Pelvic Pain

FAQ’s on Pelvic Pain

The pelvis seats many of our vital visceral organs, such as the bladder, intestines, rectum, as well as the reproductive organs. Pain from this area can come from a wide variety of causes, and can present with a wide spectrum of severity. The pain can be sudden and acute, or can be chronic (if it lasts for more than 6 months).

How is pelvic pain diagnosed?

Pelvic Pain Doctors in San DiegoThe diagnosis of pelvic pain will depend on the underlying cause. Your physician will conduct 

a complete medical history and physical examination to elicit information that will help him differentiate the condition causing the pain. You will be asked questions to characterize the pain, including questions about its severity, its character, aggravating circumstances, or other associated symptoms. Several clinical examinations will be conducted, focusing on your abdominal and pelvic area.

If the clinical consult does not provide definite diagnosis, then additional imaging studies may be requested. These include X-rays, Computerized Tomography (CT) scans, Magnetic Resonance Imaging (MRI) scans, and ultrasound scans. Other techniques have also been shown to help identify the cause of the pelvic pain, like hysteroscopy, endoscopy, among others.

What conditions can cause pelvic pain?

Any disease or condition that negatively affects the organs in the pelvis can cause pelvic pain. Pelvic pain treatment San DiegoNumerous conditions that present as pelvic pain include:

  • Cystitis/urinary tract infection – this often presents as hypogastric (below the belly button) pain, accompanied by dysuria (painful urination), and tenderness
  • Proctitis – infection or inflammation of the anus/rectum
  • Abnormalities of the reproductive organs and the genital tract
  • Appendicitis – severe pain that is normally located in the right lower area of the abdominal area, and is associated with tenderness and feeding intolerance. If this is suspected, immediate referral to a surgeon is recommended.
  • Nephrolithiasis (Kidney stones) – can present as difficulty urinating, as well as severe pain in the sides/pelvic area.

Women are also prone to conditions that cause pelvic pain. These include diseases such as:

  • Dysmenorrhea – this is pain associated with the menstrual period. The severity varies widely, from mild to debilitating.
  • Menstrual cramps
  • Endometriosis
  • Ectopic pregnancy
  • Pelvic inflammatory disease

What are the signs to watch out for?

It is suggested that you seek a physician if you note the following symptoms along with your pelvic pain:

  • Blood seen in the stool/vomit
  • Black, tarry stools
  • Decreasing diameter of stools
  • Pain during intercourse or urination
  • Abnormal vaginal bleeding or discharge
  • Difficult urination

How is pelvic pain treated?

Pelvic Pain Clinics San DiegoThe exact treatment of pelvic pain will depend on the underlying cause. The therapy ranges from conservative, nonsurgical management, to surgical interventions.

Conservative, non-surgical management is usually done through oral anti-inflammatory medications, or analgesics such as opioid medications. Complementary alternative medicine modalities such as acupuncture and chiropractic sessions may be of benefit, although larger studies are still needed to evaluate their effectiveness.

Minimally invasive surgical techniques, such as nerve blocks, have found use in the management of chronic pelvic pain. Temporary blocks are achieved with local anesthetic and corticosteroid injections, although longer-term relief may be achieved with radiofrequency ablation and chemical neurolysis.

Open surgery is normally an option reserved for the more severe cases, or for cases that are not responsive to non-surgical management. Risks of surgery include infection, damage to muscles and other tissues, among others.

Outcomes depend on the underlying cause of pelvic pain as well as the procedure used for treatment.


Davis SN, Binik YM, Amsel R, Carrier S. A subtype based analysis of urological chronic pelvic pain syndrome in men. J Urol. 2013 Jul;190(1):118-23. doi: 10.1016/j.juro.2013.01.020.

Demir F, Ozcimen EE, Oral HB. The role of gynecological, urological, and psychiatric factors in chronicpelvic pain. Arch Gynecol Obstet. 2012 Nov;286(5):1215-20. doi: 10.1007/s00404-012-2443-y.

Gyang A, Hartman M, Lamvu G. Musculoskeletal causes of chronic pelvic pain: what a gynecologist should know. Obstet Gynecol. 2013 Mar;121(3):645-50. doi: 10.1097/AOG.0b013e318283ffea.

Failed Back Surgery Syndrome

FAQ’s on Failed Back Surgery Syndrome

What is failed back surgery syndrome?

Failed Back Surgery San Diego

Failed back surgery Syndrome (FBSS) is not, contrary to its name, a syndrome: it is a
catchall term describing the condition of continued pain after back surgery. The presentation is usually chronic, and patients who suffer from the condition often report persistent pain of the back and/or the legs, following surgery. There may be symptoms of neuropathy (problems with the nervous system) such as tingling, numbness, or shooting pain. This condition has also been described as the “post-laminectomy syndrome”, since it has been noted to occur after this procedure.

What are the causes of failed back surgery syndrome?

Failed Back Surgery Pain Clinics San Diego

There are a wide variety of causes for failed back surgery syndrome, and the physician will need to do a complete medical history, and physical examination to determine the underlying pathology. Additional imaging studies may also be requested, such as X-rays, Computerized Tomography (CT) scans, and Magnetic Resonance Imaging (MRI) scans.

Surgical operations of the spine to alleviate back pain can either (a) stabilize a painful joint or (b) decompress a nerve root that has been “pinched”. However, not all surgical operations are successful. Reasons for the failure of surgery can include:

  • Improper patient selection – the most commonly identified reason for FBSS is because the lesion/area that was operated on is revealed not to be the (anatomic) cause of the patient’s pain. For example, a patient that is treated for pain that is suspected to be secondary to a degenerative spinal condition may in fact be suffering from other conditions that mimic back pathologies.
  • Recurrent disc herniation – This presents as initial relief of pain symptoms, which is only temporary. Sudden acute pain differentiates this condition from pain from epidural fibrosis (scar tissue), wherein the symptoms develop over a longer period.
  • Surgical errors – technical errors during surgery should also be considered as a possible source of the pain. There may be fragments of bone or disc remaining, or there may have been another disc causing the pain. Some studies have shown that physicians may overlook conditions such as sacroiliac joint disease.
  • Spinal stenosis – this refers to the narrowing of the canal for the nerve roots. This has been observed as a late complication of laminectomy for disc herniation.

It should be noted that cigarette smoking has been shown in recent studies to contribute to the failure of spinal surgery. It is theorized that substances from cigarettes interfere with bone healing and growth, and some surgeons consider smoking an absolute contraindication to surgery.

How is failed back surgery syndrome treated?

Failed Back Surgery Treatment San DiegoThe exact treatment of failed back pain syndrome will depend on the identified underlying pathology. Treatment options include:

  • Conservative management – this includes non-surgical interventions, such as medications, psychological counseling, physical therapy, complementary alternative medicine, such as acupuncture, among others.
  • Spinal cord stimulation – this therapy has been proven to be effective, albeit not cost effective for some patient.
  • Nerve blocks – treatment with injections of corticosteroids (powerful anti-inflammatory drugs) have been shown to be effective in relieving symptoms of pain. Other novel treatments have been explored in recent years, such as adjuvant injection of hyaluronidase.
  • Ozone therapy – the application of ozone therapy applied by spinal endoscopy has been shown in pilot studies to provide up to 60% reduction in pain, although the effectiveness is limited to certain conditions.
  • Repeat surgery – if the pain is due to errors in surgery, a follow-up/repeat operation may be warranted.

The outcomes of treatment for FBSS are varied. They depend on the specific circumstances of the case. The best intervention for FBSS is still prevention.


Chan CW, Peng P. Failed back surgery syndrome. Pain Med. 2011 Apr;12(4):577-606. doi: 10.1111/j.1526-4637.2011.01089.x.

Hussain A, Erdek M. Interventional pain management for failed back surgery syndrome. Pain Pract. 2014 Jan;14(1):64-78. doi: 10.1111/papr.12035.

de Nêuton F, Magalhães O, Soares SC, Torres JM, Ungaretti A, Cacciacarro MF, Teixeira MJ, Fonoff ET. Effects of ozone applied by spinal endoscopy in patients with chronic pain related to failed back surgery syndrome: a pilot study. Neuropsychiatr Dis Treat. 2013;9:1759-66. doi: 10.2147/NDT.S48663.

Reverberi C, Dario A, Barolat G. Spinal cord stimulation (SCS) in conjunction with peripheral nerve field stimulation (PNfS) for the treatment of complex pain in failed back surgery syndrome (FBSS). Neuromodulation. 2013 Jan-Feb;16(1):78-82; discussion 83. doi: 10.1111/j.1525-1403.2012.00497.x. 

How To Deal With Neck Pain

How To Deal With Neck Pain

Neck pain or having a stiff neck is actually quite a common problem and usually there is no need to worry. Neck pain and stiffness will generally get better within a couple of days and it isn’t a sign that there is something serious going on.

Pain clinic in San Diego

Bracing for vertebral compression fracture.

A painful neck can occur if you sleep in an awkward position, if you are sitting in a draft, or you sit at a computer for long periods of time. Anxiety and/or stress can also lead to tension and neck pain.

Treatment for Neck Pain at Home

Whatever cause is behind your neck pain the advice remains the same. Keep on with your normal day-to-day activities and stay active. Take painkillers if you need to for relief of your symptoms. In addition, you can:

> Avoid wearing a neck collar unless prescribed by a doctor

> Check your posture – bad posture can lead to a neck ache

> Don’t drive until the pain and stiffness is gone as the inability to turn your neck can be a hazard

> Place a hot water bottle or heat pack to your neck, which can help to reduce the pain and muscle spasms.

> Sleep on a firm, low – don’t use two pillows because can force your neck into an unnatural position

> Take ibuprofen or other NSAIDs as directed to control pain

> Try to do simple neck exercises

> Use an ibuprofen gel or other type of pain relief gel that is applied topically to the neck and rubbed in. Follow the directions.San Diego pain center

When You Should See a Doctor

You should see a doctor if your neck pain or stiffness doesn’t get better in a couple of days and you are concerned or if you are unable to control your pain using OTC treatments. You should also see your doctor immediately if you have been in any type of accident such as skiing accident, bike accident, car accident, etc.

Your doctor will examine your neck; ask you a number of questions to rule out any underlying condition that could be serious. Your doctor can also prescribe stronger painkillers to help relieve your pain and he/she may recommend you see a physiotherapist.

Bone or Nerve Problems in the Neck

Occasionally neck pain can be the result of wear and tear of the joints or bones in the neck leading to cervical spondylosis, which is a form of arthritis. This occurs naturally with age and there isn’t always symptoms although there can be stiffness in the neck. If the nerves in the area become squashed, it can lead to pins and needles, pain radiating down the arm or numbness in the hand, arm, or leg. This is called cervical radiculopathy and it is often because you have held your neck in an awkward position, twisted, or used power tools that vibrate.

A Locked or Twisted Neck

Sometimes a person will wake up only to find that their neck is twisted to one side and stuck that way. This is called acute torticollis and it happens if the neck muscles are injured. It’s often the result of long exposure to a cold draft or if you neck is in an unusual position for a long period of time. This can take up to a week but usually will bring relief within 48 hours.Pain Clinic San Diego

Superior Hypogastric Plexus Block

FAQ\’s on Superior Hypogastric Plexus Block 

Why does a patient choose to do a Superior hypogastric plexus block?

Superior Hydrogastric Plexus Block  San DiegoSuperior hypogastric plexus block is a procedure performed to alleviate pain (resulting from malignant or non-malignant causes) in the pelvic region. This treatment can be performed to patients for whom oral medication is ineffective or has unbearable side effects. The Superior hypogastric plexus is a region in the lower back where there are numerous nerves linking to the organs in the pelvic region and administering block in this region would provide relief to pain originating from any of the linked organs or pain from cancerous tissues.

How is the Superior hypogastric plexus block procedure performed?

This procedure is minimally invasive and can be performed in one of three ways – Superior Hydrogastric Plexus Block posterior, anterior or transdiscal approach. Posterior approach is the most commonly used method while the remaining two are used for patients who have certain complications such as unease or difficult posture. In the posterior approach, the patient will be asked to lie down on his abdomen and a pillow will be placed under the patient\’s pelvis to aid in the treatment. Then, the patient\’s skin will be sterilized and anaesthetized carefully, after which two six inch needles will be inserted at two points in the skin. In order to make sure that the needles are positioned properly, the doctor will use fluoroscopic guidance (a radiation free imaging method).

Once the needles are placed, their position will be confirmed by using contrast dye and then blocking will carried out by the doctor. The entire procedure of a Superior hypogastric plexus block will be completed within 15 minutes.

How long do the Superior hypogastric plexus block injections last?

The duration for which the drugs last depends upon individual patients. It varies greatly from few weeks to even years. Mostly, the relief is temporary for the patients and if the first procedure was successful, repeated procedures at definite intervals can be carried out, thereby reducing the oral drug consumption for patients by seventy percent.

What are the risks or side effects are there with a Superior hypogastric plexus block?

The risks associated with this procedure are very minimal. In fact, in a study conducted among 200 patients, who were administered this block, none reported any problems in their neurological function. However there can be certain risks, even though they have not manifested much in the treated patients. Wrongful placement of needle harms nearby tissues and causes nerve damage, paralysis, etc. Direct injection into the blood vessels can cause drug allergy and seizure. Also there are chances of infection since needle penetration is involved at the injection site.

Superior Hydrogastric Plexus Block What conditions/injuries are treatable with a Superior hypogastric plexus block?

This procedure is used for treating pain arising from the pelvic areas such as urethra, bladder, vagina, vulva, uterus, perineum, descending colon, rectum, prostate and testes. It is especially effective for those who suffer from pelvic cancer (cervical, prostate, testicular), radiation injury or endometriosis. Also, it can be administered in a combined manner with other blocks such as ganglion impar block.

How successful are Superior hypogastric plexus blocks for the relief of pain?

There is no exact time period for which all the patients will be relieved from their pelvic pain. The results differ for each individual, some may experience relief for weeks while others may experience it for years. In addition, the degree of pain also varies, from zero pain to tolerable levels. The important thing here is that blocking the superior hypogastric plexus is certainly a beneficial and effective treatment on average for patients with symptomatic pelvic pain.

Facet Joint Syndrome

FAQ\’s on Facet Joint Syndrome

What is Facet Joint Syndrome?

When the facet joints of the spine have been damaged as a result of arthritic inflammationFacet Syndrome San Diego and are causing pain, a patient might be experiencing facet joint syndrome. This syndrome is the collection of symptoms directly caused by damage to these joints, which are small protrusions of bone off the spine. The facet joints house the spinal nerve roots, protecting and directing them from the spine into the surrounding tissue of the arms, legs, and abdomen.

Facet joints are also a large factor in the movement range of the spine, as they allow for the flexibility between the vertebrae. They are located on each level of the spine and composed of bone and cartilage, making them susceptible to the same arthritic degradation that other joints may experience from activity.

What causes Facet Joint Syndrome?

Facet Syndrome Treatment San DiegoThe common reason behind facet joint syndrome is arthritic inflammation in or around a facet joint. As arthritic damage can occur from use of the joints, nearly every person will experience some degree of arthritic damage during their life. When this damage is severe enough to cause inflammation however, it can be a very painful condition for the patient.

One of the common results of arthritic inflammation in the facet joints is the formation of bone spurs, which can damage surrounding tissue and may also compress one or more of the spinal nerves associated with the facet joint. Swelling due to inflammation can cause the same reactions in a patient, creating pain within the joint and potentially lowering the strength of the limbs if one or more nerves have been compressed.

It is also possible for a patient to have facet joint syndrome due to direct spinal injury. There are a number of factors that may increase the chance of developing this syndrome, including over-activity of the area due to occupation or hobbies, disease and conditions such as gout or osteoporosis, or a family history of complications in the facet joints.

The symptoms of Facet Joint Syndrome

Facet Syndrome San DiegoThe symptoms a patient will experience change based on which joint of the spine is affected, and on the severity of the condition itself. Common symptoms include pain localized to the area of the damaged joint, feelings of tenderness on the body over the joint, and a loss of mobility of the spine in the affected area. Symptoms may worsen if the condition is left untreated, and depending on the cause, may spread to include multiple facet joints given enough time.

Location specific symptoms include headaches and a feeling of numbness in the arms if a cervical joint is affected, pain felt in the abdomen and a partial loss of bladder control or intestinal complications if an abdominal facet is affected, or pain that shoots down the buttocks and legs that may worsen when sitting if the joint affected is in the lumbar spine.

How is Facet Joint Syndrome diagnosed?

Achieving an accurate diagnosis is one of the most important factors in the treatment ofFacet Injection San Diego facet joint syndrome, and can be difficult due to the complexity of the spine. A thorough examination of the patient will be conducted, with specific diagnostic imaging techniques sued on the spine to investigate the potentially damaged joints. X-rays will be used to examine the bone of the joints to check for damage, with either an MRI or a CT scan used to examine the surrounding tissue.

Patients may also be given a diagnostic nerve block in cases where the one or more nerves have potentially been compressed. If pain relief is achieved through the block, it may be determined that a nerve is compressed and requires treatment.

Treatment options for Facet Joint Syndrome

The first step in the treatment of facet joint syndrome is to alleviate the symptoms with medication while a diagnosis is made. Patients who do not see improvement over time may be advised to undergo surgical correction of the joints to obtain relief. Patients who have confirmation of a compressed nerve may receive a therapeutic nerve block to provide relief.

Arthritis of the Knee, Hip, or Shoulder

FAQ\’s on Arthritis of the Knee, Hip, or Shoulder

What is Arthritis of the Knee, Hip, or Shoulder?

Arthritis San DiegoThe joints of the body are surrounded by a layer of cartilage that allows the bones to move against one another freely without touching one another. As a person ages, this cartilage can be gradually worn down until the bones are touching. When this occurs, damage can be sustained from the bones rubbing together, resulting in pain for the patient and inflammation of the area.

Arthritic inflammation occurs most often in the knees, hips, or shoulders of a patient. This is largely due to the amount of activity these areas see on a daily basis. While there is no direct cure for the presence of arthritis, our clinic is more than apt at providing relief for the painful symptoms this condition can cause.

What causes Arthritis in these joints?

Arthritic inflammation in the knee, hip, or shoulder results from the general degradation ofHip Arthritis San Diego the cartilage lining the joints. This can occur normally as a person ages, as cartilage is lost gradually over time during routine activity of the joint. This gradual loss is known as Osteoarthritis, and is the most common form of arthritic inflammation a patient can experience. One factor that can contribute to the formation of Osteoarthritic is obesity, as the excess weight placed onto the joints can accelerate the degradation of cartilage.

The second most common arthritic condition a patient can experience is Rheumatoid arthritis, which occurs due to an autoimmune malfunction. With this, the immune system of a patient will attack portions of the joints and produce the pain, swelling, and stiffness in these joints. Rheumatoid arthritis that is left untreated can potentially reduce the function of the affected joint to a state of complete disability.

The symptoms of Arthritic Inflammation in the Knee, Hip, or Shoulder

Arthritis Treatment San DiegoThe symptoms of arthritis are very similar across all three joint areas, and will be similar regardless of the root cause. The first symptom many experience will be pain and a stiffness of the afflicted joint. Following this is a swelling of the area, and a discoloration of the skin (commonly occurring as redness) with a feeling of warmth to the flesh when touched.

A large amount of swelling in the joint may potentially immobilize it, preventing function of the joint and causing a large amount of pain anytime the joint is moved slightly. It is possible for symptoms to fade and return in the early stages of arthritis, and is crucial to begin treatment for this condition as early as possible to prevent a worsening of the damage and to provide pain relief.

How is Arthritis diagnosed in these joints?

Arthritis San DiegoDiagnosis for arthritis in the knee, hip, or shoulder will come from a combination of diagnostic tools. A physical examination will be conducted of the patient to test for areas of tenderness and to examine the functionality of the affected joint. Further testing may be performed based on the symptoms present; as physicians will opt to use diagnostic imaging techniques in instances where physical joint damage may be significant.

Treatment options for Arthritis

Regardless of which joint is inflamed, there are a number of options available for obtaining pain relief and restoring function. While there is no direct cure for the condition, symptomatic management is rather easy to achieve through the use of medication and injections. Pain medication and anti-inflammatory medications are given first to help combat the symptoms. Severe cases may require surgical correction to smooth out the surfaces of bones in the joint to reduce wear and tear.

One key thing patients can do to help provide relief is to cease whatever activity was stressing the joint to reduce the wear and tear placed on it.

Complex Regional Pain Syndrome

FAQ\’s on Complex Regional Pain Syndrome (CRPS)

Complex Regional Pain Syndrome (CRPS) San DiegoCRPS, which simply means Complex Regional pain Syndrome, was formerly known as the reflex sympathetic dystrophy (RSD) is a progressive disease, which attacks the Autonomic nervous system specifically the sympathetic Nervous system. It is a persistent pain which high levels of nerve impulses are sent to the affected site.

The condition often affects one limb (arms, legs) often after a damage or strain to that limb. CPRS develops after damage or the malfunctioning of the peripheral and central nervous system.

Who can Get CRPS?

Anyone can get CRPS. It affects both men and women regardless of their age although research has shown that it is common on women. The CRPS also commonly affects individuals in the age bracket of about 40 years, rare in the elderly and infants between the ages5-10years.

What are symptoms of CRPS?

Complex Regional Pain Syndrome (CRPS)The most common symptoms are prolonged pain that is constant and it is severe or extremely disturbing in some people. The pain feels like a burning, or commonly as pins and needles piercing one’s flesh. The pain also feels as if one is squeezing the affected limb. The pain might spread to affect the whole arm or leg, even though the injury might have been only at the finger. The sensitivity is heightened close to the affected area that even a light tough or slight contact can cause enormous pain.

Patients suffering from CRPS experience constant changes in the temperature, swelling of the affected limb, and change of the patient’s skin color. The skin of the affected limb may change color becoming blotchy, blue, pale, or red. The affected arm also might feel warmer or cooler in comparison to the affected limb. The temperature changes are because of the abnormal microcirculations, which may have resulted after the nerves controlling blood flow, and temperature are damaged.

Other symptoms may include:

– Changes in skin texture or the skin may appear shiny on the affected area

– Abnormal sweating patterns on the affected area, changes in nails and growth patterns and stiffness in the joints that are affected.

– Decrease in the ability to move of the affected body parts due to problems in coordinating muscle movement.

– Abnormal movements of the affected limbs, such as tremors or jerking of the affected limb is often experienced.

How is CPRS diagnosed and treated?

At present, there is no single diagnostic test to confirm that one is suffering from theComplex Regional Pain Syndrome (CRPS) San Diego disease. The diagnosis is specifically based on the history of the affected person’s medical records having the symptoms and signs that matches those of CPRS. Magnetic resonance imaging can be used to identify CPRS characteristic changes in the bone metabolism. The disease is associated with excessive bone resorption, which is a process that leads to breaking of certain bone cells releasing calcium to blood.

The outlined therapies can be used to treat the condition

Complex Regional Pain Syndrome (CRPS) San DiegoRehabilitation therapy: This is a program to keep the limb or the body part that is experiencing the pain moving, to improve blood flow, and reduce circulatory symptoms. The exercise also helps to improve the flexibility and strength of the affected area.

Psychotherapy: often people with CPRS develop depression, posttraumatic stress disorder that increases their perception of pain thus making rehabilitation efforts a bit difficult. Psychotherapy helps in treating these secondary conditions helping the patient to recover from the disease more quickly.

Medications: This includes non-steroidal anti-inflammatory drugs to cure moderate pain, botulinum toxic injections, opioids including the morphine and oxycontin. Nasal calcitonin is used for deep bone pain, corticosteroids that treat edema and swelling, and anesthetic creams are used.


FAQ\’s on Coccydynia

The Coccyx is the scientific name given to the small triangular bone at the base of the spinal cord in humans and other primates. It is otherwise referred to as the “tail bone.” Coccydynia refers to pain at the tail bone and is common on average of one in a 100 patients suffering from low back pain. The coccyx is positioned as the last bone of the spine; consisting of three smaller bones, or vertebrae. The main function of the coccyx is to bear weight while sitting. With the surge in the use of computers, coccydynia is becoming more common.

So if you have coccydynia, you are not alone. The good news is that, this medical condition is treatable. It is recommended that you seek medical advice on the various courses of treatment options available

Why do I experience pain at the base of my spine whenever I sit down? 

There are many causes of such pain and it is advised that you see a qualified medical practitioner to diagnose the root cause of the pain so as to know the right medication or therapy that would best help alleviate pain symptoms. Chances are that you may be suffering from coccydynia, which is a persistent pain located at the tail end of the vertebral column.

What then are the usual causes of coccydynia? 

There is not one definite cause; usually it is a combination of factors with the most common cause being age related “wear and tear.” With coccydynia usually there is a direct impact on the tail bone either, as a result of an accident or during childbirth, which resulted in the condition or had contributing factors in the development.

Shifting of coccyx bone: the coccyx may shift over time from its normal anatomical position. Posture when sitting for activities involving repetitive motion in a pivoting position, such as cycling or rowing, or repetitive pressure on the lower vertebrae.

Trauma: injury to the coccyx resulting from a road or traffic accident, or more commonly a fall.

Childbirth: women are more susceptible to coccydynia as the muscles, ligaments, and tendons that are attached to the coccyx are displaced in the body makes the passage for the baby. Naturally women have a broader coccyx in a more pronounced position. Due to these contributing factors women are five times more susceptible to develop coccydynia than men.

What are the symptoms of coccydynia? 

That is the first and most common symptom of coccydynia is pain, and in some cases extreme pain. Classically, this pain is more pronounced when sitting a hard chair or surface. Sitting on a hard surface places pressure on the tailbone, and further stress with leaning backwards in a chair.

Other symptoms may include:

  • Pain in your tail bone area whenever you sit, stand, walk or lie down.
  • Pain during the night hours when body muscles start relaxing on the coccyx area
  • Pain during a bowel movement
  • Increased pain during and after engaging in a physical activity
  • Pain after a prolonged sitting session.

How is it diagnosed?

One telltale relation in determining a diagnosis of this condition is to take note if the pain symptoms are relieved when the person stands and walks. This would indicate coccydynia.

One method is by administering anesthetics to the area. If an immediate relief is derived, then it is likely to be coccydynia. Further diagnosis is done by X-ray and scans.

How is coccydynia treated?

This depends on the severity. Pain-relieving treatments such as chiropractic care, acupuncture massage therapy, and pain medications are often employed in the treatment of coccydynia first. Severe cases may need surgical correction or a multidisciplinary pain management treatment course.

Dealing With Back Pain

Dealing With Back Pain

The spine has 33 bones along with tissue that extends from your skull through your pelvis. The bones protect your spinal cord, which is a cylinder of nerve tissue. Between each of your vertebrae is a cartilage band, which are shock absorbers.Personal Injury Doctors San Diego

What Causes Back Pain

Back pain isn’t as simple as it might seem. In fact, it can be very complex and the cause can be hard to pinpoint. There are a number of different types of back injuries that lead to back pain. When your physician is trying to determine the cause of your back pain he/she will do a full examine, talk to you about your symptoms, when they started, what you think you may have done (if anything), and your physician will also use tools like x-rays, MRI scans and CT scans to try to determine what is going on with your back.

Treating Back Pain at Home

Knee pain doctor San DiegoNot all back pain will require medical intervention. Let’s look at some things you can do at home to help relieve your back pain.

1.    Ice – The use of ice within the first 48 hours can help reduce inflammation and reduce pain. While the warmth of heat feels good it will actually increase inflammation.

2.    Don’t stop moving – When we have a backache we tend to stop doing the things we normally do. By staying active, you can reduce the pain you feel especially with muscle pain. Some forms of exercise are more beneficial than others such as walking and swimming.

3.    Remain strong – You can help to avoid future back pain by building up your core strength. A stronger core can help tremendously.

4.    Stretch – Stretching can be an excellent tool in helping to keep your muscles stretched and pliable. 20 minutes of stretching daily can be very beneficial according to the experts.

5.    Practice good posture – Many backaches are the result of poor posture especially sitting at a desk all day long, so focus on your posture and make sure you are sitting and standing tall.

6.    Wear low heels – Heals can cause unstable posture and increase the pressure to your lower spine. So trade your heels for a comfortable pair of heels that are less than one inch.

7.    Kick your smoking habit – Many are not aware that smoking actually increases your risk of osteoporosis of the spine and it can actually lead to compression fractures. In fact, one study found that smokers are 33 percent more likely to have lower back pain than those who don’t smoke.

Pain Medications

NSAIDs are anti-inflammatory drugs that can be purchased over the counter. They can help to reduce inflammation and reduce your back pain. Advil, Ibuprofen, Aleve, and Motrin are common forms. Acetaminophen products like Tylenol are available over the counter and can reduce pain. In addition, your physician can prescribe stronger medications if your pain is not controlled with the OTC. Opioid drugs can be used to control pain in some cases.

San Diego Pain ManagementYour doctor might also recommend that you try other therapies like physical therapy, massage therapy, acupressure, acupuncture, aquatic therapy and TENS. Don’t suffer with back pain any longer.

How A Pain Clinic Can Help With Back Injury

How A Pain Clinic Can Help With Back Injury


There are two types of back injuries cervical radiculopathy and spondylolisthesis. Both have their own treatment protocol.Pain Clinic San Diego

Your spine is made up of 33 bones and tissue that extends from your skull to your pelvis. These bones protect your cylinder of nerve tissues called the spinal cord. Between each vertebra is a band of cartilage that is a shock absorber between each vertebrae. There are different types of vertebrae:

• Cervical vertebrae – The 7 vertebrae that form the upper part of the spine
• Lumbar vertebrae – The 5 largest/strongest vertebrae between the chest and hips in the lower back
• Sacrum & coccyx -The bones at the base of your spine. There are 5 vertebrae fused together in the sacrum, and the coccyx or tailbone is made up of 4 fused vertebrae.
• Thoracic vertebrae – the 12 bones between the neck and the lower back

Cause of Back Pain

Back pain can be a complex matter even when it is obvious that it is the result of an accident. There are numerous different types of back injuries that can cause back pain. Your doctor will use tools like x-rays, CT scans and MRI scans to diagnose what’s at the root of your back pain and to see what type of damage, if any the back injury caused. Musculoskeletal injuries can be very painful too.imgFibromyalgia1

Types of Back Injuries

There are 2 main types of back injuries:

• Cervical Radiculopathy – Nerve function damage occurs when one of the nerve roots located near the cervical vertebrae becomes compressed. Damage to the nerve roots in the cervical area can lead to weakness, and loss of sensation in the arms shoulders or neck depending on where the damaged roots are. In almost all cases there is pain.

• Spondylolisthesis – This is a slipped vertebra that occurs usually the spine base. Spondylolysis is either a fracture or defect of one/both wing-shaped parts of the vertebra, which can cause a vertebrae to slip forward, backward, or over the bone below.
With back injuries can quickly turn into chronic conditions with chronic back pain that your family physician was unsuccessful in treating and therefore has recommended you should be seen at a pain clinic.

What is Pain Clinic

A pain clinic has a staff of professionals that all specialize in different areas but who work in unison to create the best pain management plan for you.

The pain clinic will:

• Will identify the type of back injury you sustained along with all the details surrounding that injury.
• Order new tests or rerun tests to examine what is causing our back pain.
• Look at non surgical ways to treat your back pain, which includes the use of medications
• Determine if surgery would be beneficial to your injury. If there is surgery then determine the pain management during your rehab.
• Follow your progress and maintenance to ensure you remain pain free.

Pain clinic therapies can include medications, spinal mobilization, acupuncture, chiropractic manipulations, Prolotherapy, massage therapy, and physiotherapy, are all treatments that can bring relief alone or when combined.

San Diego Pain ManagementRegularly the treatment plan will be re-evaluated to see if it is performing as anticipated and to tweak it as necessary. If you are tired of suffering from your back injury a pain clinic can help. When it all seems hopeless and when you feel that you will always be in pain, a pain clinic can help.