Don't touch me there!
December 3, 2010 3:48 PM   Subscribe

YANMD or my physical therapist either, but maybe you know enough about the failure modes of the human skeletomuscular system to suggest possible reasons for the excruciating pain I feel when someone puts pressure on the base of my spine?

For as long as I've been getting massages from friends and professionals (most of my adult life), I haven't been able to stand having any pressure put on the base of my spine/sacrum. Casual touch is fine, but the moment someone applies even the gentlest of pressure there I experience excruciating pain that makes me want to jump off the table--and I have a fairly high pain threshold and otherwise enjoy intense deep-tissue massages. Most massage therapists honor my request to avoid putting any pressure there without any further comment, but some insist that if it hurts it needs massage. It's definitely not muscle pain, though--it feels tender, like something's bruised, inflamed, or otherwise damaged. I don't recall any injuries to that area, and have never seen any visible bruises there. I've got injuries and chronic aches in other parts of my body, but I've never had chronic or unexplainable lower-back pain. What are some possible explanations for the pain?
posted by rhiannonstone to Health & Fitness (10 answers total) 2 users marked this as a favorite
Have you ever had that area x-rayed? I am inclined to wonder if you broke your tailbone at some point and it never set correctly.
posted by restless_nomad at 4:11 PM on December 3, 2010 [3 favorites]

Pilonidal cyst?
(Warning: photo at link)
posted by easy, lucky, free at 4:18 PM on December 3, 2010 [1 favorite]

(Just popping into say that I hope you get an answer here; I'm the exact same way and have been for basically my whole life.)
posted by BlahLaLa at 5:12 PM on December 3, 2010

but some insist that if it hurts it needs massage.

No, no, no. If something has soreness, it could use massage, but definitely not sharp pain, and doubly so on any place with direct nerve roots everywhere.

You may want to get it checked at some point, to make sure you a) don't have any disc issues and b) don't have nerve impingement issues -either of which could result inflammation issues etc. (Yes, you're not feeling anything right now, the spine is basically a mass of bones and cartilege discs with tiny holes for those nerves to go through - and just about anything can cause them to start closing up over time).
posted by yeloson at 5:39 PM on December 3, 2010 [1 favorite]

When you say "base of the spine," what do you mean, exactly? The tailbone itself, or the area around it, or the SI joint, which is a little higher?

Since I started having back trouble, my sacrum has been tremendously sensitive. I even asked them to check the low-back X-rays they'd already done to make sure it wasn't cracked or something. They said sensitivity like that is just often associated with low back issues.
posted by galadriel at 6:01 PM on December 3, 2010

It might be a cyst, it might be a sensitivity because of low back pain, it might be the result of a childhood injury you don't even remember, it might be otherwise-asymptomatic spina bifida occulta (which may affect as many as 10 percent of adults).

I would just, you know, tell people not to touch you there, because it's a highly sensitive spot for you. Anyone who doesn't honor that is a crappy massage therapist or physical therapist, and you should find someone else who isn't so dismissive of clients' concerns.
posted by Sidhedevil at 6:16 PM on December 3, 2010

Though restless_nomad's and yeloson's suggestions that you could get this checked out quite easily, insurance/payment issues permitting, make good sense. Something to think about.
posted by Sidhedevil at 6:18 PM on December 3, 2010

I have the same issue which I recently had checked out via an MRI. They said I have two minor issues. One is facet arthritis, which has to do with where the vertebra bones meet each other (age related; I'm almost 40). The other is spinal stenosis, which is a narrowing of the spinal canal (in my case likely due to being overweight).

In addition to being very sensitive on my sacrum, I occasionally suffer lower back pain that starts at about L3 or L4 and goes down the tail bone, and also goes out along the right iliac crest (top of the hip bone), and somewhat into the belly of the butt muscles (glutes, priiformis, etc.). It is always in the same spot(s) on the same side of the body. There is no numbness or tingling in my case, nor does the pain shoot down my leg. Those symptoms are more indicative of a disc issue.

I find that I DO like getting massage in that area as long as the pressure is where I can tolerate it (even if that's just barely touching the area). It hurts somewhat while I'm getting the massage, but afterward there is relief which can be fairly long lasting. There isn't a lot of tissue on top of the sacrum, so "deep tissue" means something a little different in that area! ;) One technique that I find I like is for the therapist to put the palm of their hand down on my sacrum, apply mild pressure, then move the hand around without sliding the palm over the skin at all. It's a very localized movement that helps target the fascia tissues. Let me know if you need a better description of the movement.

I hope you're able to find some answers! The only reason I finally got this checked out is because we met our deductible this year after I had to have surgery for another issue. Also, I was referred to a neurosurgeon, but I decided not to go because my issue is rather minor.
posted by wwartorff at 6:49 PM on December 3, 2010 [1 favorite]

I'm inclined to wonder about your SI joint, and if it is causing a referred type pain. I'm having issues with my SI joint and physical therapy has been helpful. But you need a diagnosis first, it may be something else.

If it were me, I'd be getting it checked out. Piece of mind is sometimes worth the hassle of getting to the doctor. Maybe there could be a decrease in the amount of pain by getting whatever it is treated.
posted by 6:1 at 11:54 PM on December 3, 2010

That sounds exactly like my sacroiliitis (inflammation of the SI joints). When the rest of the inflammation is under control, it doesn't bother me as long as no one ever touches it.
posted by hydropsyche at 5:59 AM on December 4, 2010 [1 favorite]

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