Is a specialty in the sacrococcygeal syndrome right for you?
Dr. Chris Kemper and his foundation, Kemper Tailbone Injury Foundation (KTIF) are dedicated to assisting spine physicians in the diagnosis and treatment of coccyx dysfunction. Coccyx dysfunction, and its obvious group of pathomechanical signs, is herein proported to be vastly underdiagnosed and therefore is emerging as an important cause or co-contributor to many serious spinopelvic symptoms.
Why so many undiagnosed cases?
Perhaps not so surprisingly, surveys suggest that while virtually every doctor of chiropractic is highly skilled and comfortable in the clinical diagnosis of subluxations, when they occur at C1, T1 or L1 for example, less than 1 in 100 will assess the coccyx with the same orderly and objective clinical protocol used when assessing other spinal levels. This practice, or lack of, is of concern to KTIF, particularly when many patients seek precision diagnosis and treatment for coccygeal trauma. Few would deny that many patients seek care, following pelvic floor trauma, when coccygeal dislocation and subluxation result from snowboarding, sedentary jobs and contact sports. For example:
- Typical Chiropractic / orthopedic evaluation of L5 includes 1) history of back pain 2) observation of swelling or spasm, 3) palpation for edema and tenderness 4) motion palpation 5) X-ray 6) range of motion including flexion, extension & lateral bending 7) leg length disparity tests 8) dural stretch signs such as SLR or cough test, as well as dozens of other primary and reinforcing orthopedic and neurologic tests 9) subjective assessments such as NPS, Roland-Morris, Revised Oswestry, Quebec etc.
- What is the current standard for evaluation of the coccyx? 1) History of Pratt fall 2) tenderness to external palpation 3) X-ray…
- KTIF has established 3 primary objective clinical measures (refer to S/C syndrome link on KTIF.org) that appear to be specific for coccygeal dysfunction. In addtion, KTIF's procedural guidelines have established what promises to be a safe, effective and long-lasting treatment protocol that routinely addresses the syndrome's objective clinical features. The procedure is believed to be compatible with all establish spinal care techniques.
Reasons for the often limited or all together absent assessment of the coccyx by DCs, and medical orthopedists alike, are several. They include: lingering notions that the coccyx is a vestigial remnant rather than a functional vertebra and a general reluctance by the examining physician or patient to perform / receive an internal contact motion-palpation examination.
Call for more research
Certainly more research is needed to study, what KTIF terms "The Big Three" coccyx-related conditions" including the role the coccyx plays in 1) Chronic spinopelvic pain and segmental motion dysfunction 2) Abnormal dural tension and 3) Obstructed birth outlets.
Efforts are being made to foster more initial interest in coccygeal function and ultimately research. At the same time Dr. Kemper and his foundation warmly welcome those interested in more thorough assessment of the S/C syndrome and its signature clinical profile.
Easy to diagnose, readily treatable, clear outcomes
Coccygeal deformation and pelvic floor compression is responsive to corrective treatment. The S/C syndrome is usually a clear, stand alone diagnosis when coccyx motion is lost to angulation or subluxation. Just as all clinicians have successfully diagnosed and treated conditions such as a sacroiliac sprain/subluxation, finger dislocation or fracture at some level, coccygeal dysfunction is easily differentiated from other regional conditions.