Understanding My Mother's Post-Fall Pain

Question #28167

45 days ago

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Understanding My Mother's Post-Fall Pain - #28167

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Hello doctor. I would like to ask about my mother’s condition. She had a fall in December. After the fall, she had pain for about 15 days. The pain improved slightly at first, but after some time it started to get worse again. Now she has almost constant pain with occasional sharp stabbing sensations. The pain is located in the cleft between the buttocks, slightly above the anus, more toward the right side. The pain gets worse when she sits, bends forward, walks a lot, or when she strains during bowel movements. It improves when she lies down, rests, or avoids physical activity. The pain is quite severe. She describes it as very strong and constant, and at times it reaches a **10 out of 10 in intensity**. For example, about two days ago she said the pain was extremely intense, around 10/10. She also feels that the area is **very inflamed**, even without touching it. Yesterday she bent forward and touched the painful area and felt that it was quite swollen. She said that was the moment when she noticed the most inflammation. She also mentioned that sometimes when she passes gas during a bowel movement, a small amount of mucus-like discharge comes out. Normally she is very active and walks a lot, but on one day when she stayed resting almost the whole day, she noticed a slight improvement in the pain. She has already been examined by a doctor who did not think the problem was directly related to the rectum. He prescribed vitamin injections for 10 days, prednisone, and amitriptyline. We would like to know what could be causing this type of pain after a fall, and whether it could be related to nerve inflammation, a soft tissue injury, or another condition in that area. Thank you very much for your help.

How long has your mother been experiencing this pain since it started worsening?:

- More than 2 months

Has she experienced any other symptoms besides pain and swelling?:

- No, just pain and swelling

What treatments has she tried for the pain so far?:

- Over-the-counter pain relievers

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Doctors' responses

Dr. Aarav Deshmukh

I am a general physician with 8 years of practice, mostly in urban clinics and semi-rural setups. I began working right after MBBS in a govt hospital in Kerala, and wow — first few months were chaotic, not gonna lie. Since then, I’ve seen 1000s of patients with all kinds of cases — fevers, uncontrolled diabetes, asthma, infections, you name it. I usually work with working-class patients, and that changed how I treat — people don’t always have time or money for fancy tests, so I focus on smart clinical diagnosis and practical treatment. Over time, I’ve developed an interest in preventive care — like helping young adults with early metabolic issues. I also counsel a lot on diet, sleep, and stress — more than half the problems start there anyway. I did a certification in evidence-based practice last year, and I keep learning stuff online. I’m not perfect (nobody is), but I care. I show up, I listen, I adjust when I’m wrong. Every patient needs something slightly different. That’s what keeps this work alive for me.

43 days ago

Given the symptoms you’re describing, your mother’s pain pattern is suggestive of a few possible conditions, primarily involving the musculoskeletal and neurological systems. Given the location and characteristics of the pain, coccyx injury or sacral fracture following the fall could be contributing factors, particularly if there was direct trauma to the tailbone. Her symptoms fitting the setup for coccygeal pain which is often exacerbated by activities like sitting or bending, occurs frequently after falls. To clarify this possibility, I would recommend an x-ray to identify any potential fractures or degenerative changes. However, the sharp pain and the nerve-like quality raise the suspicion of a nerve involvement as well, such as irritation or compression of the sciatic nerve or sacral nerves.
Inflammation from soft tissue injury or even the development of a sacrococcygeal pilonidal cyst might also explain the swelling and tenderness. The mucus discharge during bowel movements is suggestive of rectal-related conditions but considering the assessment already covered this area without immediate concern, soft tissue infection or abscess might also be worth considering. The medications prescribed, such as prednisone and amitriptyline, aim to reduce inflammation and nerve pain, respectively, which seem appropriate given the mixed presentation. If symptoms persisting unchecked or worsening, reevaluation through imaging studies—potentially an MRI if nerve impingement or further soft tissue detail is needed—might be required.
It’s crucial she avoids prolonged sitting or physical exertion when the pain is flaring. Encourage bed rest and use of cushions or doughnut pillows to minimize coccygeal pressure. Engage her physician to re-evaluate if she’s not improving or if new symptoms appear, especially concerning signs like fever, severe weakness, or loss of bowel/bladder control. In the meantime, gentle physiotherapeutic exercises to stretch and strengthen the lower back can be beneficial but should be supervised by a professional considering her pain. Within confines of existing prescriptions and advice given, managing pain adequately is key; consider topical analgesics or adjusted dosages upon discussion with her doctor if current measures aren’t sufficiently effective.

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Dr. Shayeque Reza

I completed my medical degree in 2023, but honestly, my journey in healthcare started way before that. Since 2018, I’ve been actively involved in clinical practice—getting hands-on exposure across multiple departments like ENT, pediatrics, dermatology, ophthalmology, medicine, and emergency care. One of the most intense and defining phases of my training was working at a District Government Hospital for a full year during the COVID pandemic. It was chaotic, unpredictable, and exhausting—but it also grounded me in real-world medicine like no textbook ever could. Over time, I’ve worked in both OPD and IPD setups, handling everything from mild viral fevers to more stubborn, long-term conditions. These day-to-day experiences really built my base and taught me how to stay calm when things get hectic—and how to adjust fast when plans don’t go as expected. What I’ve learned most is that care isn't only about writing the right medicine. It’s about being fully there, listening properly, and making sure the person feels seen—not just treated. Alongside clinical work, I’ve also been exposed to preventive health, health education, and community outreach. These areas really matter to me because I believe real impact begins outside the hospital, with awareness and early intervention. My approach is always centered around clarity, empathy, and clinical logic—I like to make sure every patient knows exactly what’s going on and why we’re doing what we’re doing. I’ve always felt a pull towards general medicine and internal care, and honestly, I’m still learning every single day—each patient brings a new lesson. Medicine never really sits still, it keeps shifting, and I try to shift with it. Not just in terms of what I know, but also in how I listen and respond. For me, it’s always been about giving real care. Genuine, respectful, and the kind that actually helps a person heal—inside and out.

40 days ago

severe pain in the cleft between the buttocks, swelling, worsening with sitting/straining, and occasional mucus-like discharge—suggest that this is more likely a local soft tissue or skin-related condition rather than just a nerve issue from the fall. One important possibility is Pilonidal Sinus, which commonly occurs in that exact location and can become very painful, especially when sitting or bending. Another possibility is a Perianal Abscess, which can also cause intense pain and sometimes discharge, even if initially not obvious externally. While a fall may have triggered inflammation or irritation in the area, the persistent severe pain (up to 10/10), swelling, and discharge strongly suggest that there could now be an underlying infection or cyst formation rather than just a simple injury or nerve inflammation.
The medications she was given (like prednisone and amitriptyline) can help with inflammation and nerve-related pain, but they do not treat infections or abscesses, and steroids like prednisone can sometimes mask or worsen infections. Because her pain is severe and ongoing for more than 2 months, she should be re-evaluated urgently by a general surgeon. A proper physical examination—and if needed, ultrasound or MRI—can confirm whether there is a sinus, abscess, or other structural issue. If an abscess or pilonidal disease is present, treatment may require antibiotics or a minor surgical procedure (drainage) for relief.

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Dr. Alan Reji

I'm Dr. Alan Reji, a general dentist with a deep-rooted passion for helping people achieve lasting oral health while making dental visits feel less intimidating. I graduated from Pushpagiri College of Dental Sciences (batch of 2018), and ever since, I've been committed to offering high-quality care that balances both advanced clinical knowledge and genuine compassion for my patients. Starting Dent To Smile here in Palakkad wasn’t just about opening a clinic—it was really about creating a space where people feel relaxed the moment they walk in. Dental care can feel cold or overly clinical, and I’ve always wanted to change that. So I focused on making it warm, easygoing, and centered completely around you. I mix new-age tech with some good old-fashioned values—really listening, explaining stuff without jargon, and making sure you feel involved, not just treated. From regular cleanings to fillings or even cosmetic work, I try my best to keep things smooth and stress-free. No hidden steps. No last-minute surprises. I have a strong interest in patient education and preventive dentistry. I genuinely believe most dental issues can be caught early—or even avoided—when patients are given the right information at the right time. That’s why I take time to talk, not just treat. Helping people understand why something’s happening is as important to me as treating what’s happening. At my practice, I’ve made it a point to stay current with the latest innovations—digital diagnostics, minimally invasive techniques, and smart scheduling that respects people’s time. I also try to make my services accessible and affordable, because good dental care shouldn’t be out of reach for anyone.

38 days ago

Your mother’s symptoms most strongly suggest either Coccydynia (tailbone injury after fall) or a Pilonidal Abscess, especially because of severe pain while sitting, localized swelling, and mucus-like discharge.
While a nerve-related cause is possible, the presence of swelling and discharge makes infection or a localized abscess more likely, which may require specific treatment rather than just pain control.
I strongly recommend prompt evaluation by a General Surgeon (or colorectal specialist) for examination and possible imaging, as delayed treatment can worsen pain and may require minor surgical drainage if an abscess is present.

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Dr. Bharat Joshi

I’m a periodontist and academician with a strong clinical and teaching background. Over the last 4 years and 8 months, I’ve been actively involved in dental education, guiding students at multiple levels including dental hygienist, BDS, and MDS programs. Currently, I serve as a Reader at MMCDSR in Ambala, Haryana—a role that allows me to merge my academic passion with hands-on experience. Clinically, I’ve been practicing dentistry for the past 12 years. From routine procedures like scaling and root planing to more advanced cases involving grafts, biopsies, and implant surgeries. Honestly, I still find joy in doing a simple RCT when it’s needed. It’s not just about the procedure but making sure the patient feels comfortable and safe. Academically, I have 26 research publications to my credit. I’m on the editorial boards of the Archives of Dental Research and Journal of Dental Research and Oral Health, and I’ve spent a lot of time reviewing manuscripts—from case reports to meta-analyses and even book reviews. I was honored to receive the “Best Editor” award by Innovative Publications, and Athena Publications recognized me as an “excellent reviewer,” which honestly came as a bit of a surprise! In 2025, I had the opportunity to present a guest lecture in Italy on traumatic oral lesions. Sharing my work and learning from peers globally has been incredibly fulfilling. Outside academics and clinics, I’ve also worked in the pharmaceutical sector as a Drug Safety Associate for about 3 years, focusing on pharmacovigilance. That role really sharpened my attention to detail and deepened my understanding of drug interactions and adverse effects. My goal is to keep learning, and give every patient and student my absolute best.

44 days ago

Hello dear
See i think it is trauma induced injury.
It seems very minor but could be detrimental in future.
I suggest you to please get following tests done and share result with orthopedician for better clarity
For safety and improvement please donot take any medication without consulting the concerned physician
Hopefully you recover soon
CBC
Esr
CRP
X ray pelvis
Pelvic USG
Ct scan
Mri if recommended by orthopedician
Merely medication will not provide permanent relief
Regards
Regards

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Dr. Arsha K Isac

I am a general dentist with 3+ years of working in real-world setups, and lemme say—every single patient teaches me something diff. It’s not just teeth honestly, it’s people… and how they feel walking into the chair. I try really hard to not make it just a “procedure thing.” I explain stuff in plain words—no confusing dental jargon, just straight talk—coz I feel like when ppl *get* what's going on, they feel safer n that makes all the difference. Worked with all ages—like, little kids who need that gentle nudge about brushing, to older folks who come in with long histories and sometimes just need someone to really sit n listen. It’s weirdly rewarding to see someone walk out lighter, not just 'coz their toothache's gone but coz they felt seen during the whole thing. A lot of ppl come in scared or just unsure, and I honestly take that seriously. I keep the vibe calm. Try to read their mood, don’t rush. I always tell myself—every smile’s got a story, even the broken ones. My thing is: comfort first, then precision. I want the outcome to last, not just look good for a week. Not tryna claim perfection or magic solutions—just consistent, clear, hands-on care where patients feel heard. I think dentistry should *fit* the person, not push them into a box. That's kinda been my philosophy from day one. And yeah, maybe sometimes I overexplain or spend a bit too long checking alignment again but hey, if it means someone eats pain-free or finally smiles wide in pics again? Worth it. Every time.

44 days ago

Hello
Severe tailbone (coccyx) or sacrococcygeal injury after a fall is a possible cause of this type of pain. Conditions such as Coccydynia, ligament strain, or inflammation of tissues around the coccyx can cause intense pain when sitting, bending, or straining, and relief when lying down.
Another possibility is a soft-tissue injury or inflammation near the gluteal cleft, and less commonly a Pilonidal cyst, which can cause swelling and occasional mucus-like discharge.
Since the pain is very severe (10/10) and persistent for months, it would be advisable for her to see a doctor again, preferably an orthopedic specialist or general surgeon. They may recommend a physical examination and imaging such as an X-ray or MRI of the coccyx/sacral area to rule out fracture, chronic inflammation, or a cyst.
If swelling, redness, fever, or discharge increases, she should seek medical evaluation promptly.
I hope this helps.
Thank you.
Take care.

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Dr. Prasannajeet Singh Shekhawat

I am a 2023 batch passout and working as a general physician right now, based in Hanumangarh, Rajasthan. Still kinda new in the bigger picture maybe, but honestly—every single day in this line teaches you more than textbooks ever could. I’ve had the chance to work under some pretty respected doctors during and after my graduation, not just for the clinical part but also to see how they handle people, real people, in pain, in panic, and sometimes just confused about their own health. General medicine covers a lot, right? Like from the smallest complaints to those random, vague symptoms that no one really understands at first—those are kinda my zone now. I don’t really rush to label things, I try to spend time actually listening. Feels weird to say it but ya, I do take that part seriously. Some patients just need someone to hear the whole story instead of jumping to prescription pads after 30 seconds. Right now, my practice includes everything from managing common infections, blood pressure issues, sugar problems to more layered cases where symptoms overlap and you gotta just... piece things together. It's not glamorous all the time, but it's real. I’ve handled a bunch of seasonal disease waves too, like dengue surges and viral fevers that hit rural belts hard—Hanumangarh doesn’t get much spotlight but there’s plenty happening out here. Also, I do rely on basics—thorough history, solid clinical exam and yeah when needed, investigations. But not over-prescribing things just cz they’re there. One thing I picked up from the senior consultants I worked with—they used to say “don’t chase labs, chase the patient’s story”... stuck with me till now. Anyway, still learning every single day tbh. But I like that. Keeps me grounded and kind of obsessed with trying to get better.

39 days ago

Hello
Thank you for describing her symptoms and the sequence of events so clearly. Based on what you’ve shared—pain and swelling in a specific area after a fall, increased inflammation when bending forward, and occasional mucus-like discharge during bowel movements—it’s reasonable to consider a few possibilities:
### Most Likely Causes
1. Soft Tissue Injury or Hematoma:

After a fall, bruising or swelling of the muscles, fat, or connective tissue near the rectal or perineal area is common. This can cause pain, swelling, and sometimes a feeling of fullness or inflammation, especially when moving or pressing on the area.
2. Nerve Irritation or Inflammation:

If the fall caused a stretch or compression of nerves in the lower back, buttock, or pelvic region, it can lead to persistent pain, sometimes radiating or worsening with movement. Amitriptyline is often prescribed for nerve-related pain.
3. Minor Anal or Perianal Injury:

Even if the doctor didn’t find a direct rectal problem, a small tear, fissure, or irritation near the anus can cause pain and sometimes mucus discharge, especially during bowel movements.
4. Less Likely but Possible:

- Localized infection or abscess (would usually cause redness, warmth, fever)
- Exacerbation of a pre-existing condition (like hemorrhoids or a cyst)
### Why Rest Helps
Resting reduces pressure and movement in the injured area, which can temporarily decrease pain and swelling.
### What to Watch For
- Increasing redness, warmth, or fever (could mean infection)
- Worsening pain or swelling
- Difficulty passing stool or urine
- Persistent or increasing mucus or blood in stool
### Next Steps
- Continue prescribed treatment and rest as advised.
- Apply cold packs (if swelling is recent) or warm compresses (if swelling is older than 48 hours) for comfort.
- If symptoms worsen or new symptoms develop, a follow-up with the doctor is important—sometimes imaging (like an ultrasound or MRI) is needed to rule out deeper injuries.
This type of pain after a fall is most often due to soft tissue or nerve irritation, but monitoring for any changes is important.
Thank you

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Dr. Nirav Jain

I am a qualified medical doctor with MBBS and DNB Diploma in Family Medicine from NBEMS, and my work has always been centered on treating patients in a complete, not just symptom based way. During my DNB training I rotated through almost every core department—Internal medicine, Pediatrics, Obstetrics & Gynecology, Surgery, Orthopedics, ENT, Dermatology, Psychiatry, Emergency medicine. That mix gave me the skill to manage acute illness, long term disease and preventive care together, something I find very important in family practice. In psychiatry I worked closely with patients who struggled with depression, anxiety, stress related problems, insomnia or substance use. I learned not just about medication but also about simple psychotherapy tools, psycho education and how to talk openly without judgement. I still use that exp in family medicine, specially when chronic disease patients also face mental health issues. My time in General surgery included assisting in minor and major procedures, managing wounds, abscess, sutures and emergencies. While I am not a surgeon, this gave me confidence to recognize surgical cases early, provide first line care and refer fast when needed, which makes a big difference in online or OPD settings. Now I work as a consultant in General medicine and Family practice, with focus on both in-person and online consultation. I treat conditions like fever, infections, gastrointestinal complaints, respiratory illness, and also manage diabetes, hypertension, thyroid disorders, and lifestyle related chronic diseases. I see women for PCOS, contraception counseling, menstrual health, and children for common pediatric issues. I also dedicate time to preventive health, lifestyle counseling and diet-sleep-exercise advice, since these small changes affect long term wellness more than we often realize. My key skills include holistic diagnosis, evidence based treatment, chronic disease management, mental health support, preventive medicine and telemedicine communiation. At the center of all this is one thing—patients should feel heard, safe, and guided with care that is both professional and personal.

37 days ago

Hello, thank you for sharing your concern. Based on your explanation, issues might be due to Coccyx injury or fracture, Soft tissue injury or ligament strain in that region or Local inflammation or swelling after trauma.
Pain that worsens on sitting, bending forward, walking, and straining, and improves with lying down, is very typical of tailbone (coccyx) injury.
However, the presence of swelling and mucus-like discharge suggests that there could also be a local infection, abscess, or pilonidal sinus, especially since the pain is severe and persistent. Here is my advise-
1. Avoid prolonged sitting (use a soft cushion or donut pillow). Give adequate rest and avoid strain. Use warm sitz baths (10–15 minutes, 2–3 times daily). You may use Tab. Paracetamol 650mg for pain relief.
2. Please get her examined again (preferably by a surgeon): She may need: Physical examination of the area. Possibly an X-ray of coccyx. If swelling persists, then Ultrasound/MRI.
3. Seek urgent care if: Fever develops. Swelling increases or becomes very tender. Pus discharge appears. Pain becomes unbearable.
4. The medications given earlier may help in some types of pain, but given the severity, swelling, and duration, a local structural or infective cause must be ruled out properly.
Overall, this condition is treatable, but she needs a proper re-evaluation and possibly imaging to identify the exact cause.
Feel free to reach out again.
Regards,
Dr. Nirav Jain
MBBS, D.Fam.Medicine

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