Sore bum.

October 6, 2007 9:10 AM

My tailbone is killin' me. Help? (detailed - and a little graphic - description inside)

Very recently, I have noted a sort of hard inflammation adjacent to my tailbone. The swelling becomes agitated when I sit for long periods of time -- the worse the chair, the worse the pain. This week, at the base of my tailbone, the area has developed a sore -- red, occasionally bleeding. It hurts, and doesn't really heal up well, if at all. I have made an appointment to see my doctor, but can't see him for a few weeks. In the meantime, I'm going a little nuts worrying. Any idea what this could be?

posted by anonymous to health (11 comments total)

Sounds like a pilonidal abscess to me. Read up at this website which is by far the most comprehensive one out there on the subject to see if the description matches. If that's what is, it does a much better job at explaining everything than I could ever do.
posted by Durin's Bane at 9:19 AM on October 6, 2007

I had similar symptoms and had some kind of abscess. The doctor took a look, gave me some antibiotics and it went away.
posted by disaster77 at 9:19 AM on October 6, 2007

Ditto Durin's Bane. I hit refresh before posting the exact site in my answer.
posted by kellyblah at 9:19 AM on October 6, 2007

Sounds like a pilonidal sinus. You will get immense relief by taking a shower and pushing any lump to get the blood and fluid out, because it can be incredibly painful if it is allowed to build up. Then see a doctor. It's a very common problem but one that usually takes surgery and a long period of healing to solve. If it needs to be removed the wound may have to be packed over a period of several weeks to allow it to heal together properly. Good luck.
posted by fire&wings at 9:56 AM on October 6, 2007

It doesn't always take surgery. In my case, the doc gave me antibiotics, it went down, and then he told me to come in every 4-6 months to have it looked at and cleaned. So although it *can* be very nasty, it isn't always. Hot water may provide immediate relief; pushing the lump to get out as much fluid as you can may also help, but if it's infected, it may be too painful to even try.
posted by spaceman_spiff at 11:04 AM on October 6, 2007

I've had this for years. I never have a lump, but it does hurt to sit for long periods of time (4+ hours). I can shift my weight and sort of "move" the pain, if that makes any sense (feels like cracking a joint and making pain go away, I guess). Every couple of weeks my skin gets a little irritated at the base of my tailbone, but that goes away after a day or two.

(Now that I've looked up what other people are saying, I'm terrified! I love the internet.)
posted by sian at 5:09 PM on October 6, 2007

Says the SO:

Speaking as one* who had a pilonidal for years without issue and then a massive flare-up in December which required surgery, here are a few pointers:

- Go to the doctor (your GP) to get it drained (and have a drain plug put in if it's to the point you can't sit or lie down without crying). Antibiotics should be prescribed to help quell the infection.
- If your GP recommends excising or surgery, *ask for a referral to a colo-rectal surgeon*. Yes, that's right...colo-rectal. It may be outside the body, but they know their shit (so to speak), and saved me weeks of recovery time. Instead of a golf ball sized hunk of flesh carved from my butt, it was only about a nickel in circumference and I was up and active the next day. Packing was minimal and the surgeon saw me through full recovery to make sure it healed correctly.
- Should surgery not be an option for a while, keep that area cleaner than your mouth. Make sure no shampoo/conditior/soap/lotion lingers there, and keep it hair-free if you are of the more hirstute nature. Go to your GP for more antibiotics and draining if needed.

It could stay as is or become the event where you've shown your ass to more people in one week than in your life.** But with a proper GP and/or surgeon, it's nothing to freak out about in the long term.

*"SCIENCE!" will say that this is only a male issue, and females are usually not afflicted. Bullshit, and should you be female don't let any doctor make you feel dirty for having this happen.
**The flare-up coincided with the holiday season, and I had to listen to "I Want A Hippopotomus For Christmas" on the PA system while I was bare-assed-bent-over being examined by the doc. That song will never be the same for me. Ha!

posted by Ufez Jones at 6:37 PM on October 6, 2007

You might want to go to a Doc In the Box and get the thing inspected now- or you might want to ask your doc if he can fit you in to a cancellation. If it is a pilonidal cyst then it can explode itself, which according to a guy at work that had one, hurts like all hell- he was riding a bike when the sucker erupted. As he tells it, because he let it go, he had to get surgery.
posted by bkeene12 at 7:56 PM on October 6, 2007

You should see a doctor.

However...until then, if you have an independent pharmacy in the area, call them and ask if they have "drawing-out salve" - the active ingredient is some form of icthammol, usually with suitably old fashioned additional ingredients like "green soap." If you get the right stuff, it will be black-brown, smell like diesel, and you will think I need to put the pipe down if you think I'm telling you to put it on your body.

Put it on your body. Squeeze a blob (pinto bean size) onto a gauze pad and nestle it into your crack over the swelling. Lounge about on an old towel (it stains) for a couple of hours. Relief will begin almost immediately, and if you're really lucky and have enough free time to repeat this process for a couple of hours every few hours, or overnight, the damn thing will open up (painlessly, but keep those old towels handy). I stop using the salve when it begins to drain, and switch to more gauze pads with Neosporin plus twice-daily showers with antibacterial hand soap.

Wash all sheets, towels, underpants and pants carefully and often. This is staph, and you don't want to give it back to yourself or someone nearby.

I haven't been able to find the salve anywhere but old school pharmacies (tip: they're often the ones that do chemo drugs, though not necessarily technically "compounding pharmacies") since Eckerd got bought out by CVS, but I swear by and hoard the stuff. I can't find it online.

You've got a boil, basically, but one of the nastier kinds. The first time I had that one, I had to go to the Doc In The Box to have it opened, drained, and packed (and then returned every day for 10 days to have it repacked) because I waited until I couldn't sit. Since then when it or its friends flare up, I do the salve as soon as it gets sore.

Key to a happier life: never ever again touch that spot with a bare hand unless you are in the shower with soap. I can flare mine up with just an experimental poke.
posted by Lyn Never at 9:05 PM on October 6, 2007

Oy I had one of these. My doc called it a cyst but I guess it's technically an abscess. Ask the doc for the name of a general surgeon - he will drain it for you. The bad news is that you don't have immediate relief after seeing the doc because they pack the wound with gause. The good news is that once I took a bath the next day and took out the gause I felt much better. In my case, it healed up and I haven't had any problems since.
posted by radioamy at 6:25 PM on October 7, 2007

Been here. Done this, got the t-shirt.

Nthing everyone else's suggestion to see the doc. Depending on if the abcess has tunneled anywhere, they may just lance and drain, or have to scoop it out of you. See a doctor soon (or failing that, see the ER. You don't want this sucker to burst on you) because these things can make you feel all kinds of sick (fever, chills, infection) and it hurts. Bad.

The bad news: if it has tunneled, expect full blown surgery to remove it. Hope that they can stitch it up, rather than pack it. Even if they do stitch it, expect to be uncomfortable for at least 2 weeks, and constipated for at least half that time.

Good luck!
posted by richter_x at 7:36 PM on October 8, 2007