Q: When I sit down, my muscles that are connected to the last bone in the hip (the tail bone) caue pain in the right hip. Everytime I sit, I avoid sitting down with a jerk and carefully set my hips on the chair or else I can feel a twitch in the muscles. It is difficult to sit on a hard surface and I sit on regular foam office chair. I had got an x-ray done last year of the coccyx and it showed a mild inflammation. The physiotherapist I went to advised me some exercises like bringing both hips together 10-15 times a day with force. He also treated the area with some impulses, gave heat and also manually tried to fix the muscles there after putting some jelly and rotating a steel round instrument on the bone. But I discontinued going to him as I felt very uncomfortable as he told me that I have a problem with my posture too (I do hunch down while sitting). He also massaged my back for a few sessions and in one session he tried to massage my breasts and cupped them, which I did not think was required. Since then I have not gone to any doctor. Also, I spend 4-5 hours per day on computer and then get pain below the neck on the right side near the shoulders. The pain in the shoulder gets aggravated whenever I sit for too long at the computer extending my right hand at the mouse. Please advise what I should do?

A:There is no need to get so upset. You do need to undergo extensive physiotherapy, but you will improve over a period of time. The coccyx bone you have mentioned does give a problem for patients, especially for those who have to spend long hours in sitting posture. The ultrasound treatment you have undergone is the most effective one, but as you have mentioned you did not go back to complete the treatment and your problem must have aggravated. I suggest you go to a female physiotherapist and get a clinical examination done. Once your therapist identifies the tight tissues or ligaments, stretching can be given accordingly. You might need to take a few sessions of ultrasound again. Relaxation techniques learnt from the therapist will help you. This does take a little long to subside You can buy a round air cushion with a hole to sit on so that there is no pressure on the coccyx bone. If you can spare time, try and sit in a warm water bath for 20 minutes every day. This will really relax your muscles around the lower back. Swimming will be the best bet for you. Secondly, your pain in the neck and shoulder and hand (right) is postural. PREVENTION is the word for you. 1. You will need corrective exercises for neck, shoulder and upper back. Do learn them from your therapist, 2. Check the height of your chair so that you are upright in front of your computer and not stretching your neck or bending your neck to work on the screen. 3. See that you work with your shoulders relaxed. 4. Your forearms should be approximately horizontal. 5. Upper arms should be vertical. 6. Wrist should be a little higher than elbow. 7. Feet should be flat on the floor or use a footrest. 8. Screen should be free of glare or reflection to avoid a strain on your neck. 9. Take frequent breaks and move around. Self-pacing will also reduce the stress which is a major contributing factor for pain. 10. Reverse the postures regularly and practice postural correction. 11. If you have reading glasses, get your eye-sight checked. 12. Here too ultrasound for the wrist will help you. 13. Ask your therapist to get a splint for your hand. Give yourself some good treatment and relax, you will be fine.