Coccydynia (or a painful coccyx) presents as pain isolated to the tailbone only.  The coccyx is the very end of the tailbone.  Most individuals with coccydynia are uncomfortable when sitting, especially when sitting directly on the tailbone, and may be uncomfortable when lying down flat on the back because of the pressure this position places on the tailbone.  Laying on one side or the stomach is more tolerable.  The most comfortable positions for a person with coccydynia are usually standing or walking, positions that relieve the pressure on the tailbone.  However, in a patient with a severely irritated coccyx, the motion of walking may further irritate the soft tissues and cause worsening pain.

Coccydynia typically is not associated with leg pain.  In the situation of leg pain, especially pain that travels below the knee in a radicular pattern (pain that shoots down the leg in the distribution of a nerve root), other sources of pain should be investigated, such as a disc herniation.

The key to making the diagnosis of coccydynia is a thorough history and physical examination.  A physician can localize the area of greatest discomfort to the coccyx and rule out other sources of pain.


Two causes of coccydynia exist.  The most common cause is trauma to the area.  Most of the time an individual with coccydynia incurred a specific injury, either directly falling on the tailbone with great force or being hit directly on the tailbone.  Sometimes the patient does not recall the injury until direct questioning.  The reason behind the pain in individuals who incurred a direct injury to the coccyx is a strain of the sacralcoccyx junction or a broken coccyx.  If the pain decreases with time, then the bone is healing and the problem is being solved by Mother Nature.  If the pain continues unabated or worsens, then the bone is not healing properly (a fibrous union), or has not healed at all (a non-union).

The second cause of coccydynia is congenital (the patient is born with an abnormal coccyx).  The coccyx is a remnant of a tail from a time in which man was less evolved (apes) that has not yet been fully lost in our evolution.  At this time, it serves no function for bipeds (beings that walk upright with two feet) that has been identified by anatomists.  The coccyx typically fuses to the rest of the spine as part of the normal human anatomy.  However, in some patients it remains a separate bony fragment.  Over time, if enough motion occurs between the unfused portion of the coccyx and the remainder of the spine, pain can occur.  Some individuals with an unfused coccyx will never experience pain in the area, while others will.  It is impossible to predict which individuals with unfused coccyx will experience pain.

One common event, which can begin the pain cycle in patients with an unfused coccyx, is pregnancy.  Most likely the stress of vaginal delivery and also the extra pressure on the coccyx during pregnancy irritate an unfused coccyx.


The primary symptom of degenerative disc disease (or internal disc disruption) is midline back pain. Individuals with DDD often experience “referred pain” in the buttocks, pelvis (iliac crests), sacroiliac joints (felt in back of the hips), and the back of the thighs. A referred pain is one that stems from a structure, in this case the disc, but is felt a short distance away. Pain associated with DDD is greater when sitting and standing than when lying down, which decreases the pressure on the degenerating disc. Individuals with DDD usually have difficulty finding a comfortable position when sitting or standing, and constantly have to change positions. Bending and lifting, especially heavy items, aggravate the pain and rising from a chair may be problematic. Although the pain associated with DDD may be felt while walking, it is usually not aggravated by prolonged walks.

In addition to the above, in more severe cases of DDD, individuals may experience symptoms of sciatica or a pinched nerve root, similar to that experienced by an individual with a herniated or slipped disc. The degenerating disc collapsing and causing a nerve root to be pinched causes these additional symptoms.


Discs are the cartilage that lies between the bony vertebral bodies of the spine. Since motion occurs in this area, these are considered a joint. As a natural phenomenon of the aging process, discs lose their water content and degenerate. Concurrently, tears occur in the outer lining of the disc (the annulus). In adults, the annulus has nerve fibers while the center of a disc does not. A tear in this outer annulus can be quite painful. Although these degenerative processes are part of the natural aging of the spine, the discs of some people degenerate much more quickly than others. Also, for reasons as yet unknown, some individuals experience much more pain from these degenerative changes than others (see section under imaging studies about results of MRI).

The symptoms of DDD typically follow one of three courses:

  • a significant injury followed by sudden and unexpected back pain;
  • a trivial injury accompanied by significant back pain; and
  • a gradual onset and worsening of midline low back pain;
  1. Sudden and unexpected back pain following a significant injury: Some individuals can identify specific episodes (such as weight lifting, a fall onto the legs or buttocks, or a sudden twisting motion) immediately preceding the onset of back pain. For these individuals, the sudden or unexpected episode may have brought to light an already degenerating disc or caused a new annular tear to a degenerated disc. The unexpected incidents are usually of a form that causes vertical pressure upon the spine, compressing or pushing together the disc space. Examples include jumping onto your feet from a height, or putting weight on your head. This form of compression is often referred to as “axial load”.
  2. Trivial injury accompanied by significant back pain: A second group of individuals incur a trivial injury to their back, often work-related. These individuals typically have a history of significant DDD with symptoms that were less severe than those accompanying the new injury.
  3. Gradual onset and worsening of midline low back pain: A final group of individuals cannot specifically remember an accident that caused the pain to begin. Instead, the pain worsened gradually as the disc degenerated.

A genetic predisposition to having bad discs is the most common risk factor for DDD. The second most highly correlated risk factor for developing DDD is a history of smoking. Job-related risk factors include activities that place physical pressure on the back, such as handling particularly heavy material, repeated lifting while in the upright position (assembly line and manual laborers), and being subjected to vehicular vibration (truck drivers). Leisure activities that repetitively place strain on the back have also been implicated in causing DDD. By example, recent studies have identified an increased incidence of DDD among elite soccer players, golf players and competitive weight lifters.


Taking an active, targeted approach to your home services Web marketing campaign is key to

The linkage process involves finding Web sites that fit well with your own business, product line and services, but are (of course!) not in direct competition with you. your success. And one of the most fundamental methods of promoting your Web site is through strategic linking.

Simply by getting other targeted Web sites with high volumes of traffic to link to you, a percentage of their traffic will become your traffic.

This can increase your sales exponentially.


In fact, strategic links can generate more traffic to your site than anything else (other than getting – and keeping – a top #1-5 position on a major search engine).

The drawback to the linkage process is that it’s plain hard work.

Automated systems (such as free-for-all (FFA) links pages) are not the answer. They deliver inferior and generally useless results, unqualified tire-kickers and endless spam.

Don’t go the FFA route – it will NOT build your business because it isn’t targeted.

The truth us that links to get targeted, qualified site visitors – your potential customers – can ONLY be generated through one on one contact with other site owners, one email at a time.

Your successful linkage campaign will require plenty of hours, effort and relationship building skills, but the benefits include… More traffic. Better search engine positioning. More profits and sales.

Even with these benefits, are you wondering if your efforts will be worth it? Here are 3 useful incentives to keep in mind:

1. You will make your site a destination of choice

You will add lots of value to your site and become a ‘favorite’ by creating a reciprocal links page. Build strong bonds with sites that already have lots of exposure. Give your visitors the quality they seek, and they’ll return again and again.

2. You will improve your search engine rankings

Quality links are essential. The higher traffic sites you have linking to your site, the more popular you become. The more popular your site appears to the search engines, the higher it will be ranked.

3. You will boost your credibility

You will boost your exposure and your credibility. Having sites link back to you is as good as an endorsement, and direct marketers know that endorsement marketing generates a lot more sales.


Believe or not, a possible career for medical assistants is working in the judicial system as a medical assistant or a certified nursing aid. Prisoners and inmates often contract illnesses or sustain injuries from other inmates or as punishment for disobedience. While there is certified professionals within these facilities who take care of these kinds of patients – the number of incoming cases can be overwhelming, so hiring medical assistants (or certified nursing aids) will help ease the work load.

While the job itself poses some threats and even anxieties due to the work setting it does offer a lot of pros. Government institutions pay well and have great benefit packages. Not to mention that it is the sort of career that always has openings due to the negative stigma given by others. But if you are worried about the job and would like some tips before beginning a career as a prison CAN or MA here are some tips.

  1. You will be lied to – inmates tend to be very subtle and cunning when it comes to getting what they want from people. Remember, you are dealing with charged and convicted people. While some could have a change of heart most do not and are in there for a reason. Be tough. Be familiar with dealing with manipulation, lying, and over dramatization.
  2. You will be safe – despite having one-on-one time with inmates there will always be a security officer nearby if not right next to you the entire time. Safety is the number one most important element of these facilities, and the guards take their job very seriously. As an employee you will always be kept safe by the guards, and there is never a moment in which you are truly alone with an inmate.

Have you ever asked anyone, whether a health care worker, a colleague, or even a friend or neighbor, just what it means to be titled as a medical assistant? As in, what does your career and title stand for? Usually, two things will happen. The first will be that someone will say, what the flip is medical assisting? And the second someone will say, hey let me think about that for a moment or two before returning with two answers: I don’t know and the title of some job.

So what kind of meaning do medical assistants give to their title?

It’s all a matter of a pride. Whether they say so or not, MA’s have a great sense of pride when it comes to the work they do. Because not every medical assistant goes out and gets certified, their pride in helping others, managing a business, and being efficient workers will sometimes land them the job without needing certification.

Medical assistants take pride in being able to practice what they have studied on others. They didn’t complete an MA program just for the pay and benefits, they did it for the experience and because they either care about others and want to help them, or are just genuinely interested in medical procedures and processes. Medical Assistants typically want to go out and get certified, to move up in the ranks of the healthcare industry, and to one day either be CMA’s or LPNS, so that they can really get their hands on more clinical work as opposed to administrative duties.

One last thing that defines the title medical assistant is their commitment to excellence. They will work very hard in order to learn more and keep the office running. Most MA’s are just looking for a chance to get experience and move up, and if they get that chance they will give it their all.

Working in the healthcare industry can be really hard. Not just because you have a numerous amount of tasks, tests, and resupplying to do for whatever facility you are employed for, but because you also have to deal with patients of all kinds: the good, the bad, and the ugly. Whether it is in a physician’s office, hospital, or free clinic, trained Medical Assistants will have to learn how to cope and deal with a variety of patients. A Medical assistant associate’s degree will train you how to handle these situations but here are a few tips that could help you overcome potential bad patients.


Don’t Bait them

Try to be as calm and cool as possible. Being a bit non-chalant will help patients not take your words out of context and rise to an unneeded and unnecessary argument. Some of the worst patients will make very snarky comments to try and rile you up, so just act like you didn’t even hear them , or that you just don’t care about what it is that they have to say. Usually they will critique how much time it has taken for them to get into the patient room from the waiting room, and they will try to make you feel incompetent, so don’t let them rile you up, and don’t say anything that might bait their bad behavior.


Stay cool

Don’t let their bad behavior rile you up into retaliation. Control your fight or flight response to bullying situations, and just keep a calm and expressionless face. This way they can’t feed off of your energy or expression and file a complaint against you. It has happened time after time, and the littlest of things can be turned against you when it comes to the health care industry. Make sure to always be gentle and caring but not too overbearingly positive.

Occasionally aging is a discomfort inside the throat, actually. As people era, just about everyone encounters some extent of cervical vertebrae damage. Most physicians consider the reason that is therefore common is really because after many years of our neck bones that are fairly little supporting a 9 or 10-pound head, they simply begin to wear-out. Several of the folks who’ve serious cervical deterioration may end neck arthritis that is developing up. Several of the typical indicators of neck arthritis include, difficulty retaining harmony, serious neck pain, plus a stiff neck.

Exercise Will Help
Many individuals automatically grow their neck to ease the discomfort. However, although stretching can help to your level, weight training continues to be identified to lead to throat pain relief that was important, regardless of cause of the discomfort. The outcomes are usually a lot more substantial in girls. One study found that throat pain relief that was “considerable” was described by one in four females. You could find that your ability laterally together with to shift your throat down and up may also improve.

Extending Will Help
Although not fundamentally as successful as exercise, extending may also help with serious neck pain alleviation. Extending can not be most useless if accomplished before and after exercising. Your neck muscles loosen and aids with flexibility, reducing chances of injuring oneself while training. After training extending also can lessen muscle aches the following day.

Exercise Tips

  • Stretch after exercising
  • Start the consistency and repetitions easy when you grasp the workouts raise, and do several reps out on a weekly basis.
  • Exercise your neck on the daily basis
  • Try going to bed before and after extending. This can help stop morning neck stiffness caused by neck arthritis.

If you suffer with chronic throat pain, our NJ Pain Center is here to help. We have been assisting New Jersey citizens for our board-certified and many years’ pain doctors have decades of expertise working with neck ache caused by arthritis. Contact us today to guide an appointment online, or book an appointment.