Contusion of coccyx

introduction

The coccyx contusion is one of the most common and painful injuries a person can sustain. Older people and athletes in particular are often affected by a coccyx bruise or a coccyx fracture (fracture) or dislocation (contortion) affected.

Located at the bottom of the spine is the tailbone, too Os coccygis called, responsible for numerous movements. After a tailbone contusion, however, simple activities such as running and especially sitting are suddenly no longer possible or can only be carried out with very severe pain.

A bruised coccyx is usually medically classified as harmless, but can be a real test of patience for patients due to the severe pain and immense restriction of movement. Severe pain and resulting insomnia are common symptoms. In severe cases, sick leave for several weeks may even be necessary due to inability to work.

anatomy

The tailbone, too Os coccygis called, is part of the lower spine of humans. It is bony with the sacrum above (Sacrum) connected. It forms one with him Synostosis, so one bony connection between two structures. The tailbone itself is made up of 5 originally created vertebral bodieswhich in most people are fused into a single bone. It is as rudimentary remnant of the tail of vertebrate animals to watch.In general, the tailbone forms the starting point for many muscles and Tapeswhich are especially necessary for sitting, running and bending movements. If these muscles fail or if they can only be partially used due to excessive pain, many elementary movements such as standing up or walking upright are no longer possible.

Due to its location, the coccyx is well protected from everyday stress, but it can be severely affected by falls painful bruises to lead. In severe and rather rare cases can also lead to fractures (Coccyx fractures) or Contortions (Coccyx dislocations) come. Coccyx dislocations in particular often lead to difficulty walking and must be treated surgically to avoid future damage such as osteoarthritis. Coccyx fractures can usually be treated conservatively with immobilization and pain relievers. Surgery is rarely necessary. Typical here is the development of a large hematoma on the buttocks and abnormal mobility of the tail vertebrae.

Causes of a coccyx contusion

A bruise or Contusion called, generally arises from a external blunt forceg that are used in tissue Disruption of connective tissue structures (so-called Collagen fibers) leads. This results in an influx of fluid and blood, which ultimately results in a Hematoma formation leads. This hematoma in turn presses on nearby vessels and nerves and compresses them. This is then expressed in the typical pain and numbness. Depending on the severity of the violence, one differentiates between one slight bruise (slight pain, disappears by itself after a few days), one moderate, as well as a severe bruise.

A coccyx bruise usually results from a violent fall on the buttocks. This can be done in the context of various sports such as Figure skating, ball sports or martial arts occur. Older people, who tend to fall due to their unsteady gait, are also often affected by coccyx contusion. By definition, external injuries are rarely seen, but abrasions or small bruises can occur. Also cyclistwhere only a slight, but constant stress on the coccyx present can be seen by a long time Coccyx contusion or one Coccyx fracture to be affected.

Symptoms of a coccyx contusion

The dominant symptom of a coccyx contusion is the severe pain in the pelvic area. Often the symptoms appear at rest and worsen when moving, which in turn for many sufferers Go and Stand makes impossible. That too Sit is only limited or not possible at all due to direct pressure on the tailbone. In severe cases, a coccyx contusion can occur also when lying down lead to pain. This pain in turn can lead to insomnia, sleep deprivation and resulting mental stress such as irritability, poor concentration and even depressive moods. Also numbness, muscle hardening or bruise marks in the area of ​​the tailbone are often typical accompanying symptoms of a tailbone contusion.

Due to the poor possibility of immobilization of the tailbone, the healing process and pain drag on over several weeks.

Duration of a coccyx contusion

The duration of a tailbone contusion is individually different and depends on many factors such as the severity of the bruise, accompanying symptoms and the age of those affected. You can get away from a few days to several weeks pull and quickly disappear individually. Usually, however, a duration of two to six weeks is assumed. However, in order to keep the duration of the symptoms as short as possible, adequate therapy is important right from the start. A early cooling and taking pain killers is important to combat pain as quickly as possible and the so-called Pain memory to prevent.

In some cases, however, the symptoms of a bruised coccyx can be so severe that a temporary incapacity for work with sick leave and immobilization is necessary.

Diagnosis

A coccyx contusion can often be caused by a exact anamnesis and a landmark physical exam be diagnosed. The pain can usually be clearly localized and can be caused by careful pressure in the area of ​​the coccyx. If the tip of the coccyx and the transition between the coccyx and sacrum are particularly sensitive to pressure, the suspicion of a contusion of the coccyx is obvious.

To rule out a fracture or dislocation, a rectal palpation the vertebral body. If there is abnormal mobility of the vertebrae, a tailbone fracture is suspected (fracture) Near.

If in doubt, a pelvic x-ray should always be taken. This allows a fracture of the tailbone and other possible injuries to be reliably identified. In very rare or very special cases, a CT or MRI image may also be necessary.

Therapy and Treatment

Treatment of a coccyx contusion consists primarily of taking Painkillerssuch as ibuprofen, novalgin and diclofenac. In severe cases, light opioids such as Tramal or Tillidin be prescribed. However, these should be viewed as a reserve and, due to their addictive effect, should not be prescribed too quickly. Also cooling and decongestant ointments can bring temporary relief from a coccyx contusion and should be used. In severe cases, injection (Injecting) of pain relievers such as local anesthetics and cortisone in the area of ​​the nerves around the tailbone. Although this method is slightly painful, it leads to significant and longer-lasting pain relief.

Another possibility that those affected can use is the so-called "Ring pillow“Which patients can put under their buttocks while sitting. Due to its special shape and the rear opening, the pillow requires one Exposure of the coccyx, which provides its relief and pain relief.

Alternative treatment options include acupuncture, Fango packs, Hip baths, as well as the edition of Cold pack for cooling. In acupuncture, special acupuncture points assigned to the tailbone are punctured with thin needles. This can provide good pain relief and healing after several uses.

forecast

If there is no fracture or dislocation in addition to the coccyx contusion, the prognosis of a coccyx contusion is favorable. To adequate pain therapy, Protection and cooling is after 2 to 6 weeks expect the pain to subside. Athletes in particular should, however, make sure to keep to the rest period of 2-6 weeks no sport to drift. Too early exposure can lead to disturbances in the healing phase and thus to a prolonged healing process of up to several months and years. This, in turn, can be associated with complications and restricted mobility in the long term.

Should be complicated fracture of the tailbone or one dislocation (contortion), surgery should be considered, since instabilities can lead to pain and osteoarthritis in the sacroiliac joint in the long term. But even here, the prognosis is favorable with adequate therapy.

prophylaxis

A particular prophylaxis or preventing coccyx contusion There are none. Athletes should watch out for falls and try to cushion them in other ways (special rolling techniques). Older people should be on sturdy footwear pay attention and try to avoid falls. Should pain persist for more than a few days, should consulted a doctor immediately so that a possible coccyx fracture or coccyx dislocation is excluded.

Long-sitting activities that cause permanent pressure on the tailbone should also be avoided. Running should be done to compensate.

If there is already a contusion of the coccyx, adequate therapy should be given and recovery should be observed. This can avoid future complications.