What to do for pain in the sacral spine?

general description

The sacrum is a bone formation consisting of five fixedly connected vertebrae and connecting the lumbar spine, coccyx and pelvic bones. The sacrum has a pyramidal shape, the base of which faces upward and forms a joint with the fifth lumbar vertebra, the sides form the sacroiliac joints, and the apex faces down and connects to the coccyx. The anterior surface of the sacrum has a concave shape and faces the pelvic cavity, while the posterior surface faces outward and is curved. The sacrum plays a significant role in the process of childbirth, so in women it is shorter, wider and less curved.

Why does the sacrum hurt?

Traumatic injuries

Pain in the sacrum after injury is often caused by hematomas and soft tissue bruises.
When a bruise occurs, the pain is moderate and disappears within a few days. The swelling is small, movements are slightly limited, the condition is satisfactory. With a hematoma over the sacrum, a painful tumor-like formation is detected, which either gradually resolves over 2-3 weeks or turns into a cavity with liquid contents. Fractures of the sacrum are extremely rare; as a rule, they are combined with multiple fractures of the pelvic bones. They occur after a high-energy injury: a car accident, a fall from a height, etc. The pain syndrome is very intense, movements are severely limited, and the condition is serious. Bruises may be detected in the area of ​​the sacrum and pelvic bones, and pathological mobility is possible.

Spinal diseases

The cause of pain in the sacral area is often diseases of the lower parts of the spinal column. The pain can be local and spread to the lower back and buttocks. With degenerative-inflammatory processes, muscle overstrain, painful sensations are aching or pulling, intensifying after exercise, when the weather changes. When nearby nerve structures are compressed, the pain becomes shooting, radiates to the legs, and significantly limits mobility.

Pain syndrome is observed in the following pathologies of the spine:

• Degenerative
  : intervertebral hernia, disc protrusion, osteochondrosis, spondyloarthrosis.
• Developmental anomalies
  : lumbarization, sacralization.
• Spinal curvatures
  : scoliosis, kyphoscoliosis, pathological kyphosis and lordosis, flat back.
• Inflammatory
  : spondylitis.
• Oncological
  : primary tumors and metastatic lesions of the lower spine and spinal cord.
• Polyetiological
  : spondylolisthesis.

In addition, pain syndrome is detected in all types of osteoporosis, including juvenile, senile, postmenopausal and idiopathic. Pain in osteoporosis is usually minor, intensifying after exercise and prolonged exposure to an uncomfortable position. An increase in the intensity and duration of pain with a decrease in bone tissue strength may indicate the presence of a pathological fracture.

Sacral pain

Neurological pathologies

Burning, shooting pains that radiate to the legs or buttocks, combined with disorders of sensitivity and movement, are characteristic of such neurological disorders as:

• lumbosacral plexitis;
• cauda equina syndrome;
• radicular syndrome.

Sacroiliitis

Inflammation of the sacroiliac joint is most often unilateral, but can also be bilateral, observed in many diseases, manifested by pain on the side of the sacrum. The characteristics of the pain syndrome are determined by the type of pathology:

• Purulent
  . Rapidly growing sharp pain, aggravated by straightening the limb. Combined with forced body position, chills, hyperthermia, severe intoxication.
• For tuberculosis
  . The pain is vague, without clear localization. Palpation of the joint is moderately painful. Stiffness and local hyperthermia are observed. Over time, swelling often forms on the thigh.
• For brucellosis
  . The pain is short-term, minor or moderate, intensifies with movement. Persistent pain syndrome is less common.
• For rheumatic diseases
  . Identified in ankylosing spondylitis and psoriatic arthritis. The painful sensations are not intense, intensify at rest, weaken with exercise, and are supplemented by morning stiffness.

Women's diseases

Pain in the projection of the sacrum is observed in gynecological and obstetric pathologies. Most often mild, dull, aching, accompanied by pain in the lower abdomen. In chronic processes, they persist for a long time and are often combined with chronic pelvic pain syndrome in women. Found in the following diseases and conditions:

• During pregnancy
  : spontaneous abortion, low location of the placenta.
• During childbirth
  : pathological preliminary period of labor, discoordinated labor.
• Violations of the position of the uterus
  : hyperanteflexia, retroflexion.
• Congenital anomalies
  : duplication of the uterus, uterine aplasia, one-horned and two-horned uterus, “baby” uterus.
• Inflammatory
  : oophoritis, metritis, metroendometritis.
• Associated with menstruation
  : dysmenorrhea.
• Tumors and tumor-like formations
  : paraovarian cyst, uterine fibroid, cervical cancer, uterine body cancer.
• After gynecological operations
  : abortion, curettage, plastic surgery.

Other pelvic diseases

Regular or radiating pain in the sacrum is also detected in diseases of other pelvic organs:

• Urological
  : interstitial cystitis, bladder cancer.
• Andrological
  : prostatitis, prostate cancer.
• Proctological
  : rectal cancer.
• Others
  : adhesive disease, pelvic varicose veins.

Along with pain in the sacral region in chronic andrological pathologies, chronic pelvic pain syndrome in men is often diagnosed.

Other diseases

Sometimes the following diseases cause pain in the sacrum:

• Myalgia and myositis
  . Pain occurs against the background of overload, acute infectious diseases.
• Coxarthrosis.
  Painful sensations can be provoked by non-physiological load on the spine.
• Mental disorders
  . Psychosomatic pain is observed in hysteria, neurasthenia, and depression. They do not fit into the picture of a specific disease and are often unusual in nature.

Diagnosis of pain in the sacrum

• X-ray (allows you to assess the condition of bone structures, joints, articular cartilage along the width of the joint space)
• CT/MRI (allows for a more detailed assessment of the condition of bone structures and joints in cases where radiography is not enough; MRI visualizes soft tissue well)
• laboratory diagnostics (detects pathological changes in the blood, including markers of rheumatic diseases)
• Ultrasound (diagnosis of abdominal and pelvic organs)

General rules and effective treatment methods

Pain in the sacrum, as a rule, is only a symptom of a disease. Accordingly, this particular disease needs to be treated, and this can be done in various ways.

Drug treatment

Doctors may prescribe painkillers and anti-inflammatory drugs - tablets, injections, gels and ointments for topical use. Most often, these are auxiliary measures that help reduce pain, but do not fight the underlying disease.

Manual therapy

Manual therapy and massage are prescribed to relax the muscles in the pelvic area, restore their tone, and restore blood flow in the vessels. Also, acupuncture and massage help restore the correct position of the pelvic organs and the sacrum itself, if it has been displaced, for example, due to osteochondrosis.

Physiotherapy

As physiotherapeutic procedures for pain in the sacrum, SMT, UHF, electrophoresis and other procedures that help reduce inflammation, swelling, restore blood flow and muscle tone can be prescribed.

Physiotherapy

Special physical exercises to develop the motor system and muscles can be prescribed after injuries to the sacrum or for general strengthening of the body. Loads must be strictly dosed and aimed at developing specific muscle groups.

Any of the listed treatment methods must be agreed with your doctor. You can find the best specialist who can correctly diagnose the disease and cure it at the Energo clinic. Don't delay visiting the doctor! Come to our clinic, and we will try to completely restore your health, efficiency, restore your freedom of movement and joy of life.

Minimally invasive techniques

Therapeutic blockade

Therapeutic blockades are performed by injecting an anesthetic into the area of ​​a peripheral nerve or spasmodic muscle. The blockade not only relieves pain, but also helps to relax muscles, normalize blood flow and improve tissue trophism.

Radiofrequency denervation (RFD)

Radiofrequency denervation (RFD) is a modern and safe non-surgical method suitable for patients for whom other treatment methods are ineffective or impossible.

When is this technique used?

• If conservative drug therapy is ineffective - when painkillers, even the most powerful ones, do not help enough or cannot be prescribed due to side effects;
• With a long wait for surgery, the patient often finds himself in a situation where he has to wait more than several months for surgery. In this case, RFD can reduce the intensity of pain and make the wait for the operation more comfortable;
• If surgery is not possible - when the presence of severe concomitant diseases or other reasons do not allow radical surgery to be performed, RFD is the most effective and safe alternative;

How is radiofrequency denervation performed?

After a standard examination by an algologist, additional examination and diagnostics if necessary, a decision is made to perform radiofrequency denervation.

• The procedure is performed on an outpatient basis. Under sterile conditions, the doctor, under X-ray control, inserts special needles into the area that needs to be treated. After the doctor is sure that the tip of the needle is exactly in the right place, a local anesthetic is injected so that the denervation is painless. After this, a thin electrode is inserted through the needle channel, which is connected to a radio frequency generator and the tip of the needle is heated to a predetermined temperature. The patient, as a rule, does not experience discomfort; the most painful moment of the procedure is the usual injection.

In some cases, a therapeutic and diagnostic blockade is first performed in order to determine how effective the technique will be for this particular case. Under sterile conditions, under the guidance of an x-ray system, the needles are precisely positioned in the area to be treated. To reduce discomfort, all manipulations are performed using local anesthesia. After installing the needles, a small amount of anesthetic is injected, interrupting the pain impulse.

What is contraindicated for sacral pain?

During the period of exacerbation of discomfort, sacral spine pain, massage treatment is strictly prohibited. A little later, massage can be prescribed as an auxiliary procedure for rehabilitation after an acute attack of pain.

In the first few days after the exacerbation of the pathology, it is recommended to maintain physical rest and not walk a lot. Any type of sports activity is strictly prohibited. Bicycling, skiing, etc. are also not recommended, since all these activities put a negative load on the sacral part of the spinal column.

Risk factors

The main risk factors for the development of pathologies of the lumbar and sacral region are excess weight, high growth and lack of normal physical activity. In some people, the problems may be congenital, due to spinal abnormalities and anatomical defects. A high probability of pathology of the lower back or sacrococcygeal joint appears if the following points are present in a person’s life:

• Passive lifestyle. Constantly being in a sitting position makes the muscle corset weak; over time, it keeps the vertebrae in one position worse and worse, and they are subject to an excessively high load, which shifts them to one side or another.
• Exhausting physical labor. Moving heavy objects, lifting bags or boxes, constant exhaustion of the body leads to the early appearance of radiculitis, osteochondrosis, arthritis or other pathologies. Experts recommend wearing orthopedic devices that support the belt during exercise to avoid the development of intervertebral hernia.
• Flat feet or curvature of bone tissue. The onset of pathological processes in the spine in other places also negatively affects the lower back. Because the pressure on it increases and the load is redistributed incorrectly.
• Spinal injuries. Fractures of the sacral bone, cracks in other parts (anterior sacral foramen, ramus, horns, vertebrae, promontory), and muscle sprains that are not treated properly or become complicated can cause lower back pain, problems with walking or other functions.
• Lack of proper nutrition, excess weight. If the human body does not receive the components, vitamins, and minerals necessary for normal development, this leads to serious consequences. Excess weight in this case only aggravates the situation, creating an extra load on the bones of the lumbosacral region, leading to severe deformities.

Some lower back diseases develop due to natural causes, such as aging. Bones and cartilage gradually wear out, blood circulation in neighboring tissues becomes worse, useful elements practically do not reach them, so deformations become worse.

Osteochondrosis is the most common pathology of the lumbar region

Maintaining the health of the lower back and sacrum

Prevention of the development of diseases in the lumbosacral region and coccyx is an important measure. It will allow you to maintain normal functioning for many years, without stiffness of movement, complications of conditions, pain and discomfort. To do this, a person from an early age must adhere to the following simple rules:

• Always monitor your posture and correct body position while walking, working and sleeping.
• Select only high-quality accessories for a night's rest (orthopedic mattress, pillow of sufficient height).
• Don't wear high heels every day.
• Give up bad habits (smoking, drugs, alcohol).
• Play sports with stretching elements.
• Do not overcool the body, avoid drafts, wear clothes according to the season.
• Distribute weights evenly between your hands, do not carry heavy bags.
• Do not sit in one position for a long time; during sedentary work, take breaks of 5 minutes to warm up.

Such simple rules will allow you to maintain excellent health, prevent diseases of internal organs and degenerative processes in bone tissue. In addition to preventive measures, it is necessary not to forget to undergo regular examinations, treat identified disorders, without waiting for complications in the early stages. This is important for maintaining health for many years and preventing the development of chronic pathologies.

The lumbosacral region is an important area in the human back. It must be protected from injuries and various pathologies in order to maintain excellent health for many years.

What to do?

What to do if there is pain in the sacral region? First of all, you should immediately go to see a doctor, especially if the syndrome does not disappear within a short time. Usually with such complaints they go to see a neurologist, but if a woman experiences pain, it would not be a bad idea to visit a gynecologist. Doctors will prescribe the patient to undergo all necessary examinations and tests. Based on the data obtained, a final diagnosis will be made, and then treatment will be prescribed.

The doctor will be able to make an accurate diagnosis

On a note! You may also need consultation and examination with doctors such as a traumatologist and orthopedist if other doctors in their field cannot detect anything.

Treatment of pain consists of eliminating its cause. But in general, for almost all pathologies the following can be prescribed: medications, physiotherapy, physical therapy.

Physiotherapy

If you want to learn in more detail why your back hurts above the lower back on the sides, what this could mean, and also consider treatment methods, you can read an article about this on our portal.

Diagnosis of the causes of lumboischialgia

When pain in the lower back radiates to the leg and buttock, you need to consult a chiropractor or neurologist. Our center’s specialists use an integrated approach to diagnosis and treatment, so they can quickly make the correct diagnosis. Diagnosis begins with a survey of the patient, during which the nature of the complaints, as well as the characteristics of work and rest, are clarified. The doctor must carefully examine the patient, palpating the spine, as well as conducting special functional and neurological tests. This allows you to get a complete picture of the patient’s condition, detect signs of neurological deficit and assess the extent of damage.

In order to establish the exact cause of lower back pain radiating to the leg and buttocks, instrumental diagnostic methods are prescribed. They almost always start with assessing the condition of the bones, intervertebral discs, ligaments and muscles of the spine. For this purpose the following are assigned:

• X-ray;
• CT;
• MRI.

The most complete and accurate picture of the state of the soft tissue structures of the spine is provided by magnetic resonance imaging. The method involves conducting a study of the body using powerful magnetic fields that do not have a negative effect on the human body. Therefore, it has practically no contraindications, with the exception of the presence of metal foreign bodies or implants in the body. If there are any, the patient is referred to a CT scan or x-ray. But only MRI allows one to determine the size of protrusions and intervertebral hernias with millimeter accuracy and detect the slightest degenerative-dystrophic changes in the discs, as well as signs of compression of nerve structures.

In our clinic you can also learn in more detail about the composition of your body and the state of the vascular system, which is involved in the blood supply to internal organs, musculoskeletal muscles, and the brain. Our experienced doctors will explain the data obtained to you in detail. Bioimpendansometry calculates the ratio of fat, muscle, bone and skeletal mass, total fluid in the body, and basal metabolic rate. The intensity of recommended physical activity depends on the state of muscle mass. Metabolic processes, in turn, affect the body's ability to recover. Based on the indicators of active cell mass, one can judge the level of physical activity and nutritional balance. This simple and quick test helps us identify disturbances in the endocrine system and take the necessary measures. In addition, it is also very important for us to know the condition of blood vessels for the prevention of diseases such as heart attacks, hypertension, heart failure, diabetes and much more. Angioscan allows you to determine such important indicators as the biological age of blood vessels, their stiffness, stress index (which indicates heart rate), and blood oxygen saturation. Such screening will be useful for men and women over 30, athletes, those undergoing long-term and severe treatment, as well as everyone who monitors their health.

In this case, body composition analysis gives us information that adipose tissue predominates in the body, and the bone-muscle component is in relative deficiency. These data will help the rehabilitation doctor competently draw up a physical activity plan, taking into account the individual characteristics of the patient.

If during the examinations no abnormalities in the condition of the spine are found, the patient is referred for consultation to a proctologist, gynecologist or urologist, since pain in the lower back radiating to the leg and buttock can be accompanied by proctitis, paraproctitis, prostatitis, adnexitis, uterine prolapse, prostate adenoma and other similar diseases.

Chronic pelvic pain in women

Pelvic pain (pain in the lower abdomen, sometimes in the sacrum, rectum, vagina) can be of a different nature.
First of all, pain can be acute or chronic. The causes of these two types of pain are significantly different, which means that the treatment is also different. Acute pain is a sudden onset of severe pain that lasts several hours or days. Acute pain may be accompanied by fever, nausea, vomiting, intestinal problems, severe weakness and malaise. In cases of acute pain, especially in combination with the complaints described above, it is necessary to urgently consult a doctor - this is how acute surgical diseases often manifest themselves (for example, appendicitis, cholecystitis, intestinal obstruction and others). Acute pain manifests itself in almost any inflammatory disease of the uterus and appendages, ectopic pregnancy, torsion or rupture of an ovarian cyst, cystitis and pyelonephritis (inflammation of the bladder and/or kidneys), enteritis and colitis (inflammation of the intestines), as well as a number of other conditions requiring immediate help .

Main functions

The lumbar region accounts for the maximum total weight of a person. It is this department that redistributes the load onto the stronger structures of the lower body (pelvis, legs). The main functions of this motor segment are:

• Protection of the spinal cord and nerve bundles from various negative influences.
• Cushioning for jumping, running and heavy work.
• Mobility of the human body.
• Redistribution of a person's weight to other areas.
• Helps maintain balance.
• Protection of the pelvic organs.
• Participation in the birth process.

If the functionality of the lumbar or sacral vertebrae is impaired, a person experiences severe pain, and if the situation becomes more complicated, paralysis, paresis and other pathological conditions appear.

Relationship with other bodies

The lumbar region of the adze is connected to other parts and vital human systems, and if it is injured, this affects the general condition and reduces performance. The lumbosacral region is responsible for the work of the following organs:

• Pelvic bones and lower limbs.
• Appendix and large intestine.
• Reproductive system.
• Uterus and ovaries in women.
• Bladder.
• Sciatic nerve.
• Buttocks and thighs.
• Feet, calves, toes.
• Anus and rectum.

Each lumbosacral joint can cause dysfunction of the listed organs. If they are insufficiently mobile, injured or displaced, a person may develop circulatory problems, hemorrhoids, swelling, blockage or swelling of the ankles, cystitis, sciatica, infertility or impotence.

The spine affects the functioning of internal organs

Types of back pain in men

Anatomical features

The lumbosacral region is a complex system that provides full motor activity. Most often, diseases affect this area of ​​the spine, since when walking, sitting or performing most exercises, the load falls on this part. Interesting anatomical features of the described area are:

Why does my back hurt in the lumbar region?

• The vertebrae follow each other, and between them a hollow opening is formed through which the spinal canal passes. It contains the brain, ending in the 2nd lumbar segment.
• The lumbar region contains 5 spinal motion segments. The last of them is formed from the 5th lumbar and 1st sacral vertebrae.
• The lumbar vertebrae have the most massive processes.
• The lumbar sacrococcygeal region has a normal physiological curve, which is called lordosis. It is formed in childhood and plays a key role in walking upright.
• The sacral segment has a curve that is directed backwards. It's called kyphosis.

Small deviations in the structure in some cases do not indicate pathology. Whereas strong displacements of physiological curves in one direction or another cause deformations, disorders of internal organs and other problems.

A visual representation of the structure of the lumbar region