If a fracture of the coccyx is always accompanied by acute pain, its dislocation or subluxation sometimes occurs unnoticed by the victim. Severe discomfort is usually mistaken for the consequences of injury - inflammatory swelling, extensive hematomas. But external signs of damage disappear over time, and the pain in the tailbone persists, making it difficult to lead a normal lifestyle. During the examination, displacement of the structures of the coccyx or the entire bone is diagnosed, requiring immediate treatment.
Causes of coccyx displacement
The most common cause of a displaced tailbone is injury. Damage to this organ, which has the status of a rudiment, occurs when falling from a height in a sitting position, as well as as a result of a strong direct blow to the lower back. The following factors predispose to injury:
- weakness of the ligamentous-tendon apparatus of the lumbosacral vertebrae;
- degenerative-dystrophic pathologies of the hip and knee joints, for example, coxarthrosis and gonarthrosis;
- constant microtrauma of the coccygeal bone during sports training and cycling.
The tailbone often becomes displaced (and sometimes breaks) during complicated childbirth. This becomes possible due to the large fetus and (or) the mother’s narrow pelvis. There have been cases of idiopathic damage: the coccyx is displaced, but the objective causes of the injury cannot be identified.
Symptoms
The leading symptom of a displaced tailbone is pain in the lower back. The intensity of discomfort increases even with minor physical exertion. Damage is indicated by a crunching sound that can be heard while walking, standing up, or changing body position. If the displacement was accompanied by injury to nearby soft tissues, then pain is also felt at rest. The following clinical manifestations are also observed:
- the formation of hematomas or pinpoint hemorrhages in the lumbar region;
- the patient’s inability to stay in one position for a long time.
A specific sign of displacement of the coccyx is problems with defecation, often of neurogenic origin. In order not to experience pain during bowel movements, a person postpones going to the toilet. This leads to the development of chronic constipation, digestive disorders, and an imbalance of intestinal microflora.
Clinical picture
The symptoms of dislocation and subluxation of the coccygeal bone are identical. It is possible to distinguish one injury from another only by performing an X-ray examination.
Signs of both injuries will be:
- During an injury, the victim feels a sharp pain; over time, the pain intensifies and persists for a fairly long period of time. At first the pain is acute, but it can change over time;
- if the injury was received recently, the pain is constant, the victim cannot find a position in which the pain could subside. With old injuries, pain in a standing or lying position subsides, but when sitting and rising, they resume again;
- pain can be projected to the perineum and anus;
- pain increases during straining and bowel movements. In this case, it has a shooting character;
- palpation of the sacrococcygeal area causes pain to the patient;
- a visual examination reveals swelling and bruising of varying severity in the sacrum area.
Despite the intense pain in the coccyx area, it is very difficult to independently determine the presence of a subluxation or dislocation, so it is very important to immediately go to the nearest emergency room immediately after receiving an injury to clarify the diagnosis.
Types of offset
There are congenital and acquired displacements of the coccyx. In the latter case, damage occurs as a result of trauma, difficult childbirth, or progression of systemic diseases. The cause of congenital displacement is improper intrauterine development of bone structures.
Soreness of the coccyx can be caused by its subluxation - a pathological condition in which the articulated surfaces of adjacent vertebrae are displaced while maintaining the points of contact. But more often, dislocation, or complete displacement of the vertebral bodies relative to each other, is diagnosed. The most dangerous is considered to be a fracture of the coccygeal bone.
There are various options for traumatizing the coccyx. Its structures deviate to the right, left, forward, backward. A combination of options is possible, for example, shifting forward and to the side.
The difference between a dislocation and a subluxation
A dislocated coccyx is a severe displacement of the joint surfaces that requires immediate assistance. Specialists can diagnose a coccyx fracture. With subluxation, the disturbances are not so significant; the displacement of the articular surfaces does not occur completely.
Dislocation is always preceded by injury; subluxation can appear for no reason - a sharp turn, prolonged incorrect position of the spine. The symptoms of both pathologies are similar.
Diagnostic methods
The diagnosis is made based on an examination of the patient, his complaints, and a history of systemic pathologies of the musculoskeletal system. The doctor finds out what external or internal factors preceded the appearance of coccyx pain. How the patient is examined:
- upon palpation of the lumbosacral region, displacement of the vertebrae and the presence of inflammatory swelling are determined;
- A rectal examination (through the rectum) helps to establish the angle of deviation of the coccyx, the localization of pain, and helps to exclude neoplasms, including those in the vagina.
Of the instrumental studies, radiography is the most informative. The images obtained in 2 projections clearly visualize the displaced structures of the sacrococcygeal joint. If necessary, an MRI or CT scan is performed to assess the condition of ligaments, tendons, muscles, and blood vessels.
Prevention
To prevent the recurrence of vertebral displacement in the cervical spine, you need to follow certain rules:
- Avoid placing too much stress on the spine. It is not recommended to engage in strength sports that require working with heavy weight.
- Pay close attention to your posture.
- Find the strength to give up bad habits. Alcohol and smoking greatly weaken the body - it becomes vulnerable to various diseases.
- More light physical activity: Walking or jogging are great for this.
- Proper nutrition. It is better to eliminate unhealthy foods and switch to vegetables and steamed dishes.
- Get adequate sleep from six to eight hours a day.
It is best to take X-rays of the cervical spine from time to time, so that you will always know about the state of your health. And if something happens, you can quickly get rid of the disease that has arisen, because it will only be at an early stage.
First aid
With a sharp, sudden displacement, especially accompanied by a fracture, acute pain is felt. The victim must be placed on his stomach, preferably on a hard surface. If he can endure pain, then it is better not to use painkillers until the ambulance team arrives. They will distort the clinical picture, which will significantly complicate diagnosis. The severity of pain should be reduced with cold compresses. A bag filled with crushed ice and wrapped in thick cloth should be applied to the tailbone. The duration of the procedure is no longer than 10 minutes. For acute, piercing pain, you cannot do without taking pharmacological medications. It is better to give the victim a tablet with non-steroidal anti-inflammatory ingredients: ibuprofen, nimesulide, ketorolac.
Treatment options
When choosing a treatment method, the doctor takes into account the severity of the injury, the degree of damage to the muscles, ligaments, tendons, and the characteristics of the symptoms. If the displacement is provoked by an inflammatory or degenerative pathology, then its therapy is carried out simultaneously. Immediately after examining the x-rays, the doctor adjusts the tailbone and returns it to its original position.
Drug therapy
Drug blockades with glucocorticosteroids (Diprospan, Triamcinolone, Dexamethasone) and anesthetics (Lidocaine, Novocaine) help eliminate severe pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) for intramuscular administration are also used to relieve acute pain. The therapeutic effect is secured by taking tablets - Nise, Ibuprofen, Ketoprofen, Diclofenac.
Gradually, the pain subsides, so NSAIDs for local application are included in treatment regimens. These are ointments and gels Voltaren, Fastum, Artrosilene.
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Muscle relaxants (Baklosan, Mydocalm, Sirdalud) are used for displacement of the coccyx complicated by muscle spasms. At the rehabilitation stage, ointments with a warming and local irritating effect are recommended - Nayatox, Finalgon, Viprosal.
To normalize peristalsis, patients are prescribed mild herbal laxatives and, if necessary, probiotics and prebiotics.
Surgical intervention
The operation is performed when conservative therapy is ineffective for several months. If the pain intensity does not decrease, the patient is prepared for surgery. Old injuries may be an indication for surgery. When a displacement of the coccyx was complicated by damage to the ligaments, muscles, and tendons, the person did not seek medical help. The result was improper fusion of connective tissue structures, leading to constant pain. The operation can be performed in 2 ways:
- coccygectomy - excision of damaged or displaced structures of the coccygeal bone;
- rhizotomy - destruction of the facet nerves, or radiculotomy.
Surgical treatment is resorted to in extreme cases, but not only because of the effectiveness of conservative therapy in most diagnosed cases. There is a possibility of complications developing during the rehabilitation stage. Although the coccyx is considered a rudiment, it serves as an attachment point for ligaments and tendons. After its removal, disorders in the functioning of the pelvic organs and lower extremities may occur.
Exercise therapy complex
At the rehabilitation stage, daily exercise therapy and gymnastics allow you to do without taking painkillers or significantly reduce the pharmacological load on the body. A set of exercises is compiled by a physical therapy doctor, taking into account the patient’s physical fitness and the severity of the injury. The first training sessions also take place under his supervision. He will tell you how to perform the exercises correctly so that there is no excess stress on the tailbone. Regular exercise helps improve blood circulation and metabolism and accelerate tissue regeneration.
Exercise therapy is also necessary to prevent repeated displacements. The muscles located near the coccyx are strengthened, further stabilizing its segments.
Diet
When recommending that patients make adjustments to their diet, doctors have two goals. Firstly, improving the overall well-being of a person. The presence of a sufficient amount of healthy foods in the daily menu strengthens the immune system, stimulates blood circulation and microcirculation. This has a positive effect on metabolism, helps increase the strength and elasticity of ligaments, muscles, and tendons. Healthy foods include cereals, lean meats, fresh vegetables and fruits.
Secondly, dietary changes normalize body weight. Obesity predisposes to displacement of the coccyx and its pain.
Obesity is a predisposing factor for coccyx displacement.
Mode
In case of complex displacement, the patient is recommended to rest in bed for several days. While in a sitting position, you should place a special orthopedic pillow under your buttocks. And during therapy, it is necessary to avoid any physical activity that slows down the restoration of damaged structures. You cannot lift heavy objects or walk long distances.
Folk remedies and recipes
The use of folk remedies is allowed only after the main treatment. During the rehabilitation period, the use of compresses, applications, alcohol or oil rubs, infusions and decoctions is allowed. Here are some effective recipes to eliminate tailbone pain:
- In a mortar, mix 100 g of baby fat cream, a teaspoon of gum turpentine, a tablespoon of cosmetic almond oil and 2-3 drops each of thyme and fir essential oils until smooth. Transfer the ointment to a dark container, store in the refrigerator, use for pain in the tailbone;
- Lightly mash a large fresh burdock leaf and brush with thick honey. Place it on your tailbone and place plastic wrap on top. Secure the compress with a regular or elastic bandage and hold until the sheet is completely dry.
Drinking teas from medicinal plants helps speed up recovery. To prepare them, you need to pour a glass of boiling water over a teaspoon of chamomile, oregano or marigold. Leave for 30 minutes, cool, strain, drink throughout the day.
Herbal collection.
Possible consequences
If a person does not seek medical help at the first symptoms of a displaced tailbone, then the likelihood of severe, often irreversible complications increases significantly.
Coccydynia
This is the name of a pathological condition characterized by constant or paroxysmal pain in the tailbone, anus, and rectum. The pain is especially pronounced when sitting on hard surfaces, and intensifies when standing up. Difficulties with bowel movements often occur. Over time, discomfort is felt even at night. Soon insomnia, depression, lethargy, apathy, and decreased libido appear. Coccydynia requires an integrated approach to treatment with the participation of a neurologist and proctologist.
Coccydynia.
Complication of the birth process
If the coccygeal segments are displaced with a fracture, women may experience difficulties during childbirth. This is especially true when bone fragments are incorrectly compared and fused in this position.
Trouble with displacement of fragments
During the operation, the bone fragments are first returned to their normal anatomical position. Usually they are well reduced, but cases of their re-displacement have been noted. This leads to disruption of the functioning of the lumbosacral spine. There is a risk of soft tissue injury and the development of an inflammatory process.
Symptoms of the disease
A headache that occurs in the temples or in the back of the head is a common symptom of vertebral displacement. Over time, it progresses and becomes a permanent migraine. As a result, the following symptoms occur:
- blood flow disturbance;
- manifestation of colds;
- weakness, depression;
- tendency to sudden, unpredictable changes in mood.
Neck pain is a bad thing, and you need to get rid of it as quickly as possible.
Problems arise with the vestibular apparatus, the person develops the following disorders:
- difficulties with orientation in space;
- dizziness;
- loss of consciousness;
- numbness of hands;
- neck and shoulder pain;
- hoarseness of voice;
- cough;
- shortness of breath up to suffocation;
- difficulty moving the head.
Displacement of the vertebra leads to damage to the trigeminal nerve. Manifests itself with the following symptoms: