Orthopedics-Online

Inflammation of the tailbone

Synonyms in the broader sense

Periosteum, coccyx, pilonidal sinus

introduction

A inflammation in the area of Coccyx can be extremely painful for the affected patient.

The symptoms caused by inflammatory processes in the coccyx region can do both To run, as well as that Sit make it almost impossible.
For this reason, the affected patients can experience high levels of suffering. Due to the large number of possible underlying diseases, inflammation of the coccyx is generally a common clinical picture.
Especially Fistulas in the gluteal fold and Impairments to the periosteum are among the typical causes for the development of inflammation in the area of the coccyx.

These underlying diseases and the immigration of immune cells cause inflammatory processes directly on the bony tailbone and in its immediate vicinity.
In addition to the typical stabbing or pulling pains, can often affect the affected patient Swelling and Redness the skin surface can be observed.
In addition, the tissue of the gluteal folds and the skin above them are usually clearly warmed up.

Patients who suffer from pain in the buttocks area and / or notice swelling in the gluteal folds should definitely get a suitable one as soon as possible Specialist seek out. Complications can only be avoided through rapid diagnosis and the introduction of suitable treatment measures

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causes

Bacteria can trigger inflammation of the tailbone.

The causes of inflammation on the tailbone can be varied.

The inflammatory processes in this area are particularly often associated with a chronic inflammatory disease of the gluteal folds. The so-called "pilonidal sinus" (synonyms: coccyx fistula, pilonidal cyst or sacraldermoid) is one of the most common causes of inflammation in the coccyx in this context.
In a comparison between the sexes, men are affected far more often than women of the same age. The peak age for a coccyx fistula is between 20 and 30. A fistula, which can lead to inflammation of the coccyx, can be either congenital or acquired. In the case of a congenital coccyx fistula, it is assumed that at the end of the embryonic period there was no complete closure of the so-called neural tube.
For this reason, in the affected patients there is a connection between the tip of the bony coccyx and the anal margin.

While congenital fistulas are extremely rare in this area, the acquired form of this disease is a common clinical picture.
The reason for the development of an acquired fistula, which can lead to inflammation of the tailbone, is the penetration of hair through the epidermis (upper skin). In these cases, tufts of broken hair can be found in the area of the fistula duct.
In addition, an acquired coccyx fistula can also arise as a result of a hair formation disorder. In these cases, the keratin produced by the hair root cannot be properly built into a hair.
As a result, clod-shaped keratin islands are deposited, which the organism regards as foreign bodies. This foreign body is encapsulated from the surrounding tissue. A so-called foreign body granuloma develops, which is often inflamed by the penetration of normal bacteria on the skin surface.

Another cause of inflammation in the coccyx is bacterial infection of the periosteum. In addition, irritation of the periosteum, which leads to inflammation of the tailbone, can be provoked by the following circumstances:

traumatic events (for example, resulting in a bruise or fracture of the bony tailbone)

the dislocation of the coccyx towards the abdomen (ventral dislocation of the coccyx)

a difficult delivery
Impairment of individual nerve fibers in the area of the coccyx
Bony fusions of the sacrum with the 1st coccyx vertebra (sacralization)
Irritation in the area of the tendons and muscles (tendopathies)
Chronic constipation (constipation)

Symptoms

If the tailbone is inflamed, the typical signs of inflammation to be watched.

Nevertheless, the symptoms that occur when the tailbone becomes inflamed depends on the underlying disease. The affected patients usually feel early onset stabbing or pulling pains.
This pain can, depending on the causal disease, extend into the Buttocks and / or the Lumbar spine radiate.

The inflammation is on the coccyx one Coccyx fistula the symptoms mostly appear in the form of sudden pain, Swelling and Redness in the gluteal fold. The entire coccyx region is strong in these cases pressure sensitive. The affected patients felt symptoms can be so pronounced that the Sit and Go is only possible to a limited extent. Lying down is also only possible in many cases Prone position.

In addition, it can be in the course of Fistula-related inflammation on the tailbone to exit purulent and bloody Fluid coming out of the opening of the fistula.

A Periosteum inflammation the coccyx, on the other hand, usually shows less pronounced symptoms. In these cases, the affected patients also feel stabbing or pulling pain, but extensive swelling and redness are rare.

At traumatic changes In the bony coccyx, injuries can often be found on the buttocks or in the area of the vascular folds. Also are Bruising not uncommon in this area after external violence.

diagnosis

Patients under long-lasting or regularly If you suffer from pain in the area of the gluteal folds, you should immediately consult a suitable specialist.
Only this can determine the causal disease and then initiate appropriate treatment.

The most important step in the diagnosis of an inflammation of the tailbone is the detailed one Doctor-patient conversation (Anamnese). During this conversation, both the intensity, as well as the quality the perceived pain is revealed. Also the temporal relationship between physical activity and the first onset of pain can provide an initial indication of the underlying disease.
Most of all that took place traumatic events can lead to an inflammation of the tailbone.

In addition, other complaints play a decisive role in the diagnosis of pain in the tailbone. This doctor-patient conversation is usually followed by an orientation physical examination. This investigation is mainly based on Skin manifestations (e.g. bruises and injuries), pain triggers and any misalignments of the body axis are respected.

The buttocks region is then imaged by making magnetic resonance imaging- or computed tomography recordings.

therapy

The operation of a coccyx fistula is usually performed under general anesthesia.

In patients with inflammation of the coccyx due to a Coccyx fistula is caused, the surgical removal as the only promising treatment measure.
in the classic procedure the fistula is removed with a special dye (Methylene blue) marked.
In this way, all of the inflamed tissue can be completely removed. Since the coccyx fistula tends to occur again and again (so-called Relapse), should be taken during the operation up to the Periosteum of the tailbone cut and the bone additionally be scraped off.
Surgical removal of the Coccyx fistula, which leads to inflammation in the tailbone, usually occurs under general anesthetic.
Only in particularly mild cases can one surgery under local anesthesia should be considered. This possibility exists especially when it is a small fistula that has not yet led to inflammatory processes.
The reason for this is the fact that inflammatory tissue often responds less well to local anesthetics, making surgery extremely difficult for the patient concerned painful would.

With a pronounced Coccyx fistula, which causes widespread inflammation in the tailbone, is often hospitalized after surgical removal three to four days necessary is. In addition, after the inflamed tissue has been completely removed, a open wound treatment (secondary wound healing) be performed.
This means that the opened areas on the tailbone are not provided with a suture. For the affected patient, this form of wound healing results in your long illness. Depending on the size of the fistula and the extent of the inflammation on the tailbone, healing can take a period of several months take advantage of.
In some cases, however, a coccyx fistula can also have a primary wound healing (i.e. wound healing after the surgical area has been closed with a suture).

This form of wound healing usually ensures a comparatively short healing time.

forecast

The prognosis of inflammation at coccyx depends largely on the underlying cause. A coccyx fistula, which causes inflammation in the tailbone, usually has one good prognosis.
After the complete removal of the Fistula tissue The wound surface usually heals completely. Experience has shown, however, that after a closed wound treatment, recurrence a coccyx fistula (so-called Relapse).

Further information

Further information on the subject can be found at: