Dr. Jennifer K. Stebbing - I Can Sit Again: Non-Surgical Treatment for Tailbone Pain

Non-Surgical Treatment
for Tailbone Pain

Dr. Jennifer K. Stebbing, DO

NEW YORK

LONDONNASHVILLEMELBOURNEVANCOUVER

I Can Sit Again

Non-Surgical Treatment for Tailbone Pain

2021 Dr. Jennifer K. Stebbing, DO

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Published in New York, New York, by Morgan James Publishing in partnership with Difference Press. Morgan James is a trademark of Morgan James, LLC. www.MorganJamesPublishing.com

ISBN 9781642799101 paperback

ISBN 9781642799118 eBook

ISBN 9781642799125 audiobook

Library of Congress Control Number: 2019919224

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Thank you to my patients and friends in New Hampshire who have supported me, challenged me, and helped me grow professionally.

Thank you to three of the important men in my life:

For my son, Julian, who has been a steady companion through my process of redefining my professional life. There is nothing more grounding then having to look into the mirror and face what may not be an ideal habit. Being your mother has been the biggest blessing and challenge. Thank you. I love you.

To Uncle Dr. Patrick Clary, my hospice and palliative care mentor, colleague, and friend. I learned to love medicine again as I learned the value of having clear, defined emotional boundaries between what is mine and what is someone elses suffering.

To Dr. Jonathon Fenton, DO, whose collegial generosity towards teaching me has not only elevated my confidence but changed my philosophy of practice from one of apprehension to one of abundance. There is no shortage of people with chronic pain or arthritis that need to be treated with regenerative orthopedic medicine. There is a shortage of physicians that need to be trained. I hope to follow in your footsteps, fostering and elevating the next generation of physicians.

I ve fallen. I landed hard right on my tailbone area, and Ive not been the same since.

This is not an uncommon story that women have come into my office with, but there are variations. I delivered my baby, he was big, I tore, and Ive had pain in my tailbone since. Or I was playing a sport, I jumped up and landed on one leg, and Ive had discomfort in my bum since. Or I was in a car accident, I stomped on my brake to avoid the impact, and I have back problems with pain that goes into my derriere. In another situation, someone had an injury with a large scar that caused pain in this same area.

Every one of these situations had pain that interfered with sitting. Sitting is an integral part of everyones life. Sitting allows you to drive a car, eat meals, and rest comfortably on the sofa at the end of the day. Effectively, it allows you to be a social individual. You sit with your family during mealtimes. A date to the movies is enjoyable as you settle comfortably into your seat. Eating out or having a cup of coffee or tea with friends usually involves sitting. Work or school requires that you sit. When your ability to sit is affected, the rest of your life is compromised as a consequence.

Chronic pain interferes with your ability to think. It affects your ability to find pleasure in life, as the pain is not distractible. This can lead to depression. It leads to compensatory or altered movement patterns that may cause other problems. For instance, some people find that if they cross one leg over the other and get the weight off the side that has pain, they can sit for longer, but the issue starts to involve the lower back, the neck, or the shoulders, as the alignment becomes twisted. One thing leads to another. Sometimes the pain causes you to yell at the people you most care about like your kids or your spouse. It causes you to feel irritable, then the guilt sets in. You judge yourself and your ability to parent or be a good partner. Your sense of who you are starts to be lost.

Tailbone pain, as some people call it, may be exactly what the issue is. Alternatively, the pain may actually be a sacroiliac joint issue, or nerve, fascia, or muscle pain. This is a complex area. It is difficult to diagnose. X-rays or MRIs dont always help with figuring out the pain. One doctor may offer a solution that is very different than another doctor. This can be very confusing. Im sure that you just want a diagnosis or a reasonable explanation of what is causing your pain and all your options for treating it. I always tell people that just because a doctor doesnt understand your pain doesnt mean it doesnt exist. Osteopathic or chiropractic treatment offers a respite or relief of pain for a short period. This starts to give you hope that there is something that can be done about your pain. Physical therapy can also be beneficial. You do the exercises as you were told to, with improvement but not complete relief. Acupuncture may work wonders, or it may not work at all. Youve changed your diet. Youve done cleanses. You try to reduce the stress in your life, but its difficult if you are the prime wage-maker or carry the insurance for the family.

Your biggest fear is that it wont go away, that you will miss out on your childrens activities, that your employment is in jeopardy, that you are not worthy of feeling whole again. Sometimes it is easier to deal with the pain or discomfort that you have rather than risk it getting worse. Your ability to make clear, thoughtful decisions becomes clouded by the pain and lack of sleep.

However, there are treatment options for all these situations. My practice is geared toward treating pain that prevents you from participating in life fully. I have helped many people with various reasons for not being able to sit comfortably. Your pain is real, even if no one else has figured out why. In this book, I will discuss these non-surgical treatment options that are medically sound and have been proven clinically for decades. I have many tools in my bag to do this with the end goal of getting you sitting comfortably again.

P ain was not something that my medical education taught me about. It wasnt until I started my training as a hospice and palliative care physician that I was exposed to how to quantify pain. We asked patients to rate their pain on a scale from zero to ten, where five is a level of pain where one would find the pain an interference to a phone conversation and need to get off. This level of pain is not distractible. I had experienced ankle sprains in high school but nothing above the level of a four out of ten. As I saw patients near their end of life, I was taught that the brain perceives all pain in the same area of the brain. Pain can be physical pain, emotional pain, and/or spiritual pain. Our brain experiences this pain the same. This means that its hard to figure out where the pain originates if one is only spending fifteen minutes or less, the standard length of time in the conventional medical model, with a patient. I realized this as I pursued my sports medicine training. Treatment of solely physical pain without considering other potential causes of pain (emotional and spiritual), may not be possible. I have noticed this especially after a patient has had a few surgical operations that have not addressed their pain. Now their pain is more complicated. It is not just physical; there is also some emotional scarring, perhaps even PTSD, that needs to be treated at the same time.