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News — Thousands of people suffer with tailbone pain, often struggling to find an accurate diagnosis and effective treatment.

Tailbone Pain Awareness Day, created by Patrick Foye, professor of physical medicine and rehabilitation at Rutgers New Jersey Medical School (NJMS), aims to change that by bringing awareness to this debilitating condition.

This year, Tailbone Pain Awareness Day falls on Nov. 13, and to mark the occasion, Foye will host a session at 7 p.m. that day to educate the public on this often-overlooked condition.

The medical doctor discusses the importance of awareness and cutting-edge advancements in treatment and care at Rutgers Health.

What inspired you to establish Tailbone Pain Awareness Day and why is awareness so important?

I created Tailbone Pain Awareness Day several years ago because so many people worldwide suffer with tailbone pain without being able to get an accurate or specific answer about what is causing their tailbone pain and the best way to treat it. Unfortunately, many people suffer for months and years before they find their way to see me for expertise in this specific condition. I created Tailbone Pain Awareness Day to bring attention to this painful condition and to support doctors and patients in learning about the most modern tests and treatments. 

What are some challenges that physicians face in diagnosing and treating tailbone pain?

One problem is that tailbone pain is dramatically less common than low back pain in the lumbar area. Tailbone pain is estimated to be thousands of times less common. So, unfortunately, many doctors don’t have much experience or training in properly caring for tailbone pain (also called coccyx pain or coccydynia). These patients get lumped in with lumbar low back pain, when in fact the testing and treatment are very different. Tailbone pain is much lower than lumbar pain. Instead of lumbar low back pain in the small of the back (near the beltline), tailbone pain is lower down, just above the anus.

Another challenge is that many patients report a social stigma to discussing tailbone pain with others. Many patients have reported that their doctors laughed out loud when the patient said they thought their pain was coming from their coccyx. Thus, patients end up feeling embarrassed and unsure where to go for help.

You mentioned 40% of your patients fly nationally and internationally to see you. Why do you think there’s a demand for specialized care for this condition?

Most of my patients travel here from out-of-state and, yes, about 40% fly in to see me. In recent years, I’ve had patients from Egypt, South Africa, South America, Europe, Australia, Asia, as well as from all around the United States. This is because unfortunately their local doctors have rarely seen or treated patients with this condition.

Although I (and others) have been publishing extensively in the medical literature on this topic for many years, doctors can’t keep up with the latest advancements for conditions that they rarely see. Rutgers NJMS is the only academic medical center in the nation with a dedicated Coccyx Pain Center, which I founded more than 20 years ago.

How has Rutgers NJMS and University Hospital supported the use of cutting-edge technology in diagnosing and treating tailbone pain?

The most common cause of tailbone pain is joint hypermobility, which results in excessive movement of the individual bones of the coccyx. But most radiology departments in the U.S. and worldwide have no experience doing the specialized types of X-rays that are the gold standard for making this diagnosis.

At University Hospital in Newark, our Radiology Department does sitting-versus-standing X-rays of the coccyx to assess whether there is abnormal movement of the coccyx while the person is sitting. When sitting, you put your body weight onto your coccyx. The tailbone position while sitting is compared with the position while standing, often revealing abnormal, excessive bony movement. Thus, a diagnosis can be reached in patients whose prior imaging studies all looked normal.

Meanwhile, within the Department of Physical Medicine and Rehabilitation at Rutgers NJMS, I spend a lot of time with each patient to assess their symptoms, physical exam findings and imaging studies to make an accurate clinical diagnosis. Based on all of this, I can provide individualized treatments, such as specialized types of pain management injections done under fluoroscopic guidance. Many patients who have suffered for years and even decades are finally able to get relief.

Can you share information about specialized treatment making a life-changing difference for patients?

My patients with tailbone pain come from all walks of life, including professional athletes, movie stars, politicians, pilots, bus drivers and construction workers. The thing they have in common is that they have tailbone pain when they sit. This can dramatically decrease their quality of life. So, it is immensely gratifying helping people be able to return to their sport or their job or to travel or simply be able to sit on the floor to play with their children.

I often get holiday cards from patients who I’ve seen many years ago, telling me that they’re still doing well and living their best lives. As a physician, it doesn’t get better than that.

What advice would you give to patients dealing with tailbone pain?

It is crucial for patients with tailbone pain to educate yourself and advocate for yourself. For education, my book Tailbone Pain Relief Now! is free on on Tailbone Pain Awareness Day and on the first day of each month. I have over one hundred free videos on YouTube and patient education articles on my website   Learn as much as you can so that you can advocate for the proper tests and treatments. These steps will be worthwhile in your journey to find relief.