Specific medical concerns can require a referral to specialist
As pain continues after wheelchair adjustments, next step is a specialist
It is important to reach out to other healthcare professionals if you are working with a patient who has a long-lasting complaint you are not able to fully solve. Michael, a patient I work with who has spinal muscular atrophy, has continued to experience increased tailbone pain since moving into his new wheelchair which has a new seat cushion.
Since my last article, we met with the company that supports his wheelchair to see if any adjustments could be made to improve his comfort. After this evaluation, it was determined Michael was sitting too far back on his cushion and in the incorrect spot. The wheelchair representative was able to make adjustments so Michael was sitting in a more comfortable place on the cushion.
This allowed for reduced pressure on his coccyx and increased comfort while sitting. She also has plans to adjust the footrest to give his feet more support as the right foot continues to exhibit increased plantar flexion, or toe-down, position. Both of these significantly helped, allowing him to sit for several hours without pain in his hips and reducing the pain going down his leg.
His primary care doctor suggested he make an appointment with a neurosurgeon to have them look at his coccyx and give their expert advice as to what options there are for increasing his comfort. We know there is swelling along his coccyx, or tailbone, from prolonged pressure to the area, and we also know there are a lot of nerve roots and nerve endings around that area. That makes it a difficult and risky spot for any surgical interventions.
We are unsure if there will be any options, such as injections or anything surgical, but this is why we feel it is best to seek the advice of a specialist. For many reasons, it is important for Michael to seek out a spinal surgeon for specialized knowledge and options for pain control going forward.
Although I have attempted many options to reduce this pain, this has been a time that I am able to manage the pain, but not fully subside it or figure out why it continues. I will continue to explore new options I can perform and continue to reach out and refer to other specialists as needed to ensure Michael gets the best care and has the most options available.
Patient perspective
If anyone had told me years ago I would be uncomfortable sitting in my wheelchair, I probably would’ve laughed. The problem with getting older is that little aches and pains tend to crop up without any kind of notification. These little monsters in our life come out of the closet and bite us in the backside.
I’m scheduled to see a spinal surgeon in the next few weeks, with hope he will be able to locate the source of my problem. While I’m optimistic, I’m also going into this meeting realistically. Many of those in pain are looking for a miracle treatment, but that only happens in a few specific cases. While nobody wants to hear bad news, I’m hoping that they find something that can be either remedied or reduced.
I’m not looking for a miracle, I’m looking for answers.
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