Hello docs,
Not looking for medical advice per se, just wondering if you can shed some light on general approaches for a case like this.
Question for you: have a former client who has had “tailbone” pain for a number of years now that’s been quite debilitating. Walking or standing for more than a few minutes causes pressure on the “sit bone” area as well as pain in her lower left lumbar. I believe she got a cortisone shot at some stage, and only after this started to have some tingling and numbness in the glute and down the back of the left leg, as well as cramping. I don’t believe there was a specific injury that caused this. She was lifting prior to this but hasn’t really been since. Has been doing physio locally among other things, but graduated lifting isn’t really improving anything.
She had an MRI done (Sacrum and SI/Lumbar), and the report says (she gave me permission to share):
-Some notes about mild degenerative changes in various areas I would think are probably irrelevant
-Large cystic structure in sacral canal measuring 5.9x4.1x2.1. This is clearly
long-standing and has resulted in expansion of the sacral canal with bony remodeling and thinning. Within the mid and inferior aspects of the lesion the lesion is centered within the sacral canal but more superiorly it extends toward the right and may be related to the right S3 nerve root. No evidence of sacroiliitis. Cystic lesion within the sacral canal resulting in significant bony remodeling. This presumably represents a perineural cyst related to one of the sacral nerve roots. These are usually asymptomatic but in view of the size in the degree of bony change related to this lesion, this could be resulting in sacral nerve root impingement.
She has had conflicting advice from seeing multiple doctors and surgeons, some saying they wouldn’t operate on this but physios and others saying it should probably be operated on.
Anyone or anything to look at to help steer her in the right direction?