Lump on the tailbone in men and women: treatment, why it hurts and fluid is released

We can talk about the formation of a coccyx cyst if there is a congenital pathology - the epithelial coccygeal tract. The defect is a narrow canal lined with epithelium, one end extending into the intergluteal fold. Over time, fragments of exfoliated skin, hair, secretions of the sweat and sebaceous glands can collect in this cavity, which leads to the accumulation of fluid and the development of inflammation. A formed coccyx cyst requires immediate treatment, otherwise serious consequences for the body are possible.

What are the types of bumps on the tailbone?

A bump on the tailbone in men is a fairly common occurrence, especially with increased skin hair growth in the stronger sex. New growth is observed in various places in the lower back. It depends on the location which disease caused the problem:

Above the tailbone. Most often, ulcers form there. They are characterized by a dense structure and severe pain when pressed. The boil initially has a red tint, but as it develops, the skin around it swells and a white ball appears in the center, an accumulation of pus. Squeezing it out is strictly prohibited.
Under the tailbone. A lump develops in such a low position as a result of inflammation of the hair follicle, or is the result of the development of a dermoid cyst. A distinctive feature is the dense structure and the presence of suppuration. The coccyx itself is not involved in the process, although the patient feels moderate pain in it. The problem can only be solved surgically.
Near the tailbone (left, right). Sometimes this is how the epithelial coccygeal tract manifests itself. It occurs in many people. The pathology is congenital, but does not appear immediately. If the lump in the lower back becomes inflamed and causes severe discomfort, treatment is prescribed. It is not dangerous in itself, but requires surgical intervention. The sooner the patient consults a doctor, the higher the effectiveness of the chosen treatment tactics.
Below the tailbone. This is how a cyst appears, which occurs against the background of old injuries. If there is a crack in the bone structure, then gradually pus begins to accumulate in it. Everything can be removed only surgically.

A small lump in the lower back is called an epithelial coccygeal cyst and is a congenital pathology, which is characterized by a narrow structure of the canal located in the soft tissues of the sacrum. It occurs predominantly in men, but is sometimes diagnosed in women. The main age of the patient group is 15-26 years. The pathology develops gradually and is manifested by severe pain in the lower region.

How should you prepare for surgery?

The night before hospitalization for surgical treatment, it is necessary to shave the sacrococcygeal and, if necessary, the gluteal region. It is possible to perform laser (Alexandrite or diode laser) or photoepilation a few days before hospitalization. However, the last two methods are ineffective for removing light hair. Another method of hair removal is electrolysis; it is more painful, but is suitable for all hair types. The effect after the procedures may not be achieved immediately, so it is better to perform them in advance - 14 days before the operation. Shaving, as an alternative to hair removal, will take you less time and money, but at the same time it may damage the skin, which can become a source of infection. No other special preparation is required for the operation; it will be enough to refuse food and liquids 8 hours before the operation.

Causes

If a lump appears on the tailbone, the specialist’s main task is to determine the cause and location. A pathological process appears under the influence of various negative factors. The main ones are:

History of trauma.
Inflammatory process in soft tissues.
Pathologies of bone structures.
Osteomyelitis.
Haemorrhoids.
Proctitis.

Only a doctor can determine with high accuracy the reason for the appearance of a lump in the tailbone area, based on the provided medical history and the results of the study. Most often, the problem arises as a consequence of injury or illness.

Bumps often form in the tailbone area as a result of hypothermia

What to do in the postoperative period?

The period of time required for complete recovery after surgery is usually no more than 3 weeks, but in rare cases it can reach 1 – 3 months. The duration of the period of incapacity rarely exceeds 21 days, and the use of modern surgical technologies makes it possible to transfer the operated patient to outpatient follow-up treatment already 1-2 days after surgery. You need to be prepared for the fact that after surgery, a drain will be installed in the area of the postoperative wound for several days to actively remove discharge from the wound for several days. In the hospital, and then on an outpatient basis, you will undergo dressings to monitor wound healing. The attending physician and medical staff will tell you in detail what work and rest regime should be followed in the immediate postoperative period. In rare cases, antibacterial drugs will be prescribed for a few days. It may also be necessary to monitor wound healing using ultrasound.

How it manifests itself

A lump that appears near the tailbone may not manifest itself in any way or may be very painful, especially when pressed. In some cases, fluid is released from the formation, which also allows the specialist to make a diagnosis. In addition, other symptoms may be observed:

What is a fistula on the coccyx

The appearance of acute pain or discomfort during bowel movements.
The appearance of a hematoma next to the lump.
Frequent cramps of the gluteal muscle.
Body temperature rises to 38C.
Increased pain, even with minor physical activity.
A burning sensation in the tailbone area or the entire lower back.
Swelling and inflammation at the site of the lesion.
Painful intercourse or severe discomfort immediately after it ends.

The patient may accidentally feel a formation between the buttocks, or notice increased discomfort in the area after going to the toilet. They increase with a long stay in a sitting position, or an attempt to bend over sharply. Even a short rest brings relief.

Varieties

Lumps on the tailbone appear equally often in both men and women. The causes and types of the disease are very different. Which doctor should I contact? If there is pain in the tailbone area and there is a tightness there, you should consult an orthopedic surgeon and neurosurgeon. Additionally, you may need to visit a vertebrologist, vascular surgeon, oncologist or dermatologist. The main task is to determine the type of pathology. Let's take a closer look at what types of bumps are above or below the tailbone.

Furuncle

A lump appears on the tailbone in the form of an abscess filled with purulent contents. The presence of pain and inflammation suggests furunculosis. The main reason for the development of the problem is non-compliance with personal hygiene rules, wearing tight or poor-quality underwear. Boils also appear as a result of microtraumas of the skin, metabolic disorders, and systemic infectious diseases.

Treatment is conservative, but in some cases surgery cannot be avoided. The operation is aimed at eliminating purulent contents if there is a high risk of complications in people with reduced immunity, or in the presence of serious chronic diseases.

Carbuncle

A carbuncle is a purulent lump, which is often localized in the area of the coccyx. This is explained by the large accumulation of hair follicles in this place. The pathological process is characterized by the presence of an inflammatory process affecting the area around the sebaceous gland. The reason for the formation is non-compliance with personal hygiene rules, increased sweating, as well as the accumulation of dirt in the lower back.

The pathology manifests itself as acute suppuration, redness of the skin around the abscess and the formation of holes in the skin like small funnels. In addition to pain, the patient may experience signs of intoxication, headache, loss of appetite, nausea or vomiting.

Spina bifida

If the lump in the lower back hurts, then you can easily suspect a spina bifida. This is a protrusion of a hernial sac filled with cerebrospinal fluid. Against the background of the pathological process, disturbances in the functioning of the pelvic organs may be observed, paresis, intestinal or bladder dysfunction may occur. Upon palpation, a fixed, hard compaction is detected.

The problem is identified using an x-ray. Comprehensive therapy is prescribed, aimed at suppressing the inflammatory process and alleviating the condition. What do they do if it does not give the desired result? Doctors resort to surgery.

Hematoma with abscess formation

A lump on the tailbone may not hurt, but it can cause a lot of inconvenience. It often forms due to mechanical damage. If the hematoma is small, then it is simply observed. In most cases, it goes away on its own. If suppuration appears and fluid is released, surgical intervention is required.

Diagnosis of a lump on the tailbone begins with a visual inspection of the problem area

Osteomyelitis

The appearance of a lump in the coccyx area is also characteristic of osteomyelitis. A distinctive feature of the pathology is the presence of accumulation of pus in the lesion. The disease is diagnosed during the initial examination. The doctor prescribes complex antibacterial treatment with broad-spectrum drugs. It is unacceptable to try to open the formation on your own, stop medications, change or reduce the dosage. Otherwise, the disease is easily complicated.

Epithelial coccygeal cyst

This is a congenital anomaly that appears during embryonic development. It appears much later after birth, when suppuration forms. Body temperature can rise to 39C. Such a seal is opened independently, which brings significant relief to the patient. But such a fistula does not go away on its own; complex treatment and consultation with a specialist are required.

Is it always necessary to treat ECX?

The determining factor in choosing a treatment method for ECC is the form of the disease. An incidentally detected asymptomatic form of the disease does not require immediate urgent surgical treatment. In order to prevent the development of acute inflammation of the pilonidal cyst in the asymptomatic form of the disease, it is necessary to carry out daily hygiene measures, avoid traumatic effects on the area of the EC and wearing tight and tight clothing, and remove hair (using periodic shaving or hair removal) in the area of the intergluteal groove and buttocks. However, such preventive measures do not guarantee the absence of complications from ECX.

In the initial stages of the formation of an ECC abscess (infiltration stage), when the first symptoms just begin to appear (increasing pain in the area of the sacrum and coccyx, tissue swelling in the area of the intergluteal fold, a slight increase in temperature), it is possible to stop the inflammatory process by using antibiotics and removing the embedded tuft of hair.

Important! Even if the symptoms are not pronounced and develop slowly, it is necessary to consult a specialist as soon as possible to rule out more dangerous diseases and properly plan treatment!

Treatment should only be trusted to an experienced specialist, since it is not always easy to find the line between an abscess (this condition requires mandatory surgical treatment!) and the so-called infiltrate, when surgical treatment is ineffective. Sometimes visual inspection and palpation are not enough to determine the stage of the inflammatory process. Then an ultrasound examination of soft tissues comes to the aid of the specialist, which makes it possible to determine further treatment tactics.

Important! In all more severe cases, with other forms of the disease, surgical treatment is indicated.

If an acute abscess occurs, urgent surgical treatment is indicated, which is aimed primarily at evacuation of pus and rapid relief of the patient's condition.

Diagnostic procedures

A lump in the lower back requires consultation with a doctor. He will conduct palpation and visual examination, determine the structure and degree of development of the pathological process. If there is a purulent focus, an additional test is prescribed to determine glucose in the blood. This is necessary to determine the presence of an infectious process and the degree of sterility of the biological fluid. In addition, the following types of instrumental studies are carried out:

X-ray. It is used to determine the presence of injury or a crack in the bone structure, intervertebral hernia or osteomyelitis. It is easy to see the affected area in the image, so it is taken in several projections.
Fistulography. Used with a contrast agent. It is one of the types of x-ray examination. The image allows you to identify the branching of the fistula and the presence of damage in neighboring organs. Before the procedure, the tract is thoroughly cleaned and washed, filled with a contrast agent based on iodine and barium. The quantity depends on its length. The procedure is prescribed primarily before surgery.
Sigmoidoscopy. The technique is used to identify fistulas. A special device allows you to examine the rectal cavity, identify a tumor or abscess, and collect material for further research in the laboratory.
Ultrasound. Diagnostics allows you to determine the condition of soft tissues, identify cysts or tumors. It is painless and can be used as many times as necessary to clarify the condition.

Prescribed when the picture is insufficient as an additional MRI technique. The research method is expensive, but highly informative. With its help, the condition of the pelvic bones, spinal discs, vascular damage, and spinal cord infarction is revealed.

To eliminate acute pain, the doctor prescribes painkillers

Treatment methods

The choice of treatment method directly depends on the type of lump and the reason for its appearance. First of all, the patient is recommended to rest in bed, correct nutrition, and take medications. It is impossible to try to cure the problem using traditional methods on your own, since in most cases this provokes rapid progression of the disease and the appearance of complications.

Drug therapy

First of all, the patient is prescribed a group of drugs aimed at suppressing the inflammatory process and disinfecting the area. Medicines are selected individually, depending on the stage of development of the process, the presence of severe symptoms and the test results obtained. The following medications are usually used:

"Aspirin", "Traumel", "Ibuprofen", "Piroxicam". They are prescribed for severe pain syndrome to alleviate the condition. Additionally, some of them have anti-inflammatory and antipyretic effects.
"Novocaine", "Lidocaine". Pericoccygeal blockades are used infrequently, only if tablets and capsules do not cope with the task and do not eliminate severe pain.
"Baralgin" and "Dexalgin". Used in the presence of muscle spasms.
Nimid and Diclofenac. Prescribed for severe inflammation.
"Dolobene." It is used in the form of a gel if the patient has suffered an injury or severe bruise to the area.

Antibiotics and immunostimulants are used for osteomyelitis and other pathological disorders. Additionally, bactericidal agents, hydrogen peroxide, sea buckthorn oil or Sophora tincture are used.

For bruises and hernias, UHF therapy is especially effective as part of complex treatment

Physiotherapy

Physiotherapeutic techniques are prescribed as a complement to the main therapy. They are aimed at strengthening the body, as well as launching regenerative processes. The following methods of restoring damaged tissue are usually used:

Phonophoresis.
Paraffin therapy.
Diadynamic therapy.
Ultrasound therapy.
Darsonvalization.
UHF therapy.

All of them are effective for benign formations, bruises, and hernias. In a short period of time, they allow you to activate metabolism in the affected area, speed up the patient’s recovery, and normalize blood flow. Many techniques have immunostimulating, antispasmodic and anti-inflammatory properties.

Surgical intervention

A lump on the tailbone larger than 1 cm in size, which does not resolve for a long time, can begin to compress the spinal cord. To prevent serious consequences, it is removed surgically. The same solution is used for furunculosis, which is accompanied by an abscess. The decision is made by the doctor after a comprehensive examination of the patient. The operation is carried out in several stages:

The purulent contents are removed from the cone. This is done by medical personnel using a syringe.
The abscess is opened, the cavity is thoroughly drained.
As the inflammation subsides, the second part of the operation is performed, which involves excision of the coccygeal tract.

Surgery is also prescribed for chondroma. The endoscopic method, stereotactic therapy or radiosurgery is used for this.

Clinic, diagnostics, treatment in Moscow

If an acute process develops in the sacrococcygeal region, you should immediately consult a doctor. The Yusupov Hospital offers patients cozy inpatient rooms. Patients will be able to receive consultations from multidisciplinary doctors, undergo examinations using modern diagnostic equipment, take tests and receive effective treatment. Operations in the coloproctology department are carried out as planned and urgent; after the operation, patients are cared for by attentive and experienced medical staff. You can make an appointment with a doctor by calling the hospital.

Possible complications

If a lump appears in your lower back, you should not put off visiting a doctor. Trying to solve the problem at home and self-medicate can lead to serious consequences. Possible complications:

A benign formation, if left untreated, quickly degenerates into a malignant one.
Destruction of the rectal wall due to exposure to pus.
A rupture of the abscess and leakage of fluid from it into the bladder or vagina.
Blood poisoning due to pus entering the bloodstream (the most dangerous condition).
Complication of the inflammatory process, development of infection when trying to squeeze out the boil on your own.

If a lump is observed in a child, then seek medical help immediately. Immunity in children is usually worse, and therefore the pathological process occurs more rapidly.

A bump on the tailbone appears as a result of exposure to a number of negative factors or as a congenital pathology. Only a doctor can determine the cause and type of the disease. You will need to contact him immediately, especially if there is inflammation, swelling, or acute pain. Only timely comprehensive treatment can slow down the process and avoid the development of serious complications.

Treatment of coccyx cyst (preoperative examination, preparation, operations)

Treatment of coccyx cyst is surgical.
To clarify the diagnosis and exclude other pathologies (rectal fistulas, presacral teratoma, osteomyelitis), an examination of the rectum is necessary; in some cases, radiography, colonoscopy or irrigoscopy may be required. Before surgery, thorough depilation of the surgical field is very important and cleansing enemas are required. In case of abscess of a coccyx cyst (festering epithelial coccygeal duct), acute inflammatory phenomena or exacerbation of a chronic process, the first stage is to drain the purulent contents of the cyst (open, drain). The abscess is opened urgently with a small incision under local anesthesia. The cavity is emptied, sanitized with antiseptic solutions and drained. After the drainage of pus, relief occurs. Bandages with water-soluble ointments (levomekol) are applied. The pain goes away, the inflammation subsides, and the postoperative incision wound heals. A period of imaginary well-being begins (full recovery does not occur). A focus of dormant chronic infection remains. Without the second stage - radical surgery (complete excision or removal of the coccyx cyst), as a rule, suppuration is repeated again and again. With a long delay of radical intervention, inflammation can become chronic with the formation of new infiltrates and secondary fistulas.

Primary radical surgery (uncomplicated coccyx cyst) or the second stage of treatment after the subsidence of acute inflammatory phenomena during the period of remission (“cold period”) is carried out as planned. The operation is performed under local infiltration, spinal anesthesia or intravenous anesthesia. Surgical intervention consists of removing (excision) the pathological formation (cyst, canal, tract) along with the internal lining, the contents of the cavity, the surrounding tissues that have changed after repeated inflammatory processes to the fascia. All primary and secondary holes (holes, fistulas) are also excised. To minimize the risk of relapse, all passages and fistulas must be painted with a special dye. After excision of the coccyx cyst, the postoperative wound is usually sutured tightly. Donati sutures are applied to ensure good bleeding control and accurate alignment of the wound edges.

In a number of clinics, the postoperative wound is left open or the edges of the wound are sutured to its bottom for secondary healing (marsupilization). In our opinion, this tactic of postoperative wound management has many disadvantages:

traumatic
decrease in the patient's quality of life
possible secondary infection
high probability of relapse
vicious postoperative scars after secondary healing