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"Should I visit a pain management physician?"


I suffered a tailbone injury in February of 2011. The pain has been consistent and has esclated to my lower back. Two x-rays, both are negative. Current PCP will not perform MRI, and shows little compassion for the pain that I'm actually in, although has given small amounts of pain meds that limit me to one per day, which does not help with the pain throughout the day. Should I visit a pain management physician?


You have my sympathies. Tailbone injuries (more specifically tailbone bruises) can be very painful. They make it difficult to walk and sit down for any length of time.

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Another problem with tailbone bruises is that they consistently take between 2-3 months to heal. Since your x-ray is negative, and you aren't reporting any shooting pain down to your feet, the MRI is unlikely to show anything. What I often do in these situations is send my patients to physical therapy. This helps their lower back joints loose and prevents the low back pain that can result from the tailbone injury. I also prescribe prescription strength anti-inflammatory drugs for the pain which usually works quite well. I do not prescribe narcotics, such as oxycodon or vicodin, because the side effects of these medications are worse than the temporary relief they provide. One service that a pain medicine specialist can provide is a steroid injection. These doctors are very adept at placing injections in tricky places which can provide relief in certain circumstances. I think it would be very reasonable for you to visit a pain management specialist. After a thorough physical exam, the pain doctor will know if you need any additional imaging. There there is any entrapment or damage to a nerve suggested on your doctor's exam, then you may benefit from a steroid injection. I hope you feel better.

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