Pain syndrome in the lower spine: how to identify and treat.

Concerns with the coccygeal region are rare, but if the coccyx is damaged, the pain associated with it will be quite severe. Most often, women suffer from this symptom.

Causes of tailbone pain in women

In medical circles, this symptom characterizes coccydynia, but in everyday life it’s simple - the tailbone hurts; the causes for women are completely different. In this article we will talk about why this pain occurs and how you can get rid of it.

Characteristics of pain in the coccyx

Depending on the cause of pain in the tailbone, pain can manifest itself in completely different ways. For example, if an injury occurs, the tailbone begins to sharply bother.

Acute pain develops rapidly; if measures are not taken immediately, this can lead to impaired motor activity.

It often happens that the lumbar region and tailbone are immediately disturbed. In this case, most likely, we are talking about osteochondrosis.

If the sacral region hurts together with the coccyx, this may signal an exacerbation of hemorrhoids. In any case, you need to see a doctor to make an accurate diagnosis and begin treatment.

Why does pain occur in the tailbone area?

Let's highlight a few of the most basic reasons why this problem may occur:

• Injury to this area.
• Wearing clothes that don't fit for a long time.
• Impaired functioning of the genitourinary system.
• Damage to nerve endings in the pelvic area.
• Consequences of difficult childbirth.
• Carrying a child.
• Spinal diseases.
• Deformation of the anus, aggravated hemorrhoids.
• Constant constipation.

According to statistics, in 20% of cases, pain in the coccyx remains unclear, that is, without cause. As a rule, such discomfort is observed from time to time: it disappears and then appears again. Don't think that this is your situation.

If discomfort bothers you, you need to make every effort to find out the root cause.

Treatment tactics at Dr. Savyak’s spinal rehabilitation clinic

Our main principles of therapy are safety, gentleness, effectiveness and quick relief from pain . An integrated approach turns out to be the most effective, so the impact will be comprehensive. Typically the regimen begins with manual therapy and traction . Massage and physiotherapy are also provided . To consolidate the result, exercise therapy and taking herbal medicines .

If lower back pain persists for 2-3 days, contact our center and they will definitely help you!

Pain in the coccyx area due to various diseases

If there is any pathological process, pain in the coccyx is provoked by spasms of adjacent muscle fibers and often this is fraught with pinching of nerve fibers.

Ultimately, this leads to an inflammatory process. In this case, the pain spreads to other areas: buttocks, groin, lower back, etc.

Let us consider in more detail the characteristics of pain depending on the root cause.

Pain under the tailbone

This symptom may occur after a difficult birth, due to injury to the coccyx, or in cases of rectal pathology. This complaint is often heard at doctor's appointments.

Pain above the coccyx

Discomfort localized above the tailbone may be due to damage or pinched nerve endings.

After injury

In 90% of cases, after a bruise or blow, pain in the tailbone occurs almost instantly. The nature of the pain is acute, constantly increasing. Taking painkillers does not lead to positive dynamics. You need to go to the doctor urgently.

When you get up

If your back hurts near your tailbone when you stand up, most likely it is a consequence of an injury or it is due to scars after surgical interventions. When you suddenly get out of bed, the pain can be sharp and piercing. In this case, only temporarily staying in the same position will help, in which the pain subsides.

When you're sitting

Pain while sitting may indicate stagnation of blood in the vessels. This often happens with a sedentary lifestyle. Another common cause is salt deposits in certain areas of the spine. When squeezed, pain occurs, which radiates specifically to the coccyx area.

When tilted

If your back and tailbone hurt only when bending over, look for a problem in your internal organs. We can talk about intestinal pathologies, inflammation of the female appendages or urinary system.

Pain radiating to the tailbone

As mentioned above, radiating pain may be associated with inflammatory processes in internal organs, as well as with the consequences of difficult childbirth.

Combined with pain in the lower back, sacrum

Combined discomfort, which affects several parts of the back at once, may signal an exacerbation of osteochondrosis.

Aching and pulling

Such complaints can occur in both men and women. In the first case, we can talk about the inflammatory process in the prostate gland, in the second – about inflammation of the female appendages.

During pregnancy and after childbirth

Often pain in the back and tailbone is associated with bearing a child. This is especially true in the last weeks of pregnancy, when the uterus is maximally dilated and the fetus has reached its full weight. Another probable reason is an acute lack of beneficial microelements in the body.

During menstruation

Many representatives of the fair sex complain that their back hurts in the tailbone area during menstrual flow. Experts do not find a reasonable explanation for this situation. It is recommended to visit a gynecologist and undergo a thorough examination.

In men

Have you heard about such a pathology as “jeep” disease? It is characteristic of the male sex and is associated with increased loads on the tailbone. This usually occurs due to riding ATVs, motorcycles and other similar types of transport. This can lead to the formation of a cyst on the tailbone.

Low back pain in teenagers

At the beginning of the 21st century. The medical and social significance of the problem of low back pain (LBP) is no longer in doubt, since up to 80% of the working population in various countries of the world have experienced it at some time during their lives. And although most often acute pain in the lower back (lower back) lasts no more than 7–10 days, the economic damage from this pathology is enormous: due to a decrease in the amount of produced products, the need for expensive examination of patients, especially with a recurrent course (including MRI of the spine ), and treatment. At the same time, it cannot be emphasized enough that for every person such pain is a big psychological and somatic shock.

It was usually believed that LBP develops more often in people aged 30–59 years, mainly in men engaged in heavy physical labor, but epidemiological studies conducted in the second half of the twentieth century showed that pain of this localization is observed in people of different professions, such as both in men and women. Moreover, by the end of the twentieth century. There have been isolated reports that LBP is not uncommon in adolescents 14 years of age and older.

So what is BNS? Currently, the definition of LBP as pain localized between the 12th pair of ribs and the gluteal folds has become generally accepted. It is very important to note that LBP is not a diagnosis, but a symptom that requires a thorough examination of the patient to exclude anatomical or pathological disorders of the spine. And at the same time, accumulated experience has shown that even with the most modern examination, in the majority of people suffering from LBP, it is not possible to identify any specific diseases included in the ICD-10 subclass of dorsopathy. Thus, LBP can be qualified as a symptom that occurs so frequently that this fact served as a rationale for its inclusion in ICD-10 (M54.5). In this regard, “teenage” LBP can serve as confirmation of the position according to which pain of this nature can actually occur without significant anatomical changes in various structures of the spine, although in a number of schoolchildren with LBP it is possible to identify Spina bifida, spondylolisthesis, Scheuermann-Mau disease, and initial manifestations juvenile ankylosing spondylitis [1].

Studies have shown that LBP is registered in various countries in 7–39% of adolescents [1]. Similar data were obtained during a survey of schoolchildren in the cities of Orenburg and Orsk - 19 and 26.6%, respectively [2], which indicates the absolute significance of this pathology for our country, which worsens the health status of schoolchildren, and also often complicates the choice of profession in the future. . In this regard, one cannot but attract attention to the data on the significant contribution of “adolescent” LBP to the development of severe pathology in adults. Thus, M. Herreby and co-authors proposed answering a questionnaire of people over 48 years of age who, at the age of 14, complained of LBP at the time of examination (at the same time, X-ray studies were carried out in this area). Studies have shown that 85% of men and 86% of women have relapsed LBP over the past 25–35 years, and 25.4% of them have developed severe pain syndrome. It was especially noted that severe LBP was accompanied by a decrease in performance and quality of life [3].

Accumulated data have shown the importance of a family history of LBP in the development of this syndrome in 14-year-old adolescents. At the same time, in adolescence, in addition to hereditary factors, there were other factors that were more clearly expressed in the group suffering from severe pain in the lower back. We are talking about factors such as smoking (more than 20 cigarettes per day), insufficient sports activity and generally low physical activity. Apparently, it cannot be argued that it was the above criteria that caused the deterioration of the condition of the subjects by the age of 48, and were not a consequence of the severe course of LBP. At least, the authors of this study [3] tend to assign a primary role in this process to hereditary causes.

Despite the fact that many risk factors for the development of LBP are observed in both 14-year-old adolescents and adults, a thorough examination still allows us to identify a number of the most significant parameters. In this regard, an interesting study by D.N. Begun [2], in which male adolescents aged 14–17 years, schoolchildren in the cities of Orenburg and Orsk, took part. First of all, it was shown that the subjects complained of pain localized mainly in the lumbar region (57 and 69.4%, respectively, in Orsk and Orenburg), but often the subjects were also bothered by a combination of pain in the lumbar and cervicothoracic regions, and 9 and 15.9% of adolescents (in Orenburg and Orsk, respectively) also indicated joint pain. In addition, there is a connection between pain from the musculoskeletal system in relatives of children and LBP in the examined schoolchildren. A certain relationship was identified between the high height (more than 170 cm) of the subjects and the frequency of detection of LBP, as well as body weight (more than 63 kg) and LBP, although the latter was observed mainly in Orenburg. Other anatomical factors include differences in leg length and poor posture. The role of the physical and mixed nature of labor, static loads on the spine and heavy physical activity in general was significant; The role of prolonged sitting and unnatural body positions was ambiguously assessed, but nevertheless, these factors should be taken into account in order to be able to eliminate them in a timely manner. It is especially important to note that the risk of developing LBP was higher in those who did not regularly engage in any sports, with the exception of adolescents who regularly attended martial arts classes, who also often experienced LBP, which may be due to the increased injury rate characteristic of these kinds of sports.

It is extremely important to pay attention to the connection between LBP in adolescents and smoking, which is emphasized by almost all researchers who have studied the risk factors for LBP in both adolescents and adults.

The table presents the most significant risk factors for LBP. Obviously, half of them were significant for both cities, such as smoking, prolonged static loads, hereditary predisposition, etc. But it is equally important to pay attention to the individual response to the listed risk factors, which is due to the unequal significance of each of them .

In this regard, the generalized literature data presented by H. De Bie [1] and indicating the nonspecific nature of the various causes of LBP in adolescents are certainly interesting. However, the researcher also emphasizes the importance of low physical activity, prolonged sitting in front of the TV (“TV life”), smoking, as well as emotional behavioral problems. At the same time, it is especially important to understand that for adolescents, psychosocial factors in the development and duration of LBP are immeasurably more important than mechanical overload [4]. In the development of LBP in adolescents, injuries, disc herniations, etc., as well as a “computerized” lifestyle and wearing heavy school backpacks can play an important role [1].

On the other hand, LBP in adolescents cannot be ignored also because they can be caused by congenital disorders that cause low back pain, such as Spina bifida, spondylolisthesis, Schauermann's disease [1].

Hypermobility syndrome can also be a risk factor for the development of LBP, as convincingly shown by A.G. Belenky [5]. Thus, dorsalgia of various localizations during the study he conducted were noted in 38% of patients (out of 60 people), including predominantly lumbodynia in 12%. At the same time, dorsalgia became more frequent as patients of different ages were examined, reaching 53 and 52% in the age groups 31–40 years and 41–55 years, respectively. At the same time, LBP increased most significantly with age - from 12% at the age of 16–20 years to 43% in the group of 41–55 year olds. Clinically, the early development of scoliosis is especially significant - already at the age of 16 - 20 years in 30% of those examined with hypermobility syndrome.

Thus, the development of LBP, observed in almost 1/3 of schoolchildren, is an important problem, the need to solve which should attract the attention of parents, teachers, doctors and adolescents themselves. As mentioned above, the occurrence of this syndrome in adolescents is fraught with the development of a severe course of the disease by middle age and can serve as a limitation when choosing a profession after finishing school.

The clinical symptoms of LBP in adolescents are almost no different from the well-known clinical symptoms in adults. When questioning, it is necessary to identify the effect on the intensity of LBP of various movements in the spinal column - washing and dressing, walking, sitting and standing, lifting weights, etc. An examination is of great importance, which clarifies changes in posture and type of the spinal column, the presence or absence of physiological bends, decreased mobility of the spine when bending forward (Thomeyer and Schober tests), the presence of muscle tension, physical characteristics of the rectus dorsi muscles (tightness, pain on palpation, etc.). Naturally, a physical examination should be carried out to identify hypermobility of the joints and the spine itself.

A teenager with LBP must undergo an X-ray examination of this part of the spine, including recording of possible transient motor changes, and if necessary, an MRI is indicated.

Treatment methods for LBP in adolescents have practically not been developed, although some principles of therapy that are most widespread in adults can be recommended.

• It is necessary to avoid prolonged bed rest during an episode of acute pain and strive to return to the usual physical activity with familiar motor techniques as soon as possible, which should be alternated with a short rest. But at the same time, sudden movements and excessive loads are not shown; it is impossible for the body to be in an unnatural position for a long time.
• The bed on which the teenager sleeps should be flat, moderately hard, it is advisable to lay a woolen blanket on the mattress, covering it with a sheet, the pillow should be soft and small in size, i.e. in bed the maximum physiological position should be maintained, avoiding overload of individual parts of the body .
• Parental control is necessary over the teenager’s correct posture when sitting and standing: in both positions, the back should be straight; The height of the chair should be such that when sitting, your feet rest on the floor and your back rests on the back of the chair.
• If you have flat feet, which is typical for hypermobile syndrome, an individual selection of instep supports is necessary, and the shoes should be comfortable, with a good appropriate sole, which makes it possible to avoid twisting in the ankle joints. It must be remembered that with flat feet, the load on the knee joints and lumbar spine increases sharply.
• Massage courses for the back muscles are useful, but the bone structures of the vertebrae should not be subjected to pressure.
• Of particular importance are systematic exercises that involve strengthening the muscles of the abdomen and back.

Thus, the physical activity recommended above during the period of pain reduction is ultimately aimed at creating and maintaining the physiological position of the spine, i.e., correct posture and rational motor mode. Essentially, the proposed system of physical activity provides for the prevention of further progression and development of irreversible changes in various structures of the spine.

Adolescent LBP usually does not require specific systemic treatment with analgesics or nonsteroidal anti-inflammatory drugs (NSAIDs), but if necessary, ointments may be recommended to reduce nociceptive pain stimulation and relieve muscle spasm. Among the NSAIDs used locally: fastum gel (2.5% ketoprofen), dolt-cream (5% ibuprofen), nimulide gel (1% nimesulide), finalgon, finalgel (from 14 years), voltaren emulgel, which have a pronounced local analgesic effect and good tolerability. For the latter, appropriate dosages have been developed - a portion of cream the size of a cherry is squeezed out of the tube if it is necessary to apply it to an area of ​​~ 400 cm2, or the size of a nut - to an area of ​​~ 800 cm2.

In conclusion, it should be noted that LBP in adolescents is a relatively new, poorly developed problem, which nevertheless has national importance, since LBP at this age worsens the quality of life of adolescents, can serve as a limitation when choosing a profession, and in an adult can cause quite severe flow of LBP.

Literature

1. De Bie, Staal B. Back pain in adolescents. Annual Europ. Congress of Rheumatology, 2003, abs SPOO97, p. 31.
2. Begun D.N. Prevalence and risk factors of pain syndrome in the lower back in adolescents living in various regions of the Orenburg region: Dis. ...cand. honey. Sci. - Orenburg, 2003.
3. Herreby M., Kjer J., Hesselsoe G., Neergaard K. Severe low back pain in 48-year-old men and women: a 35-year prospective cohort study of 640 school children. Eur. Rheum. Congress, 2002.
4. Watson KD et al. Low back pain in schoolchildren: the role of mechanical and psychosocial factors. Arch.Dis. Child. 2003, 81(1), 12–17.
5. Belenkiy A.G. Hypermobility of joints and hypermobility syndrome: prevalence and clinical and instrumental characteristics: Dis. ... doc. honey. Sci. - M., 2004.

Note!

• LBP is not a diagnosis, but a symptom that requires a thorough examination of the patient to exclude anatomical or pathological disorders of the spine.
• LBP is registered in various countries in 7–39% of adolescents.
• It is especially important to understand that for adolescents, psychosocial factors in the development and duration of LBP are immeasurably more important than mechanical overload.
• The occurrence of LBP in adolescents is fraught with the development of a severe course of the disease by middle age and can serve as a limitation in choosing a profession after finishing school.
• A teenager with LBP must undergo an X-ray examination of this part of the spine, including recording of possible transient motor changes.

Coccydynia - what is it?

Few people have heard of such a concept as coccydynia. This word has a Greek meaning: koktsiks - coccyx, odyni - pain syndrome.

As a rule, it occurs after injury to the coccyx area or with concomitant diseases of the musculoskeletal system. Exacerbation of pain occurs when you change position, for example, sitting on the sofa, or lying down with your knees bent to your chest. Even attempting to have a bowel movement can cause severe pain.

To at least slightly reduce discomfort, patients have to constantly place something soft under the buttock area. Very rarely, but sometimes the pathological process becomes chronic.

Prognosis for coccydynia

Back pain in the coccyx area is quite difficult to cure, especially if we are talking about an advanced pathological process. Of course, this disease cannot lead to death.

But still, people with this diagnosis suffer from constant pain, severe discomfort and other unpleasant symptoms. You can hope for a positive prognosis if you start treatment on time.

Remember that in the initial stages you can get by with conservative treatment methods. More complex situations may even require surgery followed by recovery.

Why does the lumbar spine hurt?

There are many reasons for discomfort in the lower back. They can be divided into vertebrogenic (associated with the musculoskeletal system) and non-vertebrogenic. Among the latter are women's diseases, kidney diseases, and tuberculosis. But often pain in the lumbar region is a signal to visit a vertebrology clinic. The main causes of pain are:

• osteochondrosis and its complications ( protrusion, herniated disc );
• lumbar scoliosis ;
• injuries (cracks, fractures, bruises);
• age-related changes associated with increased fragility of the vertebrae;
• muscle spasms.

And this is not the entire list of possible causes of lower back discomfort. Making a correct diagnosis is half the success on the path to getting rid of the problem. Contact only competent specialists with impressive work experience: at Oleg Savyak’s clinic you will undergo a full examination, which has helped to build a competent treatment regimen for thousands of grateful patients.

Prevention of back and tailbone pain

To avoid having to deal with this problem again, experts recommend following preventive measures:

• Try to lead an active lifestyle. Sit less, move more and walk. Regular exercise helps strengthen the back, which reduces the likelihood of pathological processes.
• Eat nutritiously so that your body does not lack beneficial microelements.
• Go for a massage once a year, especially if you or your family have osteochondrosis.
• Do not forget about preventive medical examinations, which are recommended once a year.
• Try to avoid all kinds of back injuries.
• Avoid hypothermia, this reduces the risk of inflammatory processes.
• Treat concomitant pathologies in the body in a timely manner.
• Contact specialists: get examined by a gynecologist and proctologist.

As soon as you feel your back hurting in the tailbone area, immediately go to the doctor. First, see a therapist. Depending on the characteristics of the disturbing symptoms, the doctor will refer you for consultation to more specialized specialists.

Self-medication will not lead to anything good. Only a correct diagnosis and timely therapy guarantee a favorable outcome.