Hi! I've (male 34) been having rectal pain and tailbone pain on and off for five years now. It started with a fissure in 2013 that healed but the pain went on. I've been to surgeons, have been examinated under general anesthesia, botox shots to sphincter muscles and creams of all sorts with little to no relief. After being in pain for two years, nearly bed-ridden I really wanted to try to get my life back. I started excersising two to three times a week and after a couple of months I started to improve. I've been completly free of pain for long periods of time but it always comes back. Triggers seems to be sitting for too long. This year has been excellent with no pain from January to September when I had to sit through a course at work. It started with a low grade pain as it usually does but I quickly became obsessed and anxious about it which made the pain ramp up to unbarable levels. I've recently been seen by a physiotherapist that noticed that the tip of my tailbone was extremly tender to touch with an increase in pain afterwards. No real pain to speak of inside the anal canal (had a doctor check-up 1.5 months ago). I've never injured the coccyx which makes me (and the physio) believe the pain comes from tension. Yesterday was a good day until noon when I could feel the pain coming on. I had been free of pain for four days before this. I tried to massage and put some pressure on the tailbone which really aggravated the pain to the point of which I had to take an oxycodone 5mg and 2x500mg acetaminophen to cope with the pain. This morning for some stupid reason I started massaging the tailbone once again with an extreme onset of pain as a result. It feels like there's some extreme tender points on the tip of it. Last week was good overall, but right now I'm having doubts and don't know where to turn to. I live in Sweden where no one has ever heard of TMS. Pelvic floor therapy is barely recognised or utilised here either, and frankly I don't think I need it. I really could use some encouraging advice right now. I struggle with extreme anxiety, hypervigilance and obsessive thoughts about this whole situation. I'm usually completly free of pain when I wake up, then pain gradually builds during the day. I realize that if there was an underlying structural issue I wouldn't be free of pain for a couple of days, weeks, months or almost a year and then suddenly in hellish pain. Everytime before this goes away after a painful couple of weeks or months it starts with me being a bit calmer, relaxed, less anxious, like I've started to accept the situation. If I manage to maintain this state of mind the pain usually dissipates after a couple of days but it's always hard to get to that point. Right now I feel completly lost. Today has probably been my lowest point ever. I don't think that any repressed memories or such are to blame but I do feel like my extreme fear and anxiety about the pain is causing this issue, it's an evil loop of despair. Please help!