Pain in the coccyx is quite rare. Sometimes it causes severe discomfort and leads to a malfunction in the usual rhythm of life. There are times when the pain goes away on its own without serious complications. However, in most cases, this type of discomfort indicates serious pathological changes that occur in the body. Pain in the coccyx is an occasion to see a therapist who will refer you to a neurologist or orthopedist and traumatologist.
Anatomy
The tailbone is the end of the spinal column. Through semi-movable articulation, it is attached to the sacrum and is essentially considered a vestigial.
A person can often experience pain in the coccyx when standing up. What does it mean?
This bone includes several vertebrae called the caudal, which are not separated by scientists and are perceived as an integral structure. The tailbone is similar in shape to the sacrum, it forms the bowl of the human pelvis. In total, the anatomy distinguishes four coccyx configurations, the difference of which is in the direction and angle between the coccyx and sacrum. It is believed that for the most part, idiotic pains, that is, those appearing without specific and obvious reasons, fall on the last, fourth type.
Contrary to its rudimentary origin, the tailbone performs a number of functions. For example, tendons, muscles and ligaments are attached to it, the functionality of which includes support for internal organs and the formation of the pelvic floor. In addition, during sitting, the person’s weight is distributed to the coccyx and ischium.
Symptoms
Coccygodynia or pain in the tailbone most often occurs in people over 40 years old. In women, this phenomenon is much more common than in men. The following symptoms are characteristic of coccyalgia:
- Discomfort during intercourse.
- In rare cases, difficult bowel movements occur.
- When leaning forward in a seated position, pain relief occurs.
- The pain becomes more intense when rising from a place and with prolonged sitting on a hard surface.
- Palpation of the coccyx area causes pain.
- The pain syndrome is clearly localized and focused on the tailbone.
There are also other symptoms and signs of this syndrome, however, they differ depending on what caused the pain in the coccygeal bone. In any case, with the manifestation of pain in the coccyx, you should consult a doctor, as this may indicate the presence of a serious pathology of the spine.
Injury as a cause of coccyalgia
Coccyx injury is the most common cause of pain. The following types of injuries can cause the syndrome:
- Injuries during childbirth.
- Exposure to the coccyx of a chronic nature, for example, when riding bicycles.
- Blow directly to the tailbone. This can happen during martial arts.
- Falling on the coccyx bone in a sitting position.
Time after injury
A fairly long period of time may elapse between a fall or a stroke and the onset of the first symptoms of coccyalgia. For this reason, it is often difficult to compare existing complaints with an injury. In most cases, a fracture is the result of a strong blow to the coccyx, and a subluxation appears most often during childbirth.
Difficult birth
When childbirth occurs in normal mode, the coccyx moves backward while the baby is moving along the birth canal. This allows you to expand the pelvic bones to facilitate the exit of the fetus. However, in the case of complex childbirth, the tip may cross existing boundaries, resulting in a dislocation. At the same time, the bone becomes too mobile and painful when sitting and standing.
When is the pain in the coccyx in women possible?
During pregnancy
During pregnancy, pain in the coccygeal bone may also occur, but this phenomenon is considered physiological and should not cause concern. Ligaments of a woman in this period are in constant tension and in a state of high load, which leads to coccyalgia. Such sensations pass on their own, but the doctor needs to be told about them, since pain can indicate the presence of a tumor, cyst, or hemorrhoids.
What are the other possible causes of pain in the coccyx when sitting?
Pilonidal disease
Pilonidal cyst or epithelial coccygeal passage is a pathological process that begins in the hair follicle on the skin of the back in the coccyx. Hair grown under the skin allows bacteria to penetrate the hole formed. This process provokes the development of a cyst, which can burst and go outside in the form of pus. This disease causes severe discomfort. However, sometimes the disease passes latently and is detected randomly with complaints of back pain in the coccyx.
It is believed that a large role in the formation of cysts has a genetic predisposition to their formation. Other factors that can lead to pilonidal disease are considered overweight, inadequate personal hygiene, a sedentary lifestyle and abundant hair growth on the body. In America, this disease is called a jeep, which is associated with complaints by American soldiers about tearing abscesses after a long jeep off-road ride. After all, pain in the coccyx in men often goes unnoticed.
Signs
Signs of pilonidal disease are:
- Soreness in the formation of cysts.
- Swelling and redness of the skin around the affected area.
- Visualization of the passages and holes after a cyst breakthrough.
- Fever.
In order to confirm the diagnosis, an ultrasound study and an x-ray are performed. Sometimes a cytological examination of the contents of the cyst is performed. Therapy of suppuration consists in opening the abscess surgically and cleansing the resulting wound from pus. If there are several fistulous passages, then during the preoperative preparation a special dye is introduced into them. During the surgical intervention, all moves are excised, and after cleansing, a sterile dressing is applied. If necessary, preparations from a number of antibiotics can be prescribed after surgery. Quite often, pilonid disease manifests itself repeatedly. The causes of pain in the coccyx should be identified in a timely manner.
Diagnostic Methods
There are several methods for identifying the cause of pain in the coccygeal region. The most common are:
- Palpation. This is the first thing the doctor does during the examination. Palpation is performed to determine the localization of pain. It is checked whether pain increases with pressure on the coccyx. The affected area can be up to 6 centimeters around the tail bone. Feeling the coccyx during rectal examination is also a very informative diagnostic method. This procedure makes it possible to evaluate bone motility and exclude the presence of a tumor in the rectum or vagina.
- X-ray examination. Allows you to determine the presence of fresh or even chronic injuries that can cause pain. It should be borne in mind that for many people, the structure of the coccyx may have individual characteristics and they are not always pathological. Therefore, x-ray is not a highly accurate diagnostic method.
- MRI and ultrasound. The latest study makes it possible to exclude the presence of inflammatory diseases or tumor neoplasms. Magnetic resonance therapy allows differential diagnosis to exclude diseases of the spinal column, including hernias. Also, MRI helps to exclude pathologies of the bladder and female reproductive system.
- Bone scintigraphy. It is carried out in case of suspected metastasis of the spine. During the study, a radioactive isotope is introduced into the body with further registration of its radiation.
Treatment
Therapy for pain in the coccyx is carried out depending on the cause that caused it. If this is an inflammatory process, then antibacterial therapy is prescribed, as well as anti-inflammatory drugs. Neoplasms of a benign or malignant type involve chemotherapy and surgical intervention. A fracture or dislocation may require reduction.
Standard therapy
If the diagnosis of coccygodynia is established, then standard therapy is carried out, consisting in the following:
- Nonsteroidal anti-inflammatory drugs. This is a symptomatic treatment. It is performed to relieve pain in order to improve the patient's standard of living. All drugs in this series have similar contraindications and side effects. It is not recommended to use them for more than 5 days.
- Laxatives They are prescribed if coccyalgia provoked problems with bowel movements. This is a psychological problem caused by the need to push, which can cause severe pain.
- Local anesthesia It is used in cases where oral administration of painkillers does not give a result. Most often, the injection is made directly into the coccygeal region.
- Orthopedic pillows. They are special pillows in the shape of a donut or wedge. These devices allow you to remove the load from the coccyx and avoid contact with a solid surface.
- Physiotherapy will help relieve lower back pain in the coccyx. Appointed after removal of inflammation. This can be either magnetic, laser or ultraviolet treatment, or paraffin baths, etc. The purpose of the procedures is to relieve muscle spasm.
- Surgical removal of the tailbone. It is used very rarely. The operation is called coccycotomy. It is prescribed in cases where other methods of treatment have been ineffective. Postoperative rehabilitation takes a lot of time, and the risk of complications is quite large, therefore this method is used only in the most unfavorable prognosis for the patient.
Only comprehensive treatment under the supervision of a doctor will help to permanently get rid of problems with the spine.