June 8th, 2011
01:28 PM ET
Can my tailbone pain be cured?
Every weekday, a CNNHealth expert doctor answers a viewer question. On Wednesdays, it's Dr. Otis Brawley, chief medical officer at the American Cancer Society.
Asked by Will of Denver, Colorado
I am an average person - good health and slightly overweight. Last year on a dare/challenge from a friend I rode my bicycle 50 miles without any previous training. I successfully completed the 50 miles, although I had extreme pain in my tailbone following the ride. I assumed this was temporary and continued to live my life. However, a year or so later it still has pain when I sit down. I'm not sure where to start besides seeing my normal doctor. Is this something that can be cured or could I have done lifelong damage to my tailbone?
I think you already know that strenuous exercise without proper preparation through training is not a good idea.
That being said, the medical term for pain in the tailbone is coccydynia. It is usually caused by trauma and it usually gets better with conservative therapy over a period of several weeks, but it can sometimes take several months for it to improve.
The coccyx is a projection at the base of the spine. It is made of bone, cartilage and fibers. The coccyx bears weight when a person is sitting.
Some of the muscles that control defecation attach to the coccyx, and there may be pain in the injured tailbone upon defecation and when tightening the anal sphincter.
There are no national incidence numbers for this condition, but pain in the tailbone is a rather common problem. A busy primary care doctor usually sees a few cases per year. It is far more prevalent in women than men. It is rare in children.
The most common cause is traumatic injury from a fall backwards into a sitting position. Other causes include repetitive minor trauma from sitting a long time. People not only get it from long bike rides, but from sitting in a car or plane for a prolonged period. Sitting on hard surfaces is more likely to cause it.
Women can get coccydynia through trauma during vaginal birthing.
Obesity is a major risk factor in men and women. The diagnosis of coccydynia is made through the patient's history of the pain and trauma and from physical examination.
On examination, the physician can usually reproduce the symptoms through direct pressure on the tailbone. Initial treatment is conservative, using nonsteroidal pain medications such as ibuprofen or naproxen; protection of the area with a donut or wedge pillow; and alternating applications of heat and cold packs.
Patients with pain after more than three months of good conservative therapy merit further evaluation which might include X-rays of the pelvis and tailbone.
A very few patients will need to be treated with injections of local anesthetic, or local anesthetic and steroids, directly into the tailbone area. In a very rare case of protracted pain without improvement, the tailbone can be surgically removed. This operation is called a coccygyectomy.
About this blog
Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.
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visitors with Children Adopted from China
Boys in Adoptive FamiliesFor ages, Girls and mothers have gotten all a person's eye in books about adoption and China, But as more and more boys from China are adopted in north america, A need has arisen to find books that speak to the feeling and heritage of the boys as well.
Here is a list of the best books I've found so far, From toddler boys on up to the teenagers. I've started with books that appeal to the youngest boys and then moved on up the age ranges until we reach books which speak to fathers' experiences.
This is a book for the child who loves poring over little details in offers like maps, Eyewitness audiobooks, and your "I criminal" books. At first this appears rather spare and austere, But as you start taking a close look at it, You find that it is jam full of interesting little facts and humor as well.
The book is a elaborate, Minutely detailed work of art with no shortage of interesting little facts tucked in. The first pattern, Which unfold into a 5 page intensely conveys the enormousness of the place, With hundreds of tiny tourists roaming the grounds. Cartoons of the 16 different emperors of the Ming Dynasty support the wall, Each with a speech bubble that gives you a characterization of how to tell if a chinese girl likes you his reign. One utters "I ordered the bad manners City to be built, another says "Crickets were my past-time, And an additional admits, "I was a disaster,
The stories for the text occur to be chosen for kid appeal: "The Year Ten Thousand Envoys Came to Pay tribute, "The Last Grand bridal, "The Empress Dowager Is your pulling off Her Big Birthday,
The book even comes with a little magnifying glass so that readers can take an even closer look at the drawings that characterize this ancient landmark of China.
The drained Pot by DemiFor boys ages 4 7; think of Story Book
Ping is the greatest gardener in the village, And when the emperor says that his position will be forwarded to the child who grows the best plant from a seed given to them, Ping thinks he has a lock on getting. sadly, His plant doesn't grow while ever other child manages to coax a large flower from their seeds.
it turns out that the emperor's contest was not about horticultural ability, But dependability. This classic story is lovingly created by Demi.
Day with the Dragon King by Mary Pope OsborneFor boys in grades 1 4; essential Chapter Book
Jack and Annie travel back to ancient China to stop the powerful emperor, The monster King, From lose all the books. They are specifically interested in saving a particular bamboo book. in their time in the ancient past, They meet up with characters from Chinese legend and they also observe history while it is occurring. Though these books don't go into lots of medieval detail, They can serve to pique a children's interest and may lead them to start thinking about the many good nonfiction books about China. an ideal choice for children who have just learned to read enough to handle a short chapter book. It's actually the last of a 4 part series within a series in which the kids, jack port and Annie, Need to find four things that will assist revive Merlin's penguin. together with, mainly because it wraps up the plotline, They find out that the children did indeed find exactly what the penguin needs.
This story has the children traveling to more or less contemporary China in the time the Sichuan earthquake. They travel to the Wolong panda reserve and volunteer to keep up some of the pandas there. in case the earthquake strikes, They use a little magic to get through to the pandas and help them out. this treatment, It's a nice story with a bit of adventure, And a little the advantages of pandas and China. My radar went up a little at one point when your kids were remarking on unusual Chinese food such as green bean jelly and stinky tofu, But they likely realized that some American foods have pretty funny sounding names such ashot dogs and squash. as a whole, The tone of the book is respectful and the Chinese people featured are portrayed as intelligent and compassionate.
Thailand is top target the particular
THAILAND topped their email list for Irish globetrotters in the niche exotic market in 2010. India and Vietnam observed closely behind, Making south east Asia and India firm favourites for the "calling Irish" last year, tropical Medical Bureau said.
Brazil came fourth on its list of most preferred destinations for Irish Thai dating people seeking inoculations, and then Cambodia, Argentina, Laos, quotes, Peru and additionally Malaysia, The TMB said in its Top 10 database.
"yr after over 20,000 people visited us at within the caribbean Medical Bureau, Pre and post their vacation, Medical home Dr Graham Fry said. "We're seeing an increasing number of people travelling through South America, With long trips of three to six months typical.
"south east Asia is, unsurprisingly, Popular as it's on the way to Australia,
in comparison with 2009, The top four spots remain unchanged, But there have been some surprises, The TMB stated that.
Australia dropped from fifth most sought-after in 2009, To eighth arrange, Argentina jumped into sixth position for 2010, Having used eight in 2009. Malaysia entered the Top 10 the very first time and Cambodia joined the Top Five, After utilizing at sixth place in 2008/2009.
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