Mechanical diagnosis and therapy in chronic postpartum isolated coccygeal pain: a case report

To describe the use of Mechanical Diagnosis and Therapy in evaluating and treating a patient with chronic postpartum isolated coccygeal pain.

A 30-year-old female presented with isolated coccygeal pain that began after a vaginal birth 4 months prior. Aggravating factors included sitting and standing upright. She also expressed fear of transitioning from sitting to standing.

A directional preference for lumbar extension with right lateral flexion was identified, leading to a diagnosis of lumbar derangement and initiation of reductive forces. At follow-up, she maintained reduction and reported periods of being pain free with less fear of movement. Subsequently, force progressions were implemented. By visit 6, she was discharged with symptom resolution and functional improvement.

This case demonstrates the utility of applying the principles of Mechanical Diagnosis and Therapy in the evaluation and treatment of a patient with chronic postpartum isolated coccygeal pain who failed previous treatments.