Coccygodynia is an inflammation often linked to ligament laxity. Among other causes, obesity and trauma. Women are affected five times more than men
About 1 percent of doctors consulted for spinal pain it concerns coccyx pain or coccygodynia, which mainly affects individuals between the ages of 40 and 60 with a predilection for women.
What is coccydynia?
It is a symptom that depends on an inflammation of the osteo-ligamentous region of the coccyx he pressed Marco Minetto, associate professor in Physical Medicine and Rehabilitation at the University of Turin at the Molinette Hospital —. The female sex affected five times more than the male one, thanks to the greater posterior prominence of the coccyx compared to the man. Other factors that can contribute are also birth trauma and hormonal changes of pregnancy. These involve a increased joint and ligament laxity structures that must welcome the child and “expel” him at the end of the nine months of waiting, so it can sometimes happen that a certain sacrococcygeal instability remains after the birth.
Are there other predisposing factors?
Visceral obesity, with an increase in the waistline, change your posture, exposing the lumbosacral spine and coccyx more to chronic biomechanical overload. Coccyx pain can also be favored by classic fall on the bottom or from repeated microtraumas, as can happen in those who practice particular sporting activities, for example cycling and rowing for continuous contact with a hard surface, or for those who sit for many hours a day, perhaps in an uncomfortable chair. Pain in the coccyx can sometimes occur even after surgery in which the patient was immobile for several hours in a supine position with legs apart. In rare cases coccygodynia can finally be consequence of oncological problemssuch as an intraosseous lipoma or skeletal metastases.
How is it diagnosed?
The diagnosis of coccygodynia it is based on symptoms, or very localized pain below the sacrum and above the anus, increased by palpation and postural changes, typically from sitting to standing. Sometimes pain can occur also following the effort of defecation and during sexual intercourse. The diagnostic confirmation from the radiological point of view is obtained by resorting to the so-called dynamic radiography in lateral projection – specifies Minetto -: an x-ray with the patient standing and another in a sitting position, always sideways. In this way it is possible to highlight signs of instability of the coccyx due to which, when the patient sits down, the coccyx moves. MRI another investigation that allows you to see the coccyx very well as well as the whole rachis, is therefore especially useful for excluding other pathologies of the spine.
How can it be cured?
In the acute phase, the use of oral anti-inflammatory drugs is indicated. Also to ease the pain when you sit down you can use donut or wedge pillows that minimize postural microtrauma. In general, the pain resolves within three months, but one in five patients relapses within a year, especially if no action is taken on the predisposing factors, replies the expert.
In some cases, if the pain is particularly insidious, it is possible to resort to infiltrations with cortisone in the coccyx area or in the focused shock waves which favor an increase in the vascularization of the district with very good results. Manual therapy can also be of great help. This can be done in the traditional way through vertebral micromanipulations and of the sacrococcygeal region which have the effect of restoring the postural structure and decontracting the paravertebral muscles.
In the event that the coccyx is subluxated, therefore displaced from its optimal position, the intrarectal invasive manual therapy which mechanically stimulates a repositioning of the coccyx. In the presence of a hypermobile coccyx that tends to subluxate, they are finally recommended stretching and strengthening exercises for the last stretch of the spine. The use of surgical removal therapy, partial or complete, of the coccyx is indicated only in extreme cases.
June 25, 2023 (change June 25, 2023 | 08:36)
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