Coccyalgia: symptoms and treatment. Symptoms and treatment of coccygodynia Coccygodynia in children

Date: 19.10.2019

Coccyalgia - anococcic pain syndrome - is a polyetiological symptom complex, which is represented by diverse pain in the coccyx, anus or perineum.

The pains can have different durations, in some cases they bother the patient for several years, they can be continuous or paroxysmal, aggravated by pressure on the coccyx, walking, straining, sitting, and they can suddenly disappear. They cannot be explained in terms of concomitant gynecological or urological pathologies, spondylosis or osteochondrosis. Pain can be different - dull, stitching, radiating to the lower abdomen, perineum, thigh, buttocks, etc. In some cases, it is not possible to determine their exact location, and patients complain of pain in the rectal region, burning sensation and heaviness in the area tailbone, as well as constant discomfort in this area.

Only traumatic anoccopic pain syndrome is singled out when the cause of its development is directly trauma.

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Causes of coccyalgia

There are many reasons that contribute to the development of coccyalgia, often their diagnosis requires a lot of time and effort. The main causes of the appearance of anococci pain syndrome are:

consequences of trauma (bruise or coccyx fracture), which could be long before the manifestations of coccyalgia;
bone changes in this area;
long sitting in the toilet;
dysfunctions of the neuromuscular apparatus in the perineum and the entire pelvic floor;
prolapse of the perineum;
psycho-emotional overstrain;
heavy labor;
bone column pathology with pronounced neurological symptoms;
diseases of the genitourinary system;
surgical interventions in the anus, which provoked deformation of the anus and scarring;
diseases of the rectum, even if they are cured (proctitis, paraproctitis, anal fissure, hemorrhoids, sigmoiditis, etc.);
stool disorders (frequent constipation or diarrhea).

Classification of coccyalgia

Classification of coccyalgia implies the presence of two types of this disease:

primary coccyalgia, the cause of development is directly tailbone injury;
secondary coccyalgia, has many etiological factors (proctological, urological, gynecological pathologies, etc.).

This form includes two subspecies:

anorectal pain (pain in the perineum, buttocks, anus and rectum);
proctalgia (pain spreads mainly along the rectum).

Symptoms of coccyalgia

Anokopchikovy pain syndrome combines a combination of such symptoms:

pain in the coccygeal region (directly coccyalgia);
anorectal pains (pain in the anus), which can be of different durations, can suddenly appear and also suddenly disappear, occur at any time of the day and for no apparent reason. The pain can be of any nature, be sharp or dull, stitching, cutting, cramping, throbbing or constant. Also, anorectal pain in this syndrome is characterized by irradiation to the sacrum, thigh or gluteal region.

Symptom proctalgia

Proctalgia (pain in the rectum) is characterized by an unexpected appearance, usually at night, the duration is about 15-30 minutes, after which there comes a period of relief. Between such attacks can be quite long intervals. In some cases, pain is accompanied by cramping in the intestine. Pain in the perineum in the male can provoke the development of priapism (pathological persistent painful erection). Sometimes sexual intercourse provokes an attack of anorectal pain. Often, the acute period of anoccopic pain syndrome is associated with the presence of common neurovegetative symptoms - sweating and pallor of the skin.

The coccygodynia is localized to the coccyx, the severity of pain increases with pressure on it or when walking. Often, determining the localization of pain is quite problematic and difficult to diagnose, while patients complain of pain in the rectum, discomfort, burning sensation and heaviness in the coccyx.

Anorectal Neuralgia

With anorectal neuralgia, diffuse soreness develops in the anal region, in some cases with radiation to the thigh, buttocks and vagina. Such phenomena are often found in women in the postmenopausal period and can be accompanied by various neurological and neurasthenic pathologies (neurosis, depression, hypochondria).

Often anokopchikovy syndrome is neurogenic in nature. Many patients associate long-term pain with deadly pathologies, such patients often develop an obsessive fear of cancer, they require specialists to conduct a thorough and complete examination, as well as surgical treatment.

Diagnosis of coccyalgia

The diagnosis of this disease is established on the basis of the anamnesis, examination of the patient and a series of laboratory and instrumental studies. In order to exclude other pathologies, differential diagnosis is performed, pathologies with similar manifestations include:

hemorrhoids;
anal fissure;
sciatica (inflammation of the sciatic nerve);
lumbosacral radiculitis;
paraproctitis.

Only after the exclusion of these pathologies and other studies are performed, the doctor can establish the diagnosis of anoccopic pain syndrome. The complex examination of the patient includes:

general inspection;
digital examination of the rectum;
sigmoidoscopy;
anoscopy;
ultrasound examination of the abdominal organs;
irrigography.

Patients are also sampled for clinical analysis. A mandatory gynecological examination is shown to women, because the cause of the pain can be hidden precisely in the pathologies of the female reproductive system, especially for women who survived a difficult birth.

Finger examination

Using a digital rectal examination, the doctor can identify pathological changes in the walls of the rectum, which are characteristic of hemorrhoids, papillitis, chronic proctitis, this makes it possible to assess the condition of the sacrococcygeal joint, as well as the coccyx itself. In addition, this study helps to determine the presence of muscle spasm and the presence of pain during pelvic palpation.

Sigmoidoscopy and anoscopy

Sigmoidoscopy and anoscopy allow the doctor to see and examine in detail all the flaws of the walls of the rectum, as well as detect diseases such as tumors, polyps, anal papillae, and internal hemorrhoids.

Irrigography

Irrigography is also a method of examining the rectum, but it is based on the use of radiopaque substances and x-rays. This method also allows you to identify tumors and other pathological deformities of the rectum. In order to exclude coccyx pathologies, an X-ray examination is used (except in cases where the use of X-rays is strictly contraindicated). On the radiograph, you can see traces of fractures, cracks and dislocations.

Electrophysiological study

One of the important studies in the detection of anocopy syndrome is an electrophysiological study of the sphincter of the rectum and the condition of the muscles of the pelvic floor. Such a study is conducted to exclude muscle cramps in this area.

Ultrasound procedure

Ultrasound examination of the abdominal cavity makes it possible to diagnose the state of organs, to exclude concomitant pathology, and also to evaluate intestinal motility.

Other specialists are often involved in diagnosing this disease - a urologist, gynecologist, andrologist. If no other diseases could be identified, and the symptom complex has a place to be, the doctor can establish a diagnosis of anoccopic pain. Particular attention is paid to the psychoemotional state of the patient, because it is likely that the cause of the anoccopic pain syndrome is mental imbalance.

Coccyalgia treatment

The basis for the success of the treatment of coccyalgia, like many other diseases, is competent diagnosis and the correctness of the established diagnosis. A set of measures for the treatment of anoccopic pain syndrome includes the use of etiological therapy (elimination of the factor that provoked the syndrome), pathogenetic treatment (elimination of the pathology development mechanisms) and symptomatic therapy (elimination of pain and discomfort).

Coccyalgia treatment tactics include the use of physiotherapeutic methods, such as UHF, ultrasound, low-frequency laser therapy, x-ray therapy, mud therapy, and exposure to dynamic current.

To eliminate the pain, locally apply microclysters, suppositories, neuroblockades and anti-inflammatory drugs. Massage makes it possible to relieve muscle spasm. In some cases, treatment by a psychiatrist is necessary.

Pain medication

To date, in medical practice, special attention is paid to the elimination of pain. Different countries practice the organization of diverse institutions whose main task is the treatment of pain, including those of unknown origin. As a rule, pain relief is preferable to be carried out without the use of drugs: local anesthetics, nerve fiber blockade with novocaine, peloid therapy (hot mud applications) are used. Widely used in the past, cortisone blockades are practically not used today, since they have lower effectiveness and patients do not tolerate them.

Treatment of anoccopic pain syndrome of a psychogenic nature

If it turned out that the anokopchikovy pain syndrome is psychogenic in nature, placebo gives quite good results. In the presence of depression, increased anxiety or other neurotic pathologies, treatment of coccyalgia with the use of centrally acting drugs (tranquilizers, sedatives, antipsychotics, etc.), as well as psychotherapeutic techniques, are indicated.

Surgery

In some cases of traumatic coccyalgia, surgical intervention (coccyx removal) is recommended. With complete or partial separation of the coccyx due to trauma, the coccyx is resected. If there is no such indication, surgery will be inappropriate. Surgery can be performed only if the cause of coccyalgia is precisely the injury.

The prognosis of coccyalgia

Anokopchikovy pain syndrome is very difficult to cure, since it is difficult to find out the etiological factors affecting its development, and it often has a pronounced psychopathological component. But nevertheless, with an integrated approach, the correct and thorough examination of the patient, you can choose the appropriate treatment tactics and free the patient from this disease.

Anokopchikovy pain syndrome has no connection with the deadly pathologies of the pelvic organs, spinal bones and perineum, it also does not lead to the development of somatic complications and cannot be the cause of death. But nevertheless, coccyalgia causes great discomfort and worsens the patient’s quality of life, therefore it cannot be ignored, patients need to be patient, undergo a full examination and follow all the recommendations of the attending physician.

Many people have to deal with pain in the coccyx, which is called coccygodynia. Moreover, women suffer several times more often from such a problem than men. Pain does not threaten a person’s life, but seriously worsens its quality and causes a number of psychological problems. That is why you can not ignore the pain in the coccyx.

What is coccygodynia

The occurrence of pain in the coccyx area, provoked by inflammation or damage to nerve endings, is called coccyalgia. Discomfort can spread to neighboring areas, covering the perineum or anus.

Coccyalgia is accompanied by severe pain and makes life very difficult. The discomfort is aggravated while walking, it is difficult for the patient to sit. The act of defecation causes serious difficulties, because it involves the need to tighten the peritoneum.

Pathology is sometimes called:

coccyx pain;
anokopchikovym pain syndrome;
coccalgia;
anoccopic pain.

To understand in more detail the mechanism of formation of unpleasant sensations, one should turn to the anatomical structure of a person.

Functions and structure of the coccyx

The tailbone in a person has the shape of a slightly curved pyramid, the base of which is facing down. This is an underdeveloped tail, which during the course of evolution became unnecessary. It consists of 3-5 small vertebrae fused together.

Characteristics:

The tailbone is attached to the sacrum using a sedentary joint. It is this connection that provides the possibility of rejection of the tailbone during childbirth in women.
Ligaments and muscles are attached to the front sections, which take part in the work of some sections of the large intestine, and the genitourinary system.
In this area is the nerve plexus. Branches extending from it go to the internal organs of the pelvis, reproductive system, anus and muscles.

Due to this anatomical structure, even small injuries can provoke quite severe pain and lead to disturbances in the functioning of internal organs.

What is the danger

You should not be frivolous about the pathology. The appearance of pain can signal the development of serious disorders in the body:

osteochondrosis of the lower part of the spine;
the appearance of tumors;
splicing of the sacrococcygeal joint as a result of damage (and this during childbirth can lead to injuries to the baby).

What is coccygodynia - video

Pathology classification

Coccyalgia is divided into:

Primary. The pain is provoked by damage to the coccyx itself.
Secondary Discomfort is caused by a malfunction of the internal organs of the pelvis, gynecological, urological diseases, pathologies of the large intestine or anus. This form is divided into the following types:
1. Anorectal pain. Discomfort is localized in the anus, spreading to the perineum, genitals, buttocks.
2. Proctalgia. A painful sensation is concentrated in the rectum.

Analyzing the causes of the syndrome, several types of pathology are distinguished:

Vertebrogenic. The appearance of pain is associated with a lesion of the coccyx, as a result of which pinched nerve endings occur.
Miodystrophic. Discomfort is caused by pathological impulses coming from inflamed pelvic floor muscle tissue.
Post-traumatic. Unpleasant sensations appeared after the injuries.
Inflammatory The pain is caused by inflammatory reactions that occur in this area.

Causes of pathology

A variety of factors can lead to the appearance of pain in the tailbone.

Most often, the following sources of the problem are the basis of the pathology:

Injuries. This is the most common cause of discomfort in the coccyx. Causing injury can fall, bumps. And often they are not strong and most people just forget about them. Such bruises and bumps make themselves felt, as a rule, only after a time (after several years), when a callus forms on the damaged segment.
Neuritis, myositis. Inflammation of the nerves can provoke the appearance of pain. Coccygodynia is sometimes based on muscle sprains in the pelvis or in the perineum.
Constipation If this problem has become chronic (stool is absent for a long time) and every act of defecation is associated with severe straining, then the patient has excessive tension of the pelvic floor muscle tissue. This leads to pain. The same tension is characteristic for the other extreme - chronic diarrhea.
Weakening of ligaments and muscles in the perineum. Such a violation is characteristic of the elderly.
The consequences of operations. After surgical interventions in the area of \u200b\u200bthe perineum, rectum, scars remain. They can lead to tissue deformation, against which coccygodynia appears.
Pelvic diseases (general). Anoccopic pain usually accompanies pathologies such as:
1. Hemorrhoids - a disease in which the hemorrhoidal veins of the rectum become inflamed and very painful nodes form.
2. Fracture of the pelvic bones.
3. Paraproctitis - the inflammatory process is localized in the rectum and spreads to adjacent tissues.
Reproductive system diseases. Depending on the gender of the onset of pain, they can lead to:
1. In men. Prostatitis is a disease in which the prostate gland becomes inflamed.
2. Among women:
  1. Vulvovaginitis is an inflammatory process that encompasses the vagina.
  2. Parametritis - the uterus and the musculo-ligamentous system near it are affected.

Predisposing factors

Coccygodynia most often develops under the influence of the following factors:

prolonged sitting position (especially on an uncomfortable hard surface);
childbirth (if the woman has a narrow pelvis or large fetus);
horse riding, hobby for cycling;
excessive stress;
prolapse of the perineum (with displacement of the uterus, vagina or rectum).

Symptoms of coccyalgia

For anokopchikova pain syndrome, the following clinical manifestations are characteristic:

Pain syndrome. It can appear periodically or last a long time (months and even years). Discomfort can occur after sitting, an act of defecation, physical activity, sexual intercourse. Sometimes pain occurs even for no apparent reason.
Localization of discomfort. The patient experiences discomfort in the area of \u200b\u200bthe projection of the coccyx - at a point located just above the anus. Sometimes the pain radiates to neighboring areas. Touching the coccyx leads to increased discomfort.
The appearance of itching. A burning sensation may be felt in the area of \u200b\u200bthe projection of the coccyx.
Gait change. Since the discomfort is very painful, a person tries in every possible way to reduce its severity. Therefore, all movements become slow, very smooth. The patient usually rolls upside down.
Features of a sitting position. A person almost never leans back in his chair. While sitting, the body is tilted forward. It is in this position that the load on the coccyx is reduced, pain is reduced.
Irritable bowel syndrome. There is abdominal pain, bloating. Discomfort decreases after bowel movement.
Chronic constipation. Since the act of defecation causes considerable discomfort, the patient tries to go to the toilet less often.
Depression. A person has a constant depressed mood, a feeling of hopelessness. This depressive state can last about 3 months.
Vegetative disorders. Sometimes the syndrome is accompanied by disorders such as a change in pressure, increased sweating, dizziness, palpitations, shortness of breath.
Temperature increase. This is an optional symptom. If inflammation is the basis of coccyalgia, then an increase in temperature can be observed.

Pathology Diagnostics

Coccygodynia has quite pronounced symptoms. However, pain can signal the development of some other pathologies. Therefore, initially the doctor will examine the patient to exclude other diseases.

Differential diagnosis

To confirm coccyalgia, it is necessary to exclude pathologies of the pelvic organs:

hemorrhoids;
radiculitis;
anal fissure;
urological pathologies (urethritis, prostatitis);
gynecological diseases (inflammation, tumor formation).

Laboratory tests

Blood tests. They identify inflammatory processes, characterize the content in the body of certain substances.
Analysis of urine. It makes it possible to assess the condition of the urinary system.
Coprogram. Allows you to evaluate the work of the intestinal tract.

Instrumental examinations

In addition to laboratory tests, the patient will be prescribed such measures:

Ultrasound procedure. This diagnosis allows you to exclude damage to the genitals, intestines.
X-ray. The condition of the vertebrae is being studied. The coccyx is located in the thickness of the muscles, so in most cases this diagnosis is uninformative.
Colonoscopy The procedure allows you to examine the intestinal mucosa. The study is necessary to exclude damage to the wall, tumors.
Magnetic resonance imaging. The event reveals post-traumatic changes in the tailbone, characterizes the state of the musculo-ligamentous apparatus.

Coccyalgia treatment

The primary examination of patients experiencing pain in the coccyx may be performed by a physician. And one of the following doctors will deal with the treatment of the patient (depending on the source of the pathology):

proctologist;
traumatologist;
gynecologist;
vertebrologist (if the pathology is accompanied by osteochondrosis);
neuropathologist;
surgeon;
neurosurgeon.

Most often, pathology does not require inpatient treatment. If the patient complies with all the doctor's prescriptions, then therapy can be carried out at home.

It is quite difficult to deal with coccyalgia. Pathology is difficult to treat. Therefore, it is important to observe the whole range of therapeutic measures, consisting of:

drug therapy;
physiotherapy exercises;
physiotherapeutic procedures;
folk treatment.

To reduce the load on the tailbone while sitting, doctors recommend the use of special pillow lining. They provide a rounded hole, which falls precisely on the projection area of \u200b\u200bthe coccyx. This helps protect the patient from exacerbations.

Drug treatment

First of all, therapy is aimed at stopping the pain syndrome and, of course, at combating the underlying pathology that led to coccyalgia.

Treatment usually includes the following groups of medicines:

Painkillers. Such drugs are prescribed in the form of tablets or, with severe discomfort, in the form of injections. Good painkillers are: Armadol, Analgin, Sedalgin, Apizon.
Nonsteroidal anti-inflammatory drugs (NSAIDs). Such medications eliminate moderate-intensity pain. Medications can be prescribed in tablet, injectable form. Quickly and effectively eliminate the pain of NSAIDs in the form of rectal suppositories. When coccyalgia recommend: Diclac, Diclofen, Ketolong, Voltaren, Indomethacin, Movalis.
Muscle relaxants. They allow you to relax the muscles, due to which the spasms are removed and the infringement of the nerve roots is eliminated. Excellent muscle relaxants are: Midokalm, Baclofen, Sirdalud, Tizanidin, Baclosan.
Blockades. Apply them if the pain cannot be stopped by other methods. Most often, alcohol-novocaine blockades are used. This mixture is introduced at 3 points in the coccyx. Novocaine instantly makes the injection painless. And alcohol has a long pain relief, affecting the nerve endings. In addition to Novocaine for blockades can be used: Lidocaine, Hydrocortisone, Kenalog.
Psychotropic drugs. These drugs reduce the severity of depression, improve mood and indirectly help fight pain. Usually recommended: Motherwort, Sedafiton, Valerian, Barboval, Amitriptyline.
Antibiotics. These drugs are recommended only in cases where pelvic organs infections, such as cystitis, adnexitis, proctitis, etc. are the basis of the pathology. These drugs are prescribed only after determining the pathogen and determining its sensitivity to antibiotics.
Chondroprotectors. Taking these drugs protects the tailbone from the progression of degenerative processes. Patients are most often prescribed: Teraflex, Arthra, Structum, Don, Karipain.
Laxatives. Prescribe these medications to those patients who suffer from chronic constipation. Usually recommend means in the form of rectal suppositories: Calciolax, Ferrolax, Glycelax, Bisacodyl, Microlax.
Immunostimulants. These drugs enhance the body's defense and activate the process of repairing damaged tissues. Coccygodynia therapy may include: Immudon, Immunal, IRS-19, Timalin, Taktivin, Myelopid.
Vitamin complexes. For lesions of the coccyx and impaired nerve endings, doctors recommend taking B vitamins. Very useful drugs: Neurovitan, Milgamma, Neuromultivit, Neurorubin, Neurobion, Nerviplex, Neurobeks.

Medicines for coccyalgia - gallery

Analgin helps reduce the severity of pain Movalis eliminates moderate-intensity pain Midocalm eliminates muscle cramps Novocain is used for blockade
Barboval reduces nervous excitability
Structum protects cartilage from further destruction Bisacodyl helps relieve constipation Milgamma allows you to restore the body much faster

Physiotherapeutic Methods

The following events are considered highly effective:

Immobilization. During treatment, it is recommended to partially or completely restrict movement. If coccygodynia occurred against a background of a fracture or other injury to the coccyx, then the patient is shown bed rest for 1–1.5 weeks.
Massage (and / or manual therapy). Such an impact with the hands on the back and the damaged area, using special techniques, allows you to return the displaced vertebrae to their place, eliminate muscle cramps.
Mud therapy. Procedures reduce inflammation, activate blood circulation, stimulate blood vessels. Mud therapy reduces pain, accelerates the process of bone regeneration in fractures.
Laser Therapy This physiotherapeutic treatment provides a strong analgesic and anti-inflammatory effect. The event activates blood flow, improves metabolism. The laser helps strengthen the immune system and stimulates tissue regeneration.
Darsonvalization. Therapy on the affected area with pulse currents helps to improve microcirculation, strengthen the immune system. In addition, the event favorably affects the nervous system, providing a decrease in excitability and protection against depression.
UHF Ultra-high frequency therapy allows you to eliminate pain, provide anti-inflammatory effects, strengthen immunity, and improve tissue regeneration.
Therapeutic baths. They activate microcirculation. Water procedures provide strengthening of the nervous system, stimulate protective functions.

Physiotherapy

Necessarily in conservative therapy include gymnastics. Special exercises allow you to perform several important tasks:

improve muscle and ligamentous tissue in the pelvic area;
activate trophic processes;
improve metabolism;
strengthen immunity.

The approximate set of exercises

For pain in the tailbone, such exercises are very useful:

Standing up Hands relaxed along the torso. They gently raise their hands and take one leg back. In the back you need to bend.
Standing up Hands on the lower back. Shallow rotations are made by the body.
Standing up The leg is bent and raised up. The knee must be pressed to the chest. The second leg should remain straight.
Lying down. Exercise "Birch". Straight legs and pelvis lift up. In this position, you need to linger for a few seconds. Then drop to the floor.
Lying down. Hands are on my stomach. The legs are bent. Between the knees you need to hold a small rubber ball. Within 7-10 seconds, it is necessary to squeeze it with all his strength. Then relax. And again, repeat squeezing the ball with your knees.
Lying down. Spread your legs. Now hold the ball between your feet. Also squeeze it and linger for 7-10 seconds.
Lying down. Straight legs slowly lift up, put them behind the head so that the fingers touch the floor. Then carefully return to the starting position.
Lying down. Exercise "bike."

Gymnastics with coccyalgia - video

Surgical intervention

Of course, preference is given to conservative therapy. But if such treatment is ineffective, then doctors are considering the possibility of surgical intervention. The operation is also prescribed in cases where it is impossible to do without a scalpel.

The main indications for surgery:

the presence of tumors, cysts;
rectal pathology (proctitis, hemorrhoids, paraproctitis);
fistulas;
dislocation, fracture of the coccyx.

During surgery, a deformed coccyx is most often removed. Tendons and spasmodic muscles dissect. Now these fabrics are left without a fulcrum. Such simple measures relieve spasm and, accordingly, from pain.

In the postoperative period, antibiotics are prescribed to the patient to prevent wound infection, daily dressings. In addition, the patient is recommended to review his diet in order to protect the body as much as possible from possible constipation.

Folk remedies

Alternative therapy often includes methods of alternative medicine. However, it should be remembered that the use of folk remedies is possible only after their approval by a doctor. In addition, it is important not to forget that coccyalgia is a rather complex pathology, which can only be cured with alternative medicine. This syndrome needs an integrated approach.

To get rid of pain. Need flowers narrow-leaved lavender. Dry raw materials (1 part) are poured with vegetable oil (5 parts). The mixture is infused in a dark place for 45 days. Then the tool is filtered. Tincture is used to rub the coccygeal zone for severe pain.
To improve cartilage nutrition. It is necessary to stock up on wheat grains. They are wrapped in cloth and filled with water. In this form, it is necessary to leave the grains for 1-2 days. Then they are sorted out, selecting those that have sprouted. It is germinated wheat that is eaten. It is recommended to eat 30 g per day.
Anesthetic. It is necessary to break off the sprouts from sprouted potatoes. They are carefully washed and put in a glass container. Sprouts (1 part) are filled with medical alcohol (2 parts). The remedy is infused in a dark place for 10 days. This tincture is intended for daily rubbing of the coccyx area for pain.
To eliminate inflammation and general strengthening. Rosehips (50 g) are poured with boiling water (650 ml). Insist a drink for about 35 minutes. Then it is filtered. Rosehip tea is recommended to drink for one day.
Analgesic Fresh radish needs to be crushed on a grater. Then juice is squeezed out of it. The resulting drink (4 parts) is combined with honey (2 parts) and vodka (1 part). The mixture is mixed well. You can use it the very next day. Such a tool is allowed to be used orally for severe pains of 10 g once a day. The resulting mixture is suitable for grinding affected areas.

Folk remedies for coccyalgia - gallery

Lavender Infusion Helps Eliminate Pain Sprouted Wheat Provides Better Nutrition for Cartilage Potato sprout tincture has a strong analgesic effect Rosehip tea has a restorative effect and eliminates inflammation Radish gruel is used to prepare anesthetic

Coccyalgia is a pain syndrome in the coccyx that is caused by various causes of both the coccyx and the structures adjacent to it. Women get sick 3-4 times more often than men (due to the anatomical features of the pelvis and childbirth). The average age of the pathology is 40-55 years. With timely diagnosis and treatment, this disease goes away without a trace.

Causes

The causes of pain in the coccyx are many. The main ones are:

Injuries to the coccyx and sacrum (falling on the buttocks, direct blow to the coccyx, traffic accidents, sports injuries);
The omission of the perineum (complications after childbirth) and other birth injuries (hemorrhage in the coccyx, dislocation, etc.);
Scars of the rectum and anal passage (trauma, surgery), as well as other organs and tissues (due to severe inflammation or surgery);
Damage to the nerves in the pelvic area (neuritis);
Frequent constipation or diarrhea (prolonged sitting in the toilet);
Prolonged sitting in an uncomfortable position (“television disease” - from frequent and prolonged sitting on a hard support with legs raised to the stomach with emphasis on the tailbone);
Prostatitis;
Hemorrhoids;
Paraproctitis;
Frequent stress;
Rectal fissures;
Coccygeal fistulas.

Under the influence of one or more causative factors, spasm of the muscles of the perineum and shortening of the pelvic ligaments occur. This, in turn, entails an infringement of the nerve endings, deformation of the sacrococcygeal portion of the spine and the occurrence of pain. A direct effect on the nerve bundles with a tumor, hematoma, purulent formations, etc. is also possible.

Classification

Two types of coccygodynia are distinguished:

Primary coccyalgia - caused by damage to the coccyx;
Secondary coccyalgia - caused by pathology of the pelvic organs (gynecological, urological, proctological). There are two subspecies:
- Anorectal pain (pain spreads mainly to the anus, rectum, perineum and buttocks);
- Proctalgia (pain affects mainly the rectum).

Symptoms of coccyalgia

Coccygodynia is characterized by typical symptoms and manifestations:

Pain in the coccyx. It radiates to the anus, sacrum, buttocks, genitals, perineum, inner thigh. By nature, aching, stitching, dull, most often paroxysmal, less often - constant. Strengthens with bowel movements, sitting, abrupt rising and at night;
Discomfort and heaviness in the coccyx;
Restriction of physical activity;
Increased sweating, especially during pain;
Pallor of the skin during pain attacks;
Depression and depressed mood background;
Increased pain in contact with the coccyx and during palpation;
Gait disturbance (associated with severe pain and attempts to alleviate it) - slow, overwhelming movements.

Diagnostics

For the diagnosis of coccygodynia, vivid clinical manifestations are sufficient. But to establish the causes of coccygeal pain and prescribe the correct therapy, a number of studies are necessary:

Finger examination of the rectum - to identify pathologies of the rectum and other pelvic organs;
Radiography (direct and lateral projections) of the sacrococcygeal spine - for the detection of bone pathology;
Ultrasound of the abdominal organs - to detect intestinal pathologies;
Irrigography - to identify the structure of the rectum and the presence of neoplasms in it;
Sigmoidoscopy - to detect small tumors and other small pathologies of the rectum;
Colonoscopy - allows you to identify pathologies of the large intestine;
Gynecological examination;
Urological examination.

Coccyalgia treatment

Treatment of coccyalgia should be aimed both at eliminating the pain syndrome and eliminating the underlying disease that led to the development of these pains. As anesthetic therapy are used medical treatments:

NSAIDs. They eliminate pain of mild to moderate intensity. These are Dikloberl, Diklak, Analgin, Sedalgin, Pentalgin, Ketalong, etc. The multiplicity of doses and the duration of therapy depends on the severity of the disease and its symptoms - from 1 to 4 times a day, from 5 days or more.
Blockade of the nerve plexus in the coccyx. Apply Novocain, Lidocaine, Kenalog, Hydrocortisone, etc.
Psychotropic drugs. They can improve the general mood background, reduce the severity of depression and indirectly reduce pain. The most commonly used are Valerian, Sedafiton, Amitriptyline, Barboval, etc.

High efficiency in the fight against coccyalgia have physiotherapeutic methods of treatment.

Anokopchikovy pain syndrome (coccyalgia) - This is a pathological condition characterized by paroxysmal or persistent pain in the coccyx, anus and rectum in the absence of organic pathology. Pain is more pronounced at rest and at night, is not associated with an act of defecation. The disease is debilitating in nature, causes insomnia, depression, sexual dysfunction, often leads to disability. The disease is diagnosed on the basis of complaints and examination data after exclusion of other diseases. Treatment - physiotherapy, psychotherapy, with inefficiency, surgery is indicated.

General information

Anokopchikovy pain syndrome - a disease whose main sign is persistent pain in the perineum, in the anus and coccyx. It is a polyetiological pathology, which indicates the variety of probable factors of its occurrence. It combines such clinical manifestations as anism, proctalgia, anal neuralgia, anorectal pain, coccyalgia.

The diagnosis of coccyalgia requires a thorough examination to identify the causes of the syndrome and the choice of treatment tactics. As a separate disease, traumatic coccyalgia is considered, which occurs as a result of injuries of the tailbone, prone to pathological mobility. Anokopchikovy pain syndrome is characterized by persistent prolonged (sometimes existing for several years) pains that suddenly arise and also stop unexpectedly, can grow and weaken depending on the position of the body, intensify when walking, straining and pressing on the tailbone.

As a rule, pain with coccygodynia is not associated with weather changes, diseases of the genitourinary system, osteochondrosis and spondylosis. In connection with certain difficulties in identifying the cause and choosing the etiological treatment measures, the cure of anoccopic pain syndrome is a difficult, sometimes insoluble task.

Causes of coccyalgia

Anoccopic pain can be the result of injuries: a bruise or a fracture of the coccyx (both fresh and occurred in the past, sometimes quite a long time ago), disorders of the functioning of the neuromuscular system of the pelvic floor and retroanal zone, pathology of the bones of the pelvis and lower spine, diseases of the spinal column with pronounced neurological component, diseases of the rectum (hemorrhoids, anal fissure, proctitis and paraproctitis, sigmoiditis, etc.), including those treated, the consequences of a difficult labor, omission of the perineum, klonnost to prolonged sitting on the toilet, psycho-emotional reasons (sometimes sick coccygodynia need a therapist or psychiatric care consultation). Stool disorders (chronic constipation or diarrhea) can also contribute to the development of anorectal pain.

Anokopchikovy pain syndrome for the primary localization of pain is subdivided directly into coccyalgia (pain in the coccyx) and anorectal pain (pain is mainly located in the anus and rectum).

Symptoms of coccyalgia

Anokopchikovy pain syndrome includes the following clinical symptoms: pain in the coccyx (coccyalgia), in the anus (anorectal pain), which occurs for no apparent reason at any time of the day, can have a different duration and also suddenly or gradually subside. The pain can be diverse: be dull or sharp, cutting, stitching, constant and cramping, throbbing. Irradiation of pain in the gluteal region, sacrum, thigh can take place.

The pain localized in the rectum (proctalgia), as a rule, appears unexpectedly, more often at night, lasts 15-30 minutes, after which it subsides. The intervals between attacks of proctalgia can be quite long. Pain is sometimes accompanied by bowel spasm. Pain in the perineum can contribute to the development of painful priapism in men. Sometimes an attack of anorectal pain can be triggered by sexual intercourse. Often anoccopic pain syndrome during the acute clinic is accompanied by general neurovegetative symptoms - pallor and sweating of the skin.

Coccygodynia is localized mainly in the coccyx, increases with pressure on it, and may increase after walking. Sometimes the pain is difficult to localize, patients complain of pain in the rectum, in the coccyx, noting a feeling of heaviness, burning, discomfort.

Anorectal neuralgia is a diffuse soreness in the anus, sometimes with radiation to the sacrum and buttocks, thigh and vagina. Anorectal neuralgia most often occurs in women of postmenopausal age and often accompanies various neurasthenic and neurological diseases (depression, neurosis, hypochondria).

Anokopchikovy pain syndrome often has a neurogenic character. In many patients, prolonged pain is associated with a dangerous fatal disease, persistent carcinophobia often develops, patients require the attending physician to perform the most complete examination and prescribe surgical treatment.

Diagnosis of coccyalgia

The diagnosis of “anoccopic syndrome” is established only after a thorough examination and exclusion of the organic nature of the pain. To do this, it is necessary to carry out diagnostic measures to exclude pathologies of the rectum (hemorrhoids, anal fissure, paraproctitis, etc.), genitals (adnexitis, endometritis, prostatitis), neurological and rheumatological diseases (radiculitis, spondylitis, sciatica). The exclusion (or identification and cure) of these pathologies with the subsequent preservation of painful manifestations allows us to diagnose an anoccopic pain syndrome.

To analyze pain, the patient is examined in the knee-elbow position, and then on the gynecological chair. The proctologist performs a digital examination of the anus, determining the presence or absence of cicatricial changes, signs of inflammation, injuries to the coccyx and sacrococcygeal joint, muscle spasms of the anal canal or pelvic floor. A consultation with a gynecologist is recommended for women; a bimanual examination of the vagina and rectum is performed.

In order to exclude diseases of the final sections of the large intestine, sigmoidoscopy is performed. Anoscopy (anal canal research) and sigmoidoscopy give an idea of \u200b\u200bthe state of the rectal mucosa, reveal internal hemorrhoids, rectal polyps and inflamed anal papillae (papillitis).

X-ray examination of the rectum (irrigoscopy) allows you to detect tumors, narrowing the lumen of the colon. Radiography is also used to visualize the condition of the coccyx and sacrum, pelvic bones, and hip joints. On the radiograph, traces of a tailbone fracture, dislocations (subluxations), areas of osteoporosis and other bone tissue pathologies can be found.

In order to identify muscle spasm, an electrophysiological study of the obturator apparatus of the rectum and the muscular diaphragm of the pelvic floor is performed. In addition, such a study allows us to form an idea of \u200b\u200bthe type of intestinal motility and the features of the work of its terminal departments. Laboratory studies include a coprogram, bacteriological stool culture, fecal occult blood test, general urine analysis, if necessary, take vaginal smears for women and prostate secretion for men for analysis. Intrarectal intussusceptions taking place are detected by irrigoscopy.

In addition, pelvic organs are visualized using ultrasound. For the diagnosis of anoccopic pain syndrome, a urologist, gynecologist and andrologist, traumatologist are often involved in consultations, and, in a necessary order, a neurological examination is carried out. To identify the psycho-emotional causes of pain, a consultation with a therapist is prescribed. Massage. If necessary, treatment is prescribed with the participation of a psychiatrist.

Currently, medicine pays special attention to the treatment of pain itself. In developed countries (also in Russia) a system of medical institutions is being organized, which are aimed primarily at treating pain of any, including unknown, etiology. It is preferable to carry out the treatment of pain without the use of narcotic analgesics: apply nerve fiber blockade with novocaine, local anesthetics, hot mud applications (peloid therapy). Today, the use of cortisone blockades is limited because they have lower efficacy and are poorly tolerated by patients.

Sometimes (in the case of the psychogenic nature of the pain), a good effect is achieved using a placebo. In cases of increased anxiety, depression, and other neurotic conditions, treatment is prescribed with the help of psychotherapeutic effects and centrally acting drugs (sedatives, tranquilizers, antipsychotics, etc.).

Traumatic coccyalgia can be an indication for surgical treatment (extirpation of the coccyx). Resection of the apex of the coccyx or its fixation to the sacral bone is carried out in case of its complete or partial detachment. If this is not observed, surgery is inappropriate and may lead to a deterioration. It is possible to plan surgical measures only with the exact determination of the traumatic origin of coccyalgia and the exclusion of other possible causes of pain.

The prognosis of coccyalgia

Anokopchikovy pain syndrome is difficult to respond to therapeutic measures and has a very pronounced psycho-emotional component. However, with an integrated approach and a thorough examination, the right treatment tactics helps to relieve pain from patients and restore the quality of life.

Coccyalgia and anorectal tenderness, not associated with serious pathologies of the bones of the spine, pelvic organs and perineum, do not lead to the development of somatic complications and do not cause death.

The term coccygodynia is used by doctors to describe persistent or periodically recurring pain in the lower part of the spinal column - the coccyx. Symptoms of coccygodynia are more common in women, the treatment is long, with a timely treatment, the prognosis is positive.

Before understanding the classification and symptoms of pathology, it is worth familiarizing yourself with the anatomy of the human coccygeal spine. This element is recognized as rudimentary, it is believed that in the earlier stages of evolution a tail was in its place. In the process of change, the need for this element disappeared, the vertebrae fused, forming the fifth part of the spine. Despite its rudimentarity, the functional significance of the department is great. The muscles and ligaments attached to the upper parts of the coccygeal bone participate in the work of the genitourinary system, rectum, the lower part serves as a fastening place and support for the gluteus maximus extensor muscles. To ensure the innervation of such a large number of muscles, many nerve fibers are located in the department.

According to the generally accepted international classification of diseases in our time (the 10th revision), coccyalgia has the code M53.3, refers to other multifactorial degenerative diseases in which resistance and spine functionality are impaired.

The development of anococcyclic pain syndrome in women is accompanied not only by pain, pathologies of the pelvic organs appear, the innervation of which is disturbed due to pinching of the nerve roots. Perhaps limiting movements in the lower extremities.

Classification

The clinical classification of the disease depends on the area of \u200b\u200bdamage, with injuries, inflammatory, degenerative processes directly in the coccyx they make a diagnosis - the primary form of coccyalgia.

The secondary form implies the pathology of the organs of the urethra, reproductive system, and rectum.

Also distinguish:

true coccyalgia, in which pain symptoms are directly associated with the coccygeal spine;
proctalgia - damage to the rectum, pathology of the anus;
anorectal-pain syndrome - pain manifests itself in the inguinal, anal zone, but the reason is outside this area, since the pains are irradiating in nature.

Reasons for development

Factors in the development of coccyalgia coccyx among women are conditionally divided into two groups:

The consequences of injuries, bruises, other mechanical damage. After falling onto the back or buttocks, it may take a long time before the onset of symptoms of the disease. Victims often forget about the bruise, and therefore do not immediately associate painful sensations with a previous injury. This complicates the differential diagnosis of the condition. Patients seek help in the later stages of the development of the pathological process.
Problems of muscles, nerves, pelvic organs, among which there are:

inflammation of the nerve endings responsible for the work of organs and systems located in the pelvic area;
myositis - perineal muscle strain;
two diametrically opposite conditions, such as constipation and diarrhea, lead to increased tone of the muscles of the pelvic floor;
weakening of the ligamentous, muscular apparatus in the perineum, associated with severe labor in women, with aging in both sexes;
the formation of postoperative scars in the perineum, rectum;
inflammatory processes of the pelvic organs, reproductive system (hemorrhoids, paraproctitis, violation of the integrity of the pelvic bones, prostatitis in men, parametritis, vulvovaginitis in women).

Symptomatology

Diseases of the musculoskeletal system, which includes the spine, significantly reduce the patient's level of comfort. With coccyalgia, a forced change in gait is observed, the coccyx hurts, and this does not allow to take the usual posture when sitting, a person tries to lean a little forward, thereby unloading the affected segment.

Patient complaints of pain are specific, some experience constant pain, others speak of periodic, acute, shooting, aching, burning pains. Pain can occur after exertion, without it, depending on the time of day, body position.

Often women fall into depression, an important role in the development of depressive states is played by disorders, problems of the sexual functions of patients. Another factor is problems with bowel movements due to pain in the coccygeal segment of the spine, constipation is provoked by a fear of going to the toilet, as this is due to exacerbation of pain. The absence of stool for 2-3 days, becoming regular (chronic), leads to intoxication of the body, worsening of general well-being.

From the autonomic nervous system, there are malfunctions in the cardiovascular system, increased blood pressure, dizziness, increased sweat glands.

A disease against the background of inflammatory etiology can occur with an increase in body temperature.

Diagnostic Methods

The primary methods used when diagnosing a patient with coccygodynia include collecting an anamnesis, visual examination, palpation. They are used to identify:

complaints
lifestyle of the patient;
possible injuries.

They are carried out to exclude diseases such as:

rectal hemorrhoids;
fissures of the colon, anus.

When examining men, it is necessary to exclude urological problems, such as prostatitis, inflammation of the urethra. In women, a study is required for the presence of gynecological diseases, inflammation, neoplasms.

The next step is the conduct of laboratory tests of blood, urine, fecal analysis. The results obtained will reveal:

inflammatory reactions:
malfunctions of the intestinal tract;
urinary tract diseases.

Among instrumental studies, magnetic resonance imaging showed the greatest efficiency, the method allows you to see the full picture of changes in the coccygeal section as a result of trauma, impaired bone density, allows you to identify pathological changes in muscle tissue, ligamentous apparatus, determine the prognosis of coccyalgodynia. The disadvantage of this procedure is its high price. Unfortunately, the use of a cheaper research option - an x-ray apparatus, the study of x-ray images with coccyalgia - is uninformative. This is due to the anatomical location of the coccyx bones deep in the muscle layer.

Before the appointment of an MRI, it is advisable to conduct an ultrasound of the abdominal cavity and pelvis, to make a coprogram.

Treatment

As a rule, this disease does not require a long stay in the hospital. After carrying out all diagnostic procedures, choosing a treatment strategy, the patient is transferred to a day hospital.

You can take medication for coccyx disease at home, according to individual indications, the attending physician prescribes:

medications to relieve pain symptoms - it is permissible to use drugs in the form of tablets, to ensure a strong analgesic effect, an injection of drugs is prescribed (analgin, apisone, etc.);
with a slightly pronounced pain syndrome of coccycodhynia of inflammatory etiology, non-steroidal anti-inflammatory drugs are used in the form of tablets, solutions for injection, rectal suppositories (declac, movalis);
muscle relaxers are called to eliminate pinching of nerve endings, to relax spasmodic muscles - they are prescribed with caution in connection with many side effects, contraindications (sirdalurd, baclosan);
with an infectious etiology of the disease - antibiotics, before using the means of this group, it is mandatory to conduct a test for the sensitivity of pathogenic microflora to the selected drug, it is also recommended to conduct an allergy test;
chronic constipation is solved by the appointment of laxatives in the form of suppositories, microclysters;
motherwort, valerian help to fight depression, in cases of severe depressive states, more powerful drugs are prescribed, groups of psychotropic drugs;
to improve the general condition of bone, cartilage, chondroprotectors, drugs containing glucosamine, chondroitin;
b vitamins are necessary for the functioning of the nervous system (B6 - is involved in the synthesis of serotonin, a kind of antidepressant, B12 - without it, the full assimilation of proteins, fats, carbohydrates is impossible, it is necessary to create chromosomal chains);
immunostimulants - used to accelerate regeneration, increase the protective barriers of the body.

The medical treatment of coccygodynia includes the use of pain blockers, such procedures are carried out with sterile solutions of alcohol and novocaine, in this tandem almost instant pain relief (at the time of administration) provides novocaine, alcohol is necessary to prolong the action of the main drug. The injection may include lidocaine, hydrocortisone, and other drugs. Blockade is a fast, effective way to deal with pain with coccyalgia.

To increase the effectiveness of drug treatment, supplement, consolidate the positive dynamics of the recovery process, physiotherapeutic procedures are prescribed:

massage, manual therapy, acupuncture with coccyalgia are necessary to reduce tension in the affected area, restore the correct anatomical structure of the spine (return to the place, correct the shifted vertebrae);
laser - improves local blood circulation, accelerates regeneration, metabolic processes, has an analgesic effect;
darsonval - exposure to currents, a beneficial effect on the skin, central nervous system;
the use of ultra-high frequency devices allows you to speed up rehabilitation, strengthen the immune system;
therapeutic baths.

To strengthen muscle, ligamentous apparatus, increase tissue elasticity in the fight against coccyalgia, a complex of therapeutic exercises, physical education is prescribed. Exercises are performed in a lying or standing position, are selected individually for each patient.

Examples of exercises:

in a standing position, hands on the belt, slowly make circular movements with hips of small amplitude;
standing, raise one leg bent at the knee, pressing it to the chest;
starting position, too, smoothly roll the feet from toe to heel and back, rising to the toes, you perform the strengthening of the muscles of the pelvic floor, with the same purpose alternating contraction and relaxation of the muscles of the perineum, anus;
lying on your back, bend your knees, perform pelvic lifts, holding it at the top point for 5-10 seconds;
do not change the starting position, place a rubber ball between the knees, try to squeeze it as tight as possible, then relax your legs, do 10-15 repetitions.

All exercises should be done without sudden movements, to maintain smooth, deep breathing.

With the appearance of pain in the tailbone, many of us would like to limit ourselves to the methods of traditional medicine. Treatment of coccyalgia with folk remedies is possible, but only in combination with conservative therapy of official medicine and after prior consultation with your doctor.

Effective folk recipes include the use of inside germinated wheat, tea from rose hips. They do externally anesthetic wraps, rubbing, for this they take radish juice, alcohol, honey, mix in a ratio of 4: 2: 1, let it brew for a day.

In cases of late treatment, conservative medicine may be powerless. Surgery is the only way out. Most often, the coccyx is removed, muscles, ligaments of the department lose support, become vulnerable. In the future, such a patient should always adhere to special diets. In order to prevent complications, with the development of anoccopic pain syndrome, you should consult a doctor - therapist or neurologist in a timely manner.