Tailbone pain
General
Tailbone pain (med. Coccygodynia) denote pain in the lowest area of the Spine. This area is called coccyx (Os coccygis) describes and reacts to pressure with a sharp, stabbing or pulling pain that can radiate into the adjacent areas. Overall, tailbone pain is more likely Rare. The most common cause are chronic Microtraumas. But also Nerve pain or injury can lead to tailbone pain.
In addition, everyday clinical practice clearly shows that Women of tailbone problems more often are affected as men. Pain in the coccyx, which is more of a harmless cause, usually only lasts a few days on and are with light pain relievers (Analgesics) treat well. In many cases the problems arise spontaneous and form themselves back again. However, pain in the tailbone can also occur depending on the underlying disease Weeks to months stop, put a lot of strain on the person affected and thus make medical treatment unavoidable.
Symptoms
Many people suffer from severe pain in the area of Coccyx (Os coccygis). These can occur intermittently in certain situations, for example when sitting, during bowel movements or during exercise, or they can be chronic. This clinical picture is also called "Coccygodynia“.
Figure tailbone pain
- Tailbone - Os coccyxis
- Fifth lumbar vertebra -
Vertebra lumbalis V - Iliac crest - Iliac crest
- Sacrum-iliac joint
(Sacroiliac joint, abbreviated ISG)
Articulatio sacroiliaca - Hip joint - Articulatio coxae
- Pubic bone - Pubis
- Ischium - Os ischii
- Intervertebral disc -
Intervertebral disc - Iliac bone - Os ilium
- Lumbar cruciate ligament kink -
Promontory - Sacrum - Sacrum
- Pubic symphysis -
Pubic symphysis
Coccyx pain - coccygodynia
a - Nerve Pain - The region of the body
becomes of plexus of nerves
(Plexus coccygeus) supplied
b - inflammation of the tendons,
Muscles or bones -
chronic loads or germs
c - rectum and anus, chronic
inflammatory bowel disease
(Ulcerative colitis, crohn's disease)
d - Coccyx fracture, coccyx contusion -
Swelling, bruising (due to
Fall, kick, etc.)
e - pregnancy
(hormonal changes) -
usually in the 1st and 3rd trimester
f - sport - tensioning the ligaments
and muscles (e.g. cycling, rowing)
g - Lying for a long time - (older and
bedridden people)
h - microtraumas - prolonged sitting
on hard chairs
i - coccyx inflammation - redness,
Swelling, fistula (Pilonidal sinus)
You can find an overview of all Dr-Gumpert images at: medical illustrations
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causes
There are many different reasons for tailbone pain. The body region is supplied by the nerve plexus "Plexus Coccygeus" and is therefore very sensitive to pain.
Even if in some cases no real trigger for the pain in the tailbone can be found and one speaks of so-called psychosomatic pain, there are also events that are directly related to the pain. This plexus of nerves on the coccyx can be irritated, for example, by sitting for a long time, i.e. remaining in the same position.
However, injuries to the coccyx, such as a fracture, soft tissue injuries to the pelvic floor muscles or lumbar disc herniations, and insufficient healing are much more common reasons for the resulting pain.
In addition, women experience such pain in connection with pregnancy and childbirth.
Read more on the topic: Tailbone pain during pregnancy or inflammation of the bone skin on the tailbone
Bowel problems can also show these symptoms. The pain in the tailbone then not only occurs acutely in the phase of injury and healing, but can also remain long-term and thus become chronic. Then one speaks of coccygodynia.
Coccyx pain from microtraumas
With strong mechanical loads such as long periods of sitting on hard chairs, but also on soft surfaces, tailbone pain can occur in some people after a long time. The reason are smaller microtraumas, which cause stress on the bony coccyx and the surrounding soft tissues. These micro traumas are one of the most common causes of tailbone pain. The affected patients perceive an enormous increase in pain sensations not only after long periods of sitting, but also when lying down, running and bending down, the tailbone of many affected people hurts. This fact is due to the damage to the tissue in the rump region caused by the trauma. However, pain in the tailbone is usually not limited to the buttocks. In some cases, patients report pain radiating to the thighs or lumbar spine.
Tailbone pain from inflammation
Inflammation of the tendons, muscles or bones can result from chronic stress or germs. Usually, this inflammation is accompanied by other symptoms. The chronic inflammation in the context of arthritis (joint inflammation) often occurs over a long period of time and can usually only be cured by consistent, lengthy therapy. Long-lasting, monotonous movements also play a decisive role in the case of pain in the tailbone, which is caused by inflammation. Especially after long periods of sitting, lying down or running, tailbone pain caused by inflammation is felt to be particularly severe.
Tailbone pain after a fall
Often, tailbone pain is associated with a fall. The impact of forces on the tailbone during a fall and the comparatively low cushioning of the tailbone can result in bruises or even fractures on the tailbone.
In terms of time, the bruises are the first Paincaused by the irritation of the nerve plexus "Coccyx plexus"And possibly the"Sacral plexus" in the foreground. In the course it develops due to the damage to blood vessels bruise, which together with the edematous swelling of the surrounding tissue cause an increase in pressure on the coccyx. The irritated nerves however, are more sensitive to pressure and touch. Depending on its severity, the pain can be increased over a period of weeks, but subside somewhat as the bruise subsides.
If the tailbone breaks as a result of a fall, the Pain due to the damage to the very delicate Periosteum turn out to be stronger. Also, through the healing process of the coccyx bone, the Duration of pain or sensitivity to pain increased be. In principle, the same thing happens after a fall with a break as with a bruise, only that the bone itself is more severely damaged and the bruise can be larger. Create relief from the symptoms cooling and Protection of the coccyx. They are a little rarer but not to be neglected Coccyx dislocations (Displacement of the coccyx) due to a fall. The pain usually subsides again after successful reduction.
Tailbone pain without a fall
Even without injury from a fall, severe pain in the tailbone can occur. The reason for this can, for example, be sitting on hard ground for too long, as a high load presses on the relatively small tailbone for a long time. In addition, the levator muscles, which attach directly to the tailbone, cramp in this position after a while. In addition, when you sit down, blood flow to the buttocks and tailbone regions is reduced. In order to avoid pain, it is therefore advisable to change your position from time to time, to take a few steps or to choose another seat.
However, tissue damage in the coccyx region also causes pain. These include the coccyx fistula, a sore spot known as a "decubitus", and a perianal vein thrombosis. In addition, chronic inflammatory bowel diseases can promote the development of pain through permanent damage to the intestinal tissue, which leads to transmission pain in the coccyx due to the fuzzy interconnection of the intestinal nerves together with the other nerves on the spinal cord. Thus, the tailbone can hurt even if it is not directly affected.
Tailbone pain with diarrhea
Constipation associated with coccyx pain can best be explained by its proximity. The last part of the colon and the rectum lie just below the tailbone. When this section of the intestine becomes blocked and enlarged, the internal pressure on the coccyx increases. In the long term, this can cause pain.
Neurological causes of tailbone pain
A herniated disc in the lower lumbar vertebra or irritation of the corresponding nerve root (lumbar sciatica) leads to severe pain in the coccyx area. This is also supplied by the sciatic nerve and leads to pain when it is irritated. The anococcygeus nerve also supplies an area between the tailbone and anus. If this is irritated, inflamed or irritated by a neurological disease, it also causes pain in the tailbone.
Tailbone pain from tumors
As in many other bones, bone tumors can also affect the coccyx and cause pain after a while. Gynecological tumors can also infiltrate the area of the coccyx due to their location, or irritate or constrict the coccyx and the surrounding soft tissues due to their growth in size.
Tailbone pain after childbirth
Due to the heavy use of the woman's entire pelvis during childbirth, the tailbone can also be severely irritated. This can lead to compression or injury from the inside and thus cause pain. Towards the end of the pregnancy, the child begins to sink towards the pelvis and thereby move into an ideal birth position. This process can also lead to strong stretching of the pelvic ring, irritate various anatomical structures and thereby trigger pain in the coccyx. Especially during childbirth, the use of a so-called epidural anesthesia can be used to provide effective pain relief for the pregnant woman. The epidural anesthesia is a special form of regional anesthesia, in which an anesthetic can be injected close to the spinal cord to provide effective pain relief. This will essentially alleviate pain in the coccyx that may occur during childbirth.
Tailbone pain from an abscess
A tailbone abscess is an encapsulated inflammation in the tailbone region. Ingrown hairs on the outer skin can cause fistulas and injuries to the outer skin on the lower back. Bacterial pathogens can find their way into the body via these fistulas and cause inflammation. Long periods of sitting and little movement contribute to the development of this inflammation.
In the long term, an abscess that causes pain in the tailbone requires surgery. To do this, the entire area is cleared out, the inflammation rinsed out and the wound repaired. In most cases, the abscess and pain are healed and never recur.
You can find more detailed information on abscesses on our website Tailbone abscess.
Diagnosis of tailbone pain
Also briefly Any pain in the coccyx should be presented to a doctor in any case. In addition, it can only be the finding of the exact root cause help one optimal therapy to initiate. If the pain in the tailbone persists over a longer period of time or occurs again and again, extensive diagnostics are all the more important. They also play different Factors the for Increase or decrease in pain play a significant role in the diagnosis of tailbone pain. Furthermore, the assessment of the pain symptoms in different Postures can be used for diagnostics. Making a simple X-ray In most cases, it does not help in the diagnosis of pain in the tailbone, because the majority of the underlying changes cannot be detected by X-rays.
First, however, the patient will be asked exactly as part of an anamnesis interview with the attending physician Form of pain, Duration of pain and accurate localization questioned. The doctor also wants to know whether there is an identifiable cause, for example a fall or prolonged sedentary work. The patient is then physically examined.If there is indeed a tailbone pain, the pain can be triggered by pressure on the tailbone. A neurological disorder, such as a disc prolapse, one Sciatic neuralgia or Nerve irritation cause constant pain, but this cannot be triggered by pressure on the tailbone. To find out these causes, a Ultrasound examination (Sonography) of the pelvis, one Computed Tomography (CT) or a Magnetic resonance imaging (MRI) can be helpful. If a tumor or inflammation is suspected, the blood values should be determined in a laboratory. In addition, tumorous or inflamed areas can be caused by a strong Contrast medium absorption can be represented as images.
Therapy / treatment
In the case of tailbone pain, the Symptom relief in the foreground. Medicinal can Pain medication, which also have an anti-inflammatory effect, are used. In addition, if possible, the underlying problem should be addressed and corrected. Especially light pain relievers how Ibuprofen or aspirin are useful for relieving tailbone pain. Local injection of anti-inflammatory drugs (cortisone) or local narcotics (Local anesthetics) the pain can be relieved for some time. Also physiotherapeutic Methods like Mobilization or manipulation of the coccyx help some patients. Heat treatments or other relaxation methods have a positive effect on the surrounding muscles and can thus achieve relief. Specific Seat cushions, a soft seat ring open at the back or a soft seat wedge make it easier to sit in the event of acute complaints. In some cases, the cause cannot be found, leading to the suspicion of a psychosomatic Disease exists. In this case, psychotherapeutic measures should be considered, even if this form of therapy is initially uncomfortable for most patients.
Which doctor treats tailbone pain?
If you discover new tailbone pain, there are a number of specialists who can help you. The right search for a doctor depends primarily on the causes and accompanying circumstances of the pain. If you are already in the treatment of a doctor for similar illnesses, you should visit him so that he can sort the pain into an existing clinical picture. It is advisable to consult an orthopedic surgeon in the event of new symptoms, for example caused by exercise. If you are pregnant, the gynecologist in charge should be contacted first.
If you are unsure, it is always worth going to your own family doctor first. They can narrow down the possible causes and, if necessary, recommend them to a specialist doctor.
Home remedies
With simple home remedies, you can remedy most of the symptoms yourself. Serious injuries or illnesses that require medical treatment are rarely behind this. To prevent tailbone pain, there should be a healthy balance between sitting, standing and other monotonous, long-term activities. A seat cushion or an ergonomic office chair also largely spare your back and tailbone.
In the case of acute complaints, rest and rest help. A heat pillow or a hot bath can also alleviate the symptoms.
Medication
For acute complaints, mild pain relievers with an additional anti-inflammatory effect can be used. This group of drugs is called NSAIDs, examples are ibuprofen, diclofenac, and indomethacin.
Stronger remedies are only used for stubborn inflammation and pain. Cortisol can be used as a highly effective drug to reduce inflammation. If the pain is severe, local anesthesia or medication similar to morphine can be prescribed if necessary.
When does your pain occur?
Laying
Pain on coccyx can by all means lying down for too long or repeatedly arise in the same position. Only one can do that Tension at the relevant point or with a Tissue damage go along in the coccyx region. This is particularly the case elderly, bedridden people the case, which lie in one place for a long time. Since the tailbone is not so well padded with fatty tissue and muscles compared to the buttock region, the bone presses vertically on the tissue lying on it, depending on the position. That plays Weight of the person concerned not matter. As a result, it often occurs Pressure point on the tailbone that Pain caused. If you are still mobile and healthy from your general condition, you can react quickly and take countermeasures that allow the pressure point to heal again. In the elderly, however, the problem is that they are one anyway poor tissue circulation and have a concomitant illness that also does not have a beneficial effect on the healing of the pressure point caused by lying down. Sometimes there are also bad nerves, so that the person does not even notice that there is tissue damage on the tailbone. The pressure point can then, if it is not noticed, become an open area and possibly develop infect. In the worst case it comes to Tissue deathdamage to the coccyx itself or preventing the area from healing. Therefore, extreme caution is required when lying down for long periods of time in order to avoid major damage or pain to the tailbone.
After sitting
When sitting, the coccyx is often more stressed than in other postures. Nowadays, many complaints in the back, tailbone, neck and other parts of the body are caused by incorrect sitting postures and unhealthy habits. To blame are always long, sedentary activities at work, hard surfaces, bad chairs and a lack of exercise in between. Sitting on hard ground for a long time can cause various causes of tailbone pain. The nerve plexus, which emerges from the vertebral canal deep in the back and supplies the leg, can be depressed and affected by long sitting. The initial symptoms are tingling in the legs, up to mild numbness. Along with the nerves, the supplying blood vessels can also be affected. If these are pressed while sitting, pain can occur in the affected body regions.
Read more on the subject at: Tailbone pain when sitting
In addition, even small injuries to the bone matter in the coccyx can occur as a result of permanent pressure while sitting. By sitting, the body shifts a large part of its weight to the relatively small tailbone, which can lead to chronic bone damage in the long term. Therapy for tailbone pain by sitting consists largely of changing your sitting habits. An ergonomically adapted office chair can bring relief in the long term. Movement and alternation between sitting, running and standing strengthens the back and tailbone. If the surface is too hard, we recommend a seat cushion, which takes some of the pressure off the tailbone.
While getting up
Since the tailbone is closely connected to the spine and hips, movements in the joints put a strain on it. Almost all movements of the upper body and legs involve movements in the hip joints and between the vertebrae. Thus, when the coccyx is impaired, movements such as standing up, sitting down, bending over, jumping and others are directly affected. The pain often subsides slightly while standing, but the movement itself is painful. Rest should be observed in pain.
Pain after exercise
Even if Sports plays an important role in the well-being of the musculoskeletal system, but certain sports also their typical ones Injuries and pain result.
The coccyx can of course always after sport as a result of violent and powerful movements in the hips and legs due to the resulting Shear forces be affected. It can lead to a Tension of the ligaments and muscles on the tailbone come or even to Dislocation of the coccyx, which should be corrected therapeutically.
There are also sports in which the tailbone increasingly used comes and therefore pain after exercise can occur.
For example lead at To go biking or rowing the predominantly seated posture and the friction generated by repeating the same movements to irritate the tissue around the coccyx. This happens very quickly due to the less padding of the tailbone. In addition, there is pressure on the seated sports coccyx, which stretches the ligaments and thus again provokes pain in the tailbone.
But that is among other things a matter of practice. Such pain usually occurs after exercise Beginners or after Overexertion or Improper loading up and lay down again over time. If the tailbone hurts repeatedly after doing the same sport, this may also be due to the sport itself, which is very stressful for the tailbone.
In strength training
Many strength athletes regularly experience tailbone pain. The pain is not always directly attributable to poor posture or incorrect loading. Many exercises that are carried out in weight training involve high pressure and tensile loads on the hips, back and tailbone. The tailbone is more stressed, especially when bending over and applying force in the hips. In weight training, the already natural, stressful movement is made more difficult with additional weights. If the pain persists, a herniated disc should also be considered.
Initially, sport should be avoided until the pain has subsided. Pain medication that also inhibits inflammation, from the group of NSAIDs (e.g. ibuprofen, diclofenac), accelerates healing. In the future, the weights may have to be reduced and incorrect loads analyzed and corrected.
Pain in the tailbone when stooping
Pain in the tailbone usually occurs with any type of Move on. Most patients feel the pain symptoms when Lie, To run, Stand and Sit. Especially with pain in the tailbone that occurs when Stooping occur or through the Lean forward a so-called Radiation of pain being checked. Pains don't always have theirs root cause in the area where they are felt by the affected patient. Often times, especially in the area of the buttocks, it seems as if problems arise from the coccyx, although none direct illness this bony structure is detectable. One possible cause of tailbone pain is a disc prolapse in the field of Lumbar spine. Due to the nervous interconnection it can happen that patients in addition to the typical Back pain also feel pain in the tailbone. Especially if there is a herniated disc in the area L5 / S1 tailbone pain occurs when stooping. In addition, irritation in the area of the Ligaments or muscles cause pain in the tailbone that occurs when stooping or is aggravated by bending over.
Tailbone Pain During Pregnancy
Many women also suffer from tailbone pain during pregnancy. This pain phenomenon usually occurs in early (1st trimester) and late pregnancy (3rd trimester). Possible explanations for pain in the tailbone in pregnant women can mainly be found in the hormonal changes that the body undergoes. During pregnancy, the pelvic ring loosens. For this reason, the distance between the posterior edge of the pubic bone and the upper edge of the sacrum increases by approximately one centimeter. Due to the gradual stretching of the ligaments, you may experience pain in the tailbone. In addition, the growing child in the womb exerts additional pressure on the bony pelvis, muscles and tendons. This also causes the pelvic ring to stretch.
What might also interest you: Sacrum pain
In most cases the pain only lasts for a short period of time, but in some pregnant women this change in anatomical structures can also lead to longer-lasting symptoms. There are many treatment options available, especially for pain in the tailbone that occurs during pregnancy. Most women use seat rings and a lap belt to relieve their discomfort. In addition, so-called TENS electrotherapy can be used to treat pain. Many women with tailbone pain respond very well to targeted physiotherapy and manual applications.
In the case of severe or untreatable pain in the coccyx, local infiltration of an anesthetic is the method of choice. However, due to the possible risks of this procedure, it is one of the last treatment options Help out the acute situation with pain relievers (analgesics) such as paracetamol. This medicine can also be taken safely during pregnancy. There is no risk of harm to the unborn child. Aspirin, ibuprofen, diclofenac and naproxen can also be used during the 2nd trimester. On the other hand, ibuprofen, diclofenac and naproxen may no longer be used from the third trimester of pregnancy. When taken, the child's blood circulation in the area of the heart (so-called ductus botalli) can be blocked prematurely. Aspirin should be taken as cautiously as possible during this period, as this pain reliever can also induce premature closure of the botallus duct. Furthermore, treatment with aspirin (short: ASA) must be discontinued at the end of the 37th week of pregnancy at the latest. Since aspirin has an inhibitory effect on blood clotting, there is a risk of severe blood loss if this period is not observed during childbirth.
Read more on this topic at: Tailbone Pain During Pregnancy
Tailbone pain with abdominal pain
Abdominal pain that is accompanied by pain in the tailbone is not uncommon, especially during pregnancy. Abdominal pain can be due to the hormonal processes of the uterus. During pregnancy, muscles are loosened, which mainly affect the stability of the pelvis. With the pressure of the growing child on the pelvis and back, pain in the tailbone can also occur.
In men, too, abdominal pain can be accompanied by tailbone problems. The intestines are often affected here. For example, a loop of intestine may be trapped in the abdominal wall, which is called a hernia. It can occur more quickly in strength athletes, as can exercise-related pain in the tailbone. Light pain medication (caution in pregnancy) and rest are the primary treatment methods. If a hernia is suspected, a doctor must be consulted urgently.
Intestines
Of the Intestines plays in the creation of Pain at the coccyx a very important role. Anatomically, the rectum together with the nach a local proximity to the tailbone. Therefore, this section of the intestine in particular influences the coccyx. For one, can be a mundane constipation, diarrhea or Flatulence the pressure in the intestines and consequently also on the Pelvic floor muscles and raise the tailbone. This stretches the tissue around the coccyx, such as the levator muscles or the anococcyge ligament, and those there Irritated nerves.
On the other hand, people with inflammatory bowel disease such as Ulcerative colitis or Crohn's disease often also pain in the coccyx region. In ulcerative colitis, compared to Crohn's disease, only the superficial mucous membrane in the intestine is damaged.Nevertheless, it begins in the rectum, i.e. near the rump, while Crohn's disease can occur anywhere in the intestine. The chronic inflammation of the intestine can also spread to the surrounding tissue and then cause pain there too. Then also on the tailbone, which is caused by a phenomenon in the nerve connection to the Spinal cord is to be explained. Here, too, pathological ones play a role Bowel movement patterns to irritate the coccyx.
Another disease related to the coccyx is that Diverticulitis. This leads to protuberances in the intestinal wall, which can fill with feces and become inflamed. In the course of the inflammation it can lead to Perforation of the intestine come. Intestinal contents escape unhindered into the abdominal cavity and lead to a large area Inflammation with involvement of the peritoneum. The tailbone can also be affected as it is the deepest point in the pool and the inflammation likes to spread there. Fistula ducts, i.e. connecting ducts between two previously unconnected body cavities, can also form between the intestine and coccyx, which are also caused by inflammatory reactions Pain cause.
Ultimately, with tailbone pain, you have to go through the intestine direct pain originating from the coccyx itself (i.e. through fistulas, direct coccyx inflammation or pressure increase in the abdomen) of the Transmission pain by switching the pain on and off via the intestinal nerves to the spinal cord (which can cross with other nerves). The transmission pain can be found, for example, in the listed chronic bowel diseases.
Pain in the buttocks / anus
Pain in the coccyx is often associated with changes in the buttocks or anus. Part of the pain is caused by you deep-seated lumbar disc herniationwhich the annoy includes the buttock and coccyx region. On the other hand, they can be strong Flatulence and Diarrhea irritate the mucous membrane and muscles of the anus and through the connection of the Sphincter trigger increased tensile forces on the tailbone. Most of these pains are directly related to the Bowel movement and then subside after a short time.
But other diseases of the buttocks also cause pain in the tailbone. A perianal vein occlusion, which suddenly causes severe pain, can radiate into the coccyx. Even bigger ones hemorrhoids or Anal fissures at the anus are extremely painful and often causing pain due to the proximity to the tailbone. Another reason for tailbone pain can be a Coccyx fistula which can often occur in the immediate vicinity of the anus. The fistula represents a direct Connection between the surface of the skin and the underlying coccyx here what to Infections the periosteum and surrounding tissue in connection with pain.
pelvic floor
Of the pelvic floor with its numerous Ribbons and Muscles has an important function in the human body. It not only closes the abdominal cavity from below and carries the burden of the abdominal organs, but also includes them Sphincters of the urethra and the anus and structures of the Genital tract.
The tailbone is called the pelvic floor Attachment points for muscles and ligaments utilized. The pelvic floor muscles that attach directly to the coccyx are the levator ani muscle on the one hand and the coccygeus muscle on the other, both of which lead to the Bowel movement are needed. In addition, the anococcygeum ligament with the external ani sphincter muscle attaches to the coccyx. Pain in the tailbone can, among other things, from one Muscular weakness and the ligaments in the pelvic floor come off.
As the tailbone for its size a comparatively high load has to endure, irritation and pain can occur very quickly.
Causes of the weakness of the pelvic floor can be general, hereditary or caused by aging processes Connective tissue weakness be.
Too high a load in the abdomen, too pregnancy or Obesity, regardless of the nature of the pelvic floor, pressure and thus pain in the tailbone again.
Please also read: Tailbone pain during pregnancy
Tailbone inflammation
Symptoms
A Tailbone inflammation can either totally symptomless run or in acute cases Pain in the area of the coccyx and the immediate vicinity. In addition, a Redness and swelling or even one fistula, a connection between a body cavity near the tip of the tailbone and the surface of the body, can occur in that area.
A clean Periosteum inflammation does not have to be visible at all from the outside. If a tailbone inflammation is long and untreated, it can lead to discharge of in part bloody secretion come from the opening of the fistula.
causes
In most cases, this will lead to Hair ingrowth in the area of the coccyx in the gluteal fold to the formation of a Foreign body granuloma. This is a new formation of tissue, which is formed around the foreign body as a result of a triggered Inflammatory response. A fistula can then develop from this. This is also called "Pilonidal sinus". This is favored by poor anal hygiene, thick hair, predominantly seated posture and profuse sweating.
Another cause of tailbone inflammation can also be excessive irritation of the periosteum, for example bruise or Upsetting of the coccyx with accompanying inflammation. However, in many cases no definitive cause can be found.
therapy
First of all, you can use the Tailbone inflammation with a conservative therapy approach by applying an ointment to the affected area. At a Periosteum inflammation is it helpful to have this locally Painkillers and Cortisone to treat. If the inflammation persists without any prospect of improvement, surgical removal of the coccyx should be considered. In the case of coccyx fistula, it can be supplemented with Chamomile hip baths keep the place clean. You should also fistulacaused by the tailbone inflammation, surgically remove. The "fistula system" is completely cut out. For follow-up treatment and at the same time also for prophylaxis, it is recommended to regularly close the area where the coccyx infection took place depilate.
Tailbone fracture
Of their coccyx (lat. Os coccygis) Many people notice something for the first time when they themselves break or sprain. When diagnosing pain in the tailbone, it is important to look carefully, because when those affected show the location of their pain, it is not uncommon for them to point to it Sacrumas they suspect the tailbone is much higher than it actually is. As part of our spine, the tailbone joins the human sacrum downwards and can be easily felt on the buttocks. The tailbone is in all likelihood a rudimentary remnant of a tail that our animal ancestors, the monkeys, still have today. Even if this has receded in us humans, the former tail, now the tailbone, has not lost all of its functions. The tailbone is still forming Starting point for many muscles of the pelvic floor and the hip joint. It consists of increase in small bones and cartilagesthat have lost their previous architecture in the form of vertebrae like the rest of our spine and are all fused into a single bone.
You will usually break or bruise your tailbone Fall or this is what occurs. It has hardly any protection through it Adipose tissue or connective tissue and is therefore hit directly. There is a fracture of the tailbone extremely painful and is given to the person concerned for several weeks refuse pain-free, relaxed sitting. Activities like to cough or Sneeze be where the Pelvic floor muscles is tense. The one is also particularly uncomfortable Go to the toilet for bowel movements, as the pelvic floor muscles are particularly stressed during bowel movements and the coccyx itself rests directly on the rectum.
See also Painful bowel movements
Due to the attachment of the muscles to the coccyx, every movement of the muscles leads to traction on the coccyx and thus to severe pain if it is broken.
The state of pain in the tailbone is then called Coccygodynia. The pain is considered in most cases Pull or Sting and can radiate into the whole buttocks.
diagnosis
The Diagnosis of a fractured tailbone in contrast to a bruise by a Examination with the finger be provided by the rectum. If you carefully insert a finger, you can feel the underside of the coccyx through the intestinal wall, which is extremely sensitive to pain in the case of fractures. In addition, a X-ray image clarify the question of a break.
therapy
The Therapy of a fracture of the coccyx consists in the vast majority of cases of pure Fight pain and Protection, not infrequently at the beginning with bed rest. Also cooling can often relieve the pain. The pain therapy should ideally with a anti-inflammatory pain relievers be carried out, because this also treats the slight inflammation of the muscle attachment points on the periosteum well. If the pain is severe, a pain reliever or anesthetic can also be injected directly into the coccyx region. Splinting, as is usually the case with fractures, is unfortunately not possible in this region of the body. For this reason, an optimal fracture healing can unfortunately often not be guaranteed and the person concerned is responsible for the immobilization in order to create the best possible conditions for the fracture healing. To facilitate sitting there is a Rubber ring taken to help. This prevents the tailbone from sitting on and the affected person can sit more painlessly. In order to treat the above-mentioned pain during bowel movement, it may be advisable to ensure soft bowel movements and avoid constipation while the fracture is healing. In rare cases, a Surgery of the tailbone be necessary for healing when the usual measures are insufficient and the patient suffers from permanent pain. During this operation, the broken pieces removed.
Not just a fracture can be responsible for tailbone pain. Persistent sitting on hard surfaces, long bike rides, frequent pressing during bowel movements, complicated births or muscle tension in the pelvic floor due to poor posture can also cause pain in the tailbone. In these cases, it is usually difficult to research the cause, as falls or other events usually cannot be remembered for years or the causal malpositions are not always easy to identify.
A relieved posture due to a coccyx bruise can also lead to permanent pain. Patients suffering from permanent pain should always focus on other parts of the spine because it can too Herniated discs in the lumbar spine, the part of the spine between the chest and pelvis, causes pain in the tailbone, which is much lower down.
Duration of the tailbone fracture
A statement about that Duration of a coccyx fracture is very difficult to meet. Too many factors such as the location of the fracture, stress, misalignment, displacements, the age of the person affected or concomitant diseases influence the healing of a tailbone fracture. However, healing takes between two and six weeks. The first weeks of bone healing are particularly critical, when the newly formed bone is still very tender and unstable. Depending on the job and the intensity of the pain, a incapacity for work exist over this period.
Many sufferers still have problems in the coccyx years after the fracture or bruise. The previous injury leaves damage like Myogelosis or Trigger points on surrounding muscles and connective tissue. These cause permanent pain despite the healed bones. Myogeloses and trigger points are Thickening due to hardened muscleswhich are very sensitive to pressure and painful. Due to the permanent pulling of the muscles and connective tissue, the periosteum can easily become permanently irritated, which makes the painful state persist. In order to avoid the long-term consequences described above it is very important that Getting through the rest and healing time for a long enough time and not to let too much strain on the tailbone too soon.
Coccyx contusion
Symptoms
Is this Coccyx bruised This creates primarily pain in the area, which can radiate very widely. Finding a pain-free posture is often a challenge for those affected, as a certain pressure is exerted on the now pain-sensitive coccyx both when sitting and sometimes when lying down. Furthermore, in the area Swelling and Bruising occur when the tailbone is bruised.
causes
The tailbone is mostly through Falls directly on the buttocks or external violence bruised. This does not break the tailbone, but the surrounding one Soft tissue becomes such injuredthat there is development of fluid retention and Bruising comes.
The swelling caused by the bruised tailbone triggers severe pain, as this is the supplying Nerve plexus irritated becomes. Since the tailbone is comparatively little surrounded by fatty tissue, it is accordingly less protected by falls or violence and is therefore more prone to all types of injuries.
Diagnosis
The symptoms that arise when the tailbone is bruised can often be with more serious injuries, such as a tailbone sprain or a fractured tailbone. Since the further treatments of the individual injury patterns differ significantly from each other, it is important to rule out a break or a compression. This is done through an imaging test, such as a X-ray, since usually no difference can be seen from the outside.
therapy
It is advisable to have a bruised tailbone to cool affected area and not to overburden. A Painkiller can also relieve the symptoms for a certain period of time. Nevertheless, it is an advantage if the coccyx and the surrounding tissue are checked regularly to see how the bruise and the stored fluid develop and, if necessary, around them to remove surgically.
Prognosis and prophylaxis
In most cases the symptoms improve very fast. Around chronic courses To avoid pain, a doctor should be consulted as soon as possible in the event of persistent symptoms in order to initiate the appropriate therapy. A special one prophylaxis However, there is no. If patients are prone to tailbone pain, a corresponding one can be Seat cushions Avoid chronification of pain in sedentary activities. Around inflammatory processes or one Cancer To be able to recognize and treat at an early stage, pain should always be reported to a doctor at an early stage.
Basically, however, it should be noted that monotonous movementsthat to Continuous load A certain anatomical structure of the tail region lead in many cases to the development of pain in the tailbone.
The fact is that most people simply sit too much. During the Work in the office and or in front of the television in the evening. Most of the people have a pronounced one Sedentary lifestyle downright trained. This is a serious behavior problem that promotes a number of diseases. In addition to diseases like Obesity, diabetes and Vascular changes The bony structures and joints in particular suffer from the lack of movement. In the case of the tailbone, this can be extreme painful become. Also in the case of pain in the tailbone caused by a trauma only helps early Treatment by one chronic coccygodynia (Tailbone pain).Above all, the application of analgesic and anti-inflammatory ointments can contribute to rapid pain relief and reduce the risk of chronification.
If the woman is planning to have children, she can alleviate pain in the tailbone before she becomes pregnant Pelvic floor training prevent. Stretching the tendons and strengthening the muscles in the area of the Pelvic floor are an effective measure of pain prevention. In rare cases, the pain in the tailbone can also go through psychological causes to be triggered. For this reason, after excluding an anatomical or pathological cause, a psychotherapist must be consulted urgently.
Summary
Pain in the tailbone is generally rather rare and in most cases on one accident, so attributed to a fall. In this case, the pain often lasts for a few days. Even when the coccyx is exposed to excessive stress during long-term, daily sedentary activities Microtraumas arise and cause pain. In some cases, neurological disorders are like a disc prolapse or one Nerve irritation responsible for the pain. The exact cause can be found through a thorough medical history, clinical examination, and imaging tests. In most cases, the therapy consists of a combination of various physiotherapeutic measures, a soft seat pad and drug therapy in the acute phase of pain. Local injections of pain relievers and anti-inflammatory drugs are also possible. In most cases, the pain will go away on its own after a few days. If this is not the case, a doctor should examine the tailbone pain to prevent the pain from becoming chronic or to detect an inflammatory or tumorous disease. The pain can only be alleviated with early and targeted therapy.
When examining the coccyx is next to the anamnese especially the direct examination of the bone is important and informative. This is done with the fingers over the rectum palpate the tailbone and ideally try to grab and move between the index finger and thumb. If this examination causes pain, the suspicion of tailbone pain proves to be true. In addition, you can use imaging like a X-ray or one Computed Tomography or, in women, have a pelvic exam for clues about possible causes of the pain.
If a cause for the pain in the tailbone is found, it must be treated specifically. If there is no information, it should be included first Painkillers and Cortisone be addressed directly at the point of pain. This can be due to the persistence of the pain, which thanks to the Pain memory can now also be triggered by lighter pain stimuli, can be very tedious. Physiotherapy can have a supportive effect. In the worst case, the tailbone can be surgically removed.
A Coccyx contusion occurs far more often than a fracture of the tailbone. Even if the fracture of the bone is missing, both clinical pictures are almost equally painful. Like the break, are typical accident situations Kicks or Blows to the buttocks. Are classic Falls on the buttocks in winter on slippery roads or on skateboarders and inline skating in summer. A break should always be excluded by an examination through the rectum or an X-ray.
The therapy resembles that of the fracture in terms of Pain therapy and Protection. Even sitting on one Rubber ring will bring relief to those affected here. A bruise can also occur under unfavorable conditions years of problems entail. The reason for this is also one automatically assumed protective posture in the first acute and painful phase of the bruise. This posture leads to Tension in the muscles, Irritation of the muscle and tendon attachments at the coccyx and last but not least, as with the fractures to the formation of painful Myogeloses and trigger pointswhich can be a lengthy process to deal with.
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