetic nerve blocks and/or steroid injections of the sacral-coccygeal joint or nerve block injections around the coccyx may also be performed by a medical or osteopathic physician. I would urge you to first seek the opinion of a licensed health care professional, starting first with either your primary care physician, an osteopathic physician, or a reputable chiropractic physician in your community.