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Douglas, Thank you for your reply. The origin of my question was from a patient that one of my colleague have been treating for the past 15 months (yes, that loooooong). This guy has been diagnosed with chronic fatigue syndrome, but suffers from intermittent flare ups of low back pain. He apparently went to a chiro who suggested that it may be his coccyx, and funny enough, he began to recollect a past incidence of falling on his buttock, and believed that this single incident brought on the whole CFS and back pain. By the sounds of it, the chiro did a good job of convincing him that his problem was in the coccyx, but the irony is that this chiro does not do coccyx adjustments (I can only guess that he is either not trained in this or does not have any surgical gloves :D. Belief is a strong thing, and by the sounds of it, this guy is totally convinced. I am not even sure whether my colleague can convince him otherwise! I saw a website totally dedicated to coccyxdynia (www.coccyx.org) but yet this was not even mentioned during my undergraduate Physiotherapy training. What I do not understand or find is that if the coccyx is subluxated, will manipulation/adjustments "reposition it" and how long does it last?? Henry*** >From: "Douglas M. White" <[log in to unmask]> >Reply-To: - for physiotherapists in education and practice ><[log in to unmask]> >To: [log in to unmask] >Subject: Re: coccyx angulation >Date: Fri, 31 Aug 2001 08:19:47 -0400 > >Henry: > >I meant to ask you when you first posted your question... What were your >examination findings? > >In my experience Chiros say they find coccyx dysfunction (and pelvic >obliquity) a heck of a lot more often than other professions treating the >L/S spine. Also, in my experience I do not often agree with their dx. With >rare exception the usual hx of coccygeal dysfunction is after a fall on the >buttocks. > >The coccyx is difficult to treat. It is very reactive to forces and it is >easy to make things worse or create a new problem if someone pokes at it >too >much or too forcefully. > >A finding on x-ray of 45 degree angulation is not an indication to treat in >of it self. The physical examination must also demonstrate subluxation. >Stanley Paris teaches coccygeal manipulation in his S2 course. I have >rarely >used it in my many years of manual therapy practice. > >****************************************************** >Douglas M. White, PT, OCS >Physical Therapist, Consultant >191 Blue Hills Parkway >Milton, MA USA 02186 >P: 617.696.1974 >[log in to unmask] >http://DouglasWhite.tripod.com > > >| Sylvia, >| >| thank you very much for the references. I will definitely go and search >for >| more. It just seems that coccyxdynia is something that chiro's emphasis, >and >| there seems to be little in Physiotherapy on the coccyx. I saw one of the >| treatment techniques, where one needs to put a finger in the rectum >region >| to feel for the coccyx :O >| >| Henry*** >| >| >| >From: Sylvia van den Heuvel <[log in to unmask]> >| >Reply-To: - for physiotherapists in education and practice >| ><[log in to unmask]> >| >To: [log in to unmask] >| >Subject: Re: coccyx angulation >| >Date: Fri, 31 Aug 2001 09:25:07 +0200 >| > >| >Hello Henry >| > >| >In our database I found some references. Its also called coccygodynia. >| >Beaton, Lindsay E. >| > The sciatic nerve and the piriformis muscle : their interrelation a >| > possible cause of coccygodynia / Lindsay E. Beaton, Barry J. Anson >| > In: J Bone Joint Surg - Vol. 20, no. 3 (July 1938) ; p. 686-688 >| > >| >Wray, Christopher C. >| > Coccydynia :aetiology and treatment / Christopher C. Wray, S. Easom, >| > J. Hoskinson >| > In: J Bone Joint Surg Br - Vol. 73B, no. 2 (March 1991) ; p. >| >335-338 >| >Polkinghorn, B.S. >| > Chiropractic treatment of coccygodynia via instrumental adjusting >| > procedures using activator methods chiropractic >| > technique / Polkinghorn, B.S., ; Colloca, Ch.J., ; >| > In: J Manipulative Physiol Ther - Vol. 22, no. 6 (July/August 1999) >| > ; p. 411-416 >| > >| >Maigne, J.-Y. >| > Causes and mechanisms of common coccydynia : role of body mass index >| > and coccygeal trauma / Maigne, J.-Y., ; Doursounian, L., ; >| > Chatellier, G., ; >| > In: Spine - Vol. 25, no. 23 (December 2000) ; p. 3072-3079 >| > >| >Wesselmann, U. >| > The urogenital and rectal pain syndromes / U. Wesselmann, A.L. >| > Burnett, L.J. Heinberg >| > In: Pain - Vol 73, no. 3 (December 1997) ; p. 269-294 >| > >| >See for more information: www.doconline.nl/ >| >Its in Dutch but you can also search for english words in the title. >| > >| >with kind regards >| >Sylvia van den Heuvel >| >reference librarian physiotherapy/information specialist >| > >| >Nederlands Paramedisch Instituut >| >Afdeling Documentaire Informatie >| >Postbus 1161 >| >3800 BD AMERSFOORT >| >Amsterdamseweg 16 >| >3812 RS AMERSFOORT >| >tel: (033) 421 61 20 >| >fax: (033) 421 61 90 >| >e-mail: [log in to unmask] >| >Internet: http://www.paramedisch.org/npi >| > >| >Henry Tsao schreef: >| > > >| > > To all: >| > > >| > > I was talking to a patient who told me that a chiro told him that he >had >| >a >| > > 45 degree inclination of the coccyx, and that it was basically >jabbing >| >into >| > > his gluts. The chiro convinced him that this was where the pain was >| >coming >| > > from. >| > > >| > > My questions are: >| > > 1. How much movement is in the coccyx in "normal" patients, >| > > 2. Is what the patient described above something called >| >coccydnia(probably >| > > spelt it wrong)? I am not familiar with this... does anybody know of >| >good >| > > references? >| > > 3. How does one treat such a condition. >| > > >| > > Thank you in advance for your replies :) >| > > >| > > Henry*** >| > > >| > > _________________________________________________________________ >| > > Get your FREE download of MSN Explorer at >| >http://explorer.msn.com/intl.asp >| >| >| _________________________________________________________________ >| Get your FREE download of MSN Explorer at >http://explorer.msn.com/intl.asp _________________________________________________________________ Get your FREE download of MSN Explorer at http://explorer.msn.com/intl.asp