Pain at the coccyx – Kokzygodynie
The Kokzygodynie describes the Occurrence of coccyx pain due to various causes, which remain, in some cases, unknown. The symptoms can persist over a long period of time and Affected severely restrict. In most cases, women suffer from pain in the rump. Common treatment methods are mainly symptomatic. The variety of possible triggers, but that quite different therapeutic approaches used to fight the disease.
Table of contents
A brief Overview
Coccyx pain can be perceived very differently, and of course can be very different, what makes the Kokzygodynie rarely to a long history of illness. Prior to the detailed description of the disease image, a brief Overview of the key facts can be found here.
- Definition: The Kokzygodynie describes pain directly to the coccyx occur, or in this region of the body emit (Pseudo-variation). It is one of the diseases of the spine and the back, wherein the disease triggers are very diverse.
- Symptoms: occurring coccyx pain are very different in intensity and duration. Usually the pressure and burden increase the problems. In some cases, the pain is perceived in the surrounding areas of the body.
- Causes: It is, in principle, between the well-known causes are due to trauma and unknown causes of differences. In both cases, a variety of actuators come in question, wherein said traumatic pain is caused mostly by a dislocation, contusion, or fracture of the Coccyx.
- Diagnosis: Palpation and targeted to Move the Tailbone in, as a rule, the Existence of a real Kokzygodynie to be diagnosed. For reasons of clarification and to the exclusion of other possible diseases often x-ray examinations or other image to be added giving procedure.
- Treatment: first and foremost, to be conservative, symptomatic therapies applied, for example by means of heat, relaxation and exercise relieve pain. In addition, there are many other approaches, such as, for example, the administration of painkillers. A surgical procedure and a removal of the Coccyx is generally regarded as the last Option.
- Naturopathic treatment and alternative methods of therapy: For the treatment of pain can also be musculoskeletal and manual therapies, such as osteopathy and chiropractic, are used. Other alternative options include acupuncture or homeopathy.
Definition
The term Kokzygodynie (Latin spelling: Coccygodynia) is derived from the affected body region of the Coccyx (Os coccygis) and describes it with the word ending “-dynie” the Occurrence of pain. Consequently, it is also called tailbone pain or coccyx neuralgia. According to the International classification of diseases (ICD-10) is one of the Kokzygodynie to the diseases of the spine and of the back.
The coccyx to the sacrum (Os sacrum) and forms the lowest section of the spine, to the various muscles and ligaments attach. For most people, the individual Steißwirbel are fused to a bone (Synostosis). The coccyx is regarded as a Vestige of the caudal vertebrae of vertebrates, which is formed in the human Evolution. Nevertheless, the tailbone plays but for the structure of the body statics an important role.
A Kokzygodynie occurs rather rarely. Most often women of middle age are affected. Many possible causes come in question, which can be attributed in large part to trauma or other diseases. But not in every case, the shutter can be determined, the causes remain unknown or be attributed to other diseases and psychosomatic reasons. The disease may be chronic in nature and Affected the long-term affect.
In the case of the disease a distinction can be made between the real shape and the Pseudo-Kokzygodynie. During a real coccyx neuralgia has its origin in the coccyx or in the sakrokokzygealen joint (connection of the sacrum and coccyx), the Pseudo-variant to radiating pain caused elsewhere.
Symptoms
The coccyx pain can be short-lived or become chronic. They occur directly on the coccyx or in the surrounding areas of the body or from radiation there. In part, the complaints are perceived as very strong. The pain is often a tightening, stabbing or burning and increase under certain loads and movements. Any pressure on the coccyx is perceived as particularly painful. People report difficulty in Sitting, Sit down, Stand up, and climbing stairs. It can also lead to discomfort during defecation and sexual intercourse.
The pain from the radiation, pain and sometimes as back (back pain, sciatic pain), hip pain and groin pain or buttock pain is perceived.
Causes
From a medical point of view, a distinction is made between the traumatic and idiopathic Kokzygodynie.
Traumatic pain in the coccyx is usually formed from the injury. Falls of any kind, other accidents, as well as a natural (vaginal) birth, can be the trigger for a dislocation (Luxation), bruise (contusion), or, less frequently, a fracture of the Coccyx. Also adjacent structures such as the ligaments and muscle fibers may be affected. Also in the framework of pregnancies is also increased reports of discomfort in the coccyx. This irritation or Overstretching of ligaments, which attach to the tailbone and can be suspected as a possible cause.
In addition, congenital malformations or poorly healed vertebral fractures of the Coccyx can be painful or in the course of time cause pain. It is not by excessive weight bearing (Obesity), pain in the coccyx, obesity as a risk factor.
Even after extensive studies (in rare cases), no detectable cause found, referred to the disease as idiopathic. There may be certain peculiarities in the anatomy (shape variations) of the Coccyx (positions and mobility of the coccyx vertebrae) pain triggering. Also, the presumption that a merger between the sacrum and coccyx (sakrokokzygeale connection) could be for any discomfort responsible.
Furthermore, it is discussed whether other diseases can cause the symptoms of a Kokzygodynie. So, there are indications that a low-lying herniated disc, different diseases of the muscles and ligaments in the pelvis and pelvic floor, a Tumor or a cyst (or a fistula), the structures of the coccyx bust, overburden, or ignite, and so the same type of pain cause can put. Also, a connection with rheumatic diseases. Strikingly often neuralgia suffer from ankylosing spondylitis patients under a Coccyx.
In some studies, a connection to mental illness, such as depression, suspect. So it is possible that the Affected with idiopathic coccyx pain a psychosomatic disease is diagnosed.
Diagnosis
The diagnosis is based after a detailed patient history almost always to a physical examination by Palpation (Palpation) and targeted to Move the tip of the Coccyx, and, in particular, of the coccyx tip. The coccyx from the outside and, where appropriate, is all the touches from the inside. Be triggered by the pressure caused pain, then it is assumed, as a rule, of a real Kokzygodynie.
For further clarifying Causes and treatment form, or to the exclusion of other diseases, additional investigations can be arranged, such as x-ray or other imaging procedures.
On the x-ray images, changes in the bone can be detected, where the diagnosis is due to the variable anatomy of the Coccyx complicated (number, shape, Position, and fusion of the coccyx vertebrae). An injury is visible, don’t remember to be Concerned, often to a accident. Typical is that between the causative Trauma and the onset of pain, a certain latency time.
The x-rays show no abnormalities, depending on the patients case, the use of ultrasound, computed tomography scan or magnetic resonance imaging. Among other things, the tumors or internal inflammation can be detected. Since twice as many women as men are affected, can be a additional gynecological examination makes sense.
Treatment
The causes of clarification is an important part of a successful therapy. The treatment concepts vary depending on the cause to be relatively far apart and have not been checked extensively for their effect. The pain is chronic and persist for months or even years, the treatment is much more difficult and usually very time-consuming. In some cases, the pain but also of alone.
Often a conservative, symptomatic treatment is applied, which primarily includes physical therapy. Often heat treatments sitz baths and mud packs and massages may be used. Only slight pain, can help a short-wave therapy against the discomfort.
If the complaints occur mostly Sitting, can have certain seat cushion and seat rings analgesic. Also measures such as dynamic Sitting, moderate exercise and gym exercises (physiotherapy) to strengthen the core muscles in question, which are also used for the treatment as well as for the prevention of back pain.
In addition to the dynamic Seats should Be in a job that requires a permanent Sitting, regular, and movement will all be incorporated in the work routine. Height-adjustable desks available, it can be applied easily to the “40-15-5 rule”: 40 minutes working in dynamic Sitting, 15 minutes work, five minutes to move.
In addition to these treatment options also pain are often prescribed medication such as analgesics and anti-inflammatory Drugs, or be injected with local anesthetics (local anesthetics), pain relief and with additional active agents (corticosteroids) inflammatory processes inhibit. In the case of a relevant diagnosis in connection with a Kokzygodynie other medicines, but with very different effect spectra administered. Be used for suspected psychosomatic causes, for example, sometimes antidepressants.
The success of the symptomatic forms of therapy is, in principle, be higher, if no Trauma is present. Injuries to the Coccyx may also be treated surgically, but are not always successful and filled with risk. Therefore, surgery should only be considered if strictly indicated and only after conservative therapy try. Among the possible surgical measures, the Kokzygotomie (bilateral Umschneidung of the Coccyx), the Kokzygektomie (removal of the Coccyx or of certain parts) and nerve operations.
In total, there are only a few scientific evidence about the success of individual treatment approaches.
Naturopathic Treatment
Due to the large number of possible causes and possible treatment concepts that are sometimes difficult to determine, and a protracted course may favor, also natural remedies as an Alternative or as a supportive measure for many Sufferers.
The thermal therapy has a firm place in Natural medicine, but also other musculoskeletal and manual therapies (osteopathy and chiropractic). The coccyx is mobilized by certain handles and relieved.
Psychological causes play a role, psychotherapy is a useful Supplement in the therapy concept.