How to manage persistent pain in the tail bone after injury?

Q: I am a 27 yr old unmarried woman. I had a fall last year at home on the marble flooring, falling on my back and injuring my tailbone. By profession I am a teacher and at that point the fall did not seem as bad so I ignored it. A few months later I was down with viral fever and somehow that really aggravated my back ache. It was only then that I consulted an orthopaedic doctor who prescribed some painkillers and sitting on an air-tube. He also suggested physiotherapy. This continued for months on end without much relief. It has been a year now and my lower back still hurts at the slightest exertion. I have recently quit my job as I am getting married soon. Of late I am consulting an osteopath which has been given more relief than the previous treatment. My query is that recently I have developed this tingling sensation above my right knee. It is a very local pain, extending about 4 inches upward. I dont know why this pain has started and it has been there for about 4 months now. It actually started while I was working out at my gym but I had ignored it then. It has progressively become more sensitive and the tingling sensation has increased. Can you please advise me what to do? I am very confused why my back ache has persisted so long and this tingling sensation begun?

A:Your symptom of pain in the tail bone is fairly common, particularly after injury. It has a tendency to remain as a nagging pain but does not have any consequence whatsoever. As orthopaedic surgeons we only look at the patient clinically and perhaps with investigations to exclude some of the ominous causes of pain. These include infection and very rarely malignancies. You have already been seen by an orthopaedic surgeon and taken the usual remedial measures without relief.You have the following options before you:1. Have your case reviewed by another orthopaedic surgeon who may decide tojuggle with pain killers and hope that you improve.2. Take precautions of avoiding contact of your tail bone with any surfaceon which you sit and hope that in due course of time the pain will settle.3. Assuming you have tried everything and there is no relief, occasionally,injection of steroids locally also helps provide relief. However, this isnot to be taken lightly and the injection must be given under strict asepticconditions and in an operation theatre.Your symptom of tingling above the knee is a little unusual. Often there isa nerve of the outer side of the thigh which can get compressed causingnumbness and tingling on the front and outer aspect of thigh. The conditionis called meralgia paraesthetica. This can also be diagnosed easily by yourphysician/surgeon. Here also we need to exclude irritation of nerve rootfrom the spine this usually happens in patients with degenerative changes inthe back which is unlikely in your case as you are young.My suggestions to you would be just double check with an orthopaedicsurgeon on the lines above. If there is anything to suggest otherwise, youcould get back in touch.