The coccyx is the lower segment, the “tail” of the spine. It would seem a useless appendage that does not bear the main load. And if you think so, you will be mistaken. Ask people who know first-hand what osteochondrosis of the coccyx is and who have experienced its symptoms. Coccygeal osteochondrosis causes severe pain, moreover, it causes limitations in mobility and concomitant diseases in the pelvic area.
The scientific name for coccyx pain syndrome is coccydynia. The disease most often affects middle-aged women, mainly after 40 years, due to the peculiarities of their anatomy. However, the disease can occur in any person, especially those leading a sedentary lifestyle.
Coccydynia - what is it?
The term “coccydynia” is commonly used to describe a group of diverse pain syndromes that are localized in the coccyx area.
It is also called osteochondrosis of the coccyx or anococcygeal pain syndrome. This condition is characterized by intense periodic or constant pain in the coccyx area in the absence of any spinal disease. This pathology causes many problems in everyday life, interferes with normal movement, causes pain and discomfort.
Due to the structural features of the spine and high mobility of the joints, osteochondrosis of the coccyx most often occurs in women aged 40-60 years. It is important to identify this disease in a timely manner in order to eliminate pain and prevent the condition from worsening.
What's behind the diagnosis?
This disease is accompanied by dystrophic disorders in the cartilaginous structures of the coccygeal spine, as well as changes in the structure of the intervertebral discs. Often, trauma to the coccyx area plays an important role in the development of the disease, and it can occur long before the development of pain.
How to treat pathology?
Therapeutic manipulations include a whole range of supportive and restorative measures, including:
- anti-inflammatory drugs;
- analgesics;
- blockade with novocaine drugs;
- medicines that help relax the muscular system;
- means that help remove excess fluid from the body;
- visiting a chiropractor;
- ultrasound therapy;
- Exercise therapy.
If restorative measures are not taken, the disease threatens to develop into a critical form, leading to complete destruction of the articular part of the section in question. At risk are potential patients who are genetically predisposed to the pathology, those who work in a static position, adherents of strength sports, workers in professions associated with heavy physical activity, as well as people with underdeveloped or weakened muscle tissue.
As a preventative measure, it is recommended to regularly do exercises aimed at strengthening the muscles of the dorsal area and lower spine. It is necessary to avoid excessive loads, monitor your posture and not make sudden movements when bending and turning.
Causes and types of disease
One of the main reasons for the development of the disease is considered to be uneven distribution of the load on the spine. Other factors that can provoke osteochondrosis of the coccyx include:
- Injuries to this area of the spine, including fractures and bruises.
- Inflammation of nerve endings and muscles.
- Prolonged stay in the wrong position with emphasis on the tailbone.
- Postoperative adhesions or scars on the pelvic organs.
- Inflammation of internal organs located near the tailbone. This can be cystitis, prostatitis, adnexitis, endometritis, and also colitis.
- Inactive and sedentary lifestyle. This provokes salt deposition and other stagnation, which leads to pain.
- Excess body weight.
- Neurological diseases. Sharp pain in the coccyx or sacrum can be caused by pinching of the sciatic or lumbar nerve.
- Tendency to prolonged constipation.
- Complications after childbirth in women with a narrow pelvis.
According to the international classification of diseases, it is customary to divide 3 types of coccyx osteochondrosis:
- Actually, coccydynia itself, which appears as a result of the negative impact of concomitant diseases on the body.
- Pseudococcydynia or pain located at the coccyx.
- Anorectal pain, which is characterized by discomfort in the rectum, perineum or genital area.
Treatment of coccyx osteochondrosis
Treatment of coccygeal osteochondrosis is complex and quite lengthy. In addition to therapeutic measures, it will require changes in the patient’s lifestyle: physical activity, self-control of posture, selection of the stiffness of the chair and mattress.
Pregnant women need to wear a bandage that reduces the load on the pelvic floor.
For acute pain conditions, medications are prescribed.
Drug treatment
The use of medications for osteochondrosis of the coccyx is intended to anesthetize damaged tissue areas, relieve inflammation, and restore vertebral mobility.
The following groups of drugs are prescribed:
- Non-steroidal analgesics with anti-inflammatory effect: Indomethacin, Naproxen, Nimesulide, etc.;
- Muscle relaxants that relieve muscle tension: Mydocalm, Baclofen, Tizanidine;
- Local anesthetics (in the form of injections into the affected areas);
- Warming ointments, creams - Voltaren, Fastum-gel, Butadion, Finalgon.
Naproxen
Mydocalm
Voltaren
Butadion
Physiotherapy
Physiotherapeutic procedures give good results for coccygeal osteochondrosis. They are prescribed by a doctor to improve blood circulation, metabolic processes in the pelvic area, reduce pain and inflammation.
A course of massage treatments significantly alleviates the patient's condition. The chiropractor uses his fingers to relieve pain by relaxing the pelvic floor muscles and rectal area.
In addition to massage, you can be offered the following types of physiotherapy:
- Darsonvalization with high-frequency pulse currents;
- Ultrasound treatment;
- Paraffin applications;
- Healing mud;
- Electrophoresis;
- Laser treatment.
Symptoms
In addition to painful sensations, it is worth highlighting a number of additional symptoms of osteochondrosis of the coccyx, by which the disease can be identified:
- Depression, anxiety, insomnia, which lead to headaches and vasomotor disorders.
- Disorders of the pelvic organs, which can manifest as constipation, irritable bowel syndrome, urological problems and others.
- Gait disturbances, stiffness and changes in the foot.
- Pale skin, sweating during an attack of pain.
- Cardiopalmus.
Nature of pain
Initially, painful sensations in the tailbone occur in a sitting position, but disappear in a lying position. Over time, this tendency goes away, and the pain begins to bother you at night, causing insomnia. Gradually, the pain becomes unbearable, and patients describe it as aching or dull.
Pain in the tailbone is intermittent, can come in attacks, but sometimes can be regular. The body reacts to pain with increased sweating and pale skin. At the same time, it can even be difficult for the patient to explain the location of the pain, as a result of which it becomes difficult to control it, and for many, the gait changes.
Diagnostics
Initially, if you complain of pain in the coccyx area and consult a doctor, a general examination of the patient is carried out.
The examination is carried out visually, the presence of changes in the bone is determined by palpation, examination in the knee-elbow position is especially important. The frequency and nature of pain, the presence of concomitant diseases are revealed. To accurately diagnose the condition, it is also necessary to conduct such types of examination as:
- General blood and urine analysis.
- Ultrasound of the pelvic organs.
- X-ray.
- Computed tomography.
- Magnetic resonance imaging.
- Colonoscopy.
One method of confirming the diagnosis is a test injection of an anesthetic into the affected area. If the pain quickly disappears, then the patient has osteochondrosis of the coccyx.
Diagnosis of coccydynia
Coccygeal pain syndrome is difficult to diagnose. Since the pain radiates to the rectum and genitals, gynecologists and proctologists may be involved in the examination, who help to exclude or confirm diseases of these organs.
But the main specialist who diagnoses and treats coccydynia is a neurologist. The doctor makes a diagnosis based on the collected history, physical examination and instrumental examination.
At the initial appointment, the neurologist clarifies the nature of the pain, asks about injuries, falls on the tailbone, and surgical interventions in the pelvis. The doctor studies the patient’s medical history, then proceeds to examine and palpate the spine, in particular the sacrococcygeal region.
Note! With coccydynia, palpation is painful. If there is no pain when pressing on the tailbone, then the pain is associated with osteochondrosis, a herniated intervertebral disc or other pathology.
Mandatory diagnostic procedures include a rectal digital examination, which is performed by a proctologist in order to assess the condition of the pelvic muscles and the presence of overstrain.
To determine the cause of coccydynia, the doctor prescribes the following examination methods:
- Ultrasound of the pelvic organs;
- colonoscopy;
- X-ray, CT or MRI of the spine.
Of the instrumental methods, MRI is the most informative. With its help, you can detect post-traumatic changes, tumor neoplasms, and organic disorders. You can get an MRI at the medical office. The clinic has installed a new ultra-precise MRI scanner.
If necessary, create a 3D model of the area under study
The diagnosis is known on the day of diagnosis. After an MRI, additional examination is often not required, since the cause of pain and its etiology can be detected. Treatment is prescribed by the attending physician, referring to the diagnostic results.
Kazieva Aminat Ziyavovna
Neurologist
Rostov State Medical University
Experience since 2012
Treatment
Treatment of osteochondrosis of any kind takes quite a long time. It includes a whole range of procedures, including medication, preventive procedures, physical exercise, manual therapy, correction of neurological disorders, traditional methods, and in serious cases, surgical intervention.
Medication
Treatment with medications is primarily aimed at eliminating pain, using non-steroidal anti-inflammatory drugs.
- To relieve muscle spasms, drugs such as Tolperil, Mydocalm and others are used.
- For stress and anxiety, the use of special psychotropic drugs is recommended, including Novopassit, Amitriptyline and others.
How to relieve pain?
In order to relieve pain due to osteochondrosis of the coccyx, doctors most often use NSAIDs or anesthetics. It can be:
- pills;
- injections;
- ointments for rubbing into the affected area.
- To eliminate pain, Diclofenac, Nimulid and Butadione are most often used in different forms.
- Injections of Lidocaine or Leocaine solution are used as anesthetics.
Physiotherapy
Physiotherapy procedures used to treat the disease include:
- Rectal darsonvalization.
- Paraffin applications.
- Mud wraps.
- Magnetotherapy.
- UHF.
- Laser therapy.
- Ultrasound procedures.
- Acupuncture.
Therapeutic exercise and gymnastics
The effectiveness of treatment is achieved by special therapeutic exercises, which are selected depending on the degree of development of the disease and the characteristics of the body. Such exercises can be performed at home or in specialized centers under the supervision of specialists. They help alleviate the condition and act as an effective method of preventing osteochondrosis of the coccyx.
Useful exercises
There are many different sets of physical exercises to treat the disease, below is one of them:
- Exercise with a ball. In a lying position, you need to hold the ball between your knees and feet, squeezing it for a few seconds and pulling your tailbone back.
- While lying on your back, you need to throw your legs behind your head and remain in this position for some time.
- While lying on your stomach, you should raise your legs and arms as high as possible.
- Lying on your back, you need to grab your bent knees and pull them to your chest, while making oscillatory movements back and forth.
It is better to carry out such a complex under the supervision of a specialist, so that he can monitor the correctness of its implementation and stop the exercise if he feels unwell.
Surgical intervention
Surgery is considered a last resort in treating the disease. It can be performed when other treatment methods have failed. It is an operation to remove the coccyx.
Folk remedies
Treatment of the disease can be supplemented with folk recipes:
- You can regularly apply potato tincture to your tailbone.
- Rubbing lavender solution effectively relieves pain.
- To strengthen bones and ligaments, you can take wheat sprouts.
- Taking rosehip tincture daily is very effective for osteochondrosis.
- An excellent remedy for osteochondrosis is horse chestnut balm.
- Rubbing a mixture of radish juice and honey perfectly relieves pain and inflammation.
Preparations for blockade for pain in the tailbone
To reduce pain, drugs that have analgesic and anti-inflammatory effects are injected. Depending on the indications, they can do a monocomponent (one drug is used) or a multicomponent (mixture of several drugs) blockade.
A long, thin needle is used to administer medications.
In medicine, both well-known analgesics and new generation drugs are used:
- Novocaine. It is the safest local anesthetic because it has minimal side effects. Reduces pain, relieves spasms, improves trophism of nervous tissue.
- Lidocaine. The effect of injections of this anesthetic is longer than that of Novocaine. The pain subsides within a few minutes after the injection.
- Bupivacaine. Many times more powerful than Novacain. Although after the injection the pain does not go away immediately, but gradually, the effect remains for a long time.
- Diprospan. This is the newest analgesic drug used for coccydynia. Blockades with Diprospan are done at the SmartMed clinic. The analgesic and anti-inflammatory effect is quick and long-lasting. Just 1-2 injections of Diprospan are enough to get rid of chronic pain syndrome. It is effective against destructive-dystrophic diseases of the spine and has fewer complications compared to its analogues.
Together with Diprospan and other analgesics, corticosteroid drugs that have an anti-inflammatory effect can be used. These include Hydrocortisone, Dexamethasone.
The choice of medication is at the discretion of the doctor. The doctor chooses the safest and most effective drug for the patient.
Consequences
Such a serious disease as osteochondrosis cannot pass without leaving a trace; most often you have to give up your usual way of life. Consequences after illness include indigestion, depression, malfunction of the genitourinary system, and decreased immunity.
In this case, men may develop impotence, and women may experience pain during sexual intercourse.
Prevention
It is easier to prevent any disease than to deal with its consequences. Various preventive measures that must be followed will help avoid the occurrence of osteochondrosis of the coccyx.
Lifestyle
One of the preventive measures is maintaining a correct lifestyle:
- It is better to have orthopedic furniture for the workplace, such as a special chair or a chair cushion.
- Winter shoes should be comfortable, without slippery soles, this will prevent slipping and the risk of injury in winter.
- Clothing should also be comfortable, without tight seams, allowing you to move freely and sit straight.
- Avoid a sedentary lifestyle. Whenever possible, it is necessary to perform simple and easy exercises for the spine.
Strengthening procedures
good way to prevent and treat osteochondrosis. Preventative massage is recommended once a week for 1-2 months. Honey massage is considered especially effective, in which honey dissolved in water should be rubbed into the skin with massage movements, and then covered with a warm blanket and lie down for half an hour.
The most effective among bath procedures can be considered a white turpentine bath, for which a mixture of water, baby soap, acetylsalicylic acid tablets and gum turpentine is used.
Pregnancy and childbirth
Women are often concerned about the possibility of pregnancy and successful childbirth with a diagnosis of “osteochondrosis of the coccyx,” because this period is characterized by additional stress on the lumbar region and pelvic organs.
Many medications recommended for illness are undesirable during pregnancy, as they can cause complications in the form of bleeding. For pregnant women, treatment can be carried out using mud baths, special gymnastic complexes, acupuncture and compresses from essential oils.
All of the above procedures can be carried out under the supervision of the attending physician, gynecologist and neurologist.
Recommendations from experts
The desired effect in the treatment of osteochondrosis of the coccyx cannot be achieved without a review of nutrition. It is necessary to limit yourself in eating fatty, smoked and flour foods. It is better to give preference to foods of plant origin.
You should not self-medicate for osteochondrosis of the coccyx, as this can lead to undesirable consequences and serious complications. Any traditional methods aimed at treating the disease must be agreed with the attending physician.
It is necessary to exclude any spinal injuries and lead a healthy active lifestyle.
When the first symptoms of osteochondrosis of the coccyx appear, it is important to consult a doctor in a timely manner, conduct a diagnosis and begin treatment. In this case, it is necessary to follow all the doctor’s instructions, attend recommended classes to eliminate pain and get rid of the disease in a short time. Properly selected procedures and a balanced diet will guarantee effective treatment.