Coccyx inflammation
A coccyx inflammation can either be completely asymptomatic or, in acute cases, cause pain in the area of the coccyx and its immediate surroundings. In addition, redness and swelling or even a fistula, a connection between a body cavity near the tip of the coccyx and the body surface, can occur in the area concerned. A pure periosteal inflammation need not be visible at all from the outside at first.
If a coccyx inflammation persists for a longer period of time and is untreated, it can lead to an outflow of partially bloody secretion from the fistula opening. In most cases, the ingrowth of hairs in the coccyx area in the gluteal fold leads to the development of a foreign body granuloma. This is a new formation of tissue that forms around the foreign body as a result of an inflammatory reaction triggered by it.
A fistula tract can then develop from this. This is also called “Sinus pilonidalis”. This is favored by a lack of anal hygiene, heavy hairiness, a predominantly sedentary posture and heavy sweating.
A further cause of coccyx inflammation can be excessive irritation of the periosteum, for example by bruising or compression of the coccyx with accompanying inflammation. However, in many cases no definitive cause can be found.Initially, coccyx inflammation can be treated with conservative therapy by applying an ointment to the affected area. In the case of an inflammation of the periosteum, it is helpful to treat it locally with painkillers and cortisone.
If the inflammation persists without any prospect of improvement, surgical removal of the coccyx should be considered. In the case of coccyx fistula, the area can be kept clean with chamomile baths as a supplement. The fistula caused by the coccyx inflammation should also be surgically removed.
Here the “fistula system” is cut out completely. For follow-up treatment and at the same time for prophylaxis, it is recommended to depilate the area where the coccyx inflammation has occurred regularly. Many people notice their coccyx (lat.
Os Coccygis) for the first time when they break or sprain it. When diagnosing coccygeal pain, it is important to keep a close eye on the pain, because when people show the site of their pain, it is not uncommon for them to point to their sacrum, since they suspect that the coccyx is much higher than it actually lies. As part of our spine, the coccyx connects downward to the human sacrum and can be easily palpated on the buttocks.
The coccyx is most likely a rudimentary remnant of a tail that our animal ancestors, the monkeys, still have today. Even though it has receded in humans, the former tail, now coccyx, has not lost all its functions. The coccyx is still the starting point for many muscles of the pelvic floor and the hip joint.
It consists of several small bones and cartilages, which have lost their former architecture in the form of vertebrae like the rest of our spine, and which have all fused into a single bone. The coccyx is usually broken or bruised when falling or stepping on it. It has hardly any protection from fatty tissue or connective tissue and is therefore hit directly.
A fracture of the coccyx is extremely painful and will prevent the affected person from sitting in a pain-free, relaxed position for several weeks. Equally painful will be activities such as coughing or sneezing, during which the muscles of the pelvic floor become tense. Going to the toilet to defecate is also described as particularly unpleasant, as the pelvic floor muscles are put under particular strain during bowel movement and the coccyx itself lies directly against the rectum.
Because the muscles are attached to the coccyx, every movement of the muscles leads to a pull on the coccyx and thus to severe pain if it is broken. The condition of pain in the coccyx is then called coccygodynia. In most cases the pain is described as pulling or stabbing and can radiate into the whole buttocks.
The diagnosis of a coccygeal fracture, as opposed to a contusion, can be made by examining the coccyx with a finger through the rectum. If a finger is inserted carefully, the lower side of the coccyx can be palpated through the intestinal wall, which is extremely sensitive to pain in the case of fractures. In addition, an X-ray can clarify the question of a fracture.
The treatment of a fracture of the coccyx consists in most cases of pure pain relief and protection, often with bed rest at the beginning. Cooling can also often relieve the pain. Pain therapy should ideally be carried out with an anti-inflammatory painkiller, because this also treats the slight inflammation of the muscle attachment points on the periosteum well.
If the pain is severe, an analgesic or narcotic can also be injected directly into the coccyx region. Unfortunately, splinting, as is usually done for fractures, is not possible in this region of the body. For this reason, an optimal healing of the fracture can often not be guaranteed and the person affected is responsible for immobilization in order to create the best possible conditions for fracture healing.
A rubber ring is used to make sitting easier. This prevents the coccyx from sitting up and the affected person can sit somewhat more painlessly. In order to treat the above mentioned pain during bowel movement, it may be advisable to ensure soft bowel movement and avoid constipation during the period of fracture healing.
In rare cases, surgery on the coccyx may also be necessary for healing if the usual measures are not sufficient and the patient suffers from permanent pain. In this operation the broken parts are removed.Not only a fracture can be responsible for coccyx pain. Even sitting permanently on hard surfaces, long bike rides, frequent pressing during bowel movements, complicated births or muscle tension of the pelvic floor due to poor posture can cause pain in the coccyx.
In such cases, it is usually difficult to find the cause, since falls or other events usually cannot be remembered for years or the cause of the poor posture is not always easy to detect. Even a relieving posture due to a coccyx contusion can lead to a permanent pain situation. If patients suffer from permanent pain, other parts of the spine should always be focused on, because herniated discs in the lumbar spine, the part of the spine between the rib cage and the pelvis, can also cause pain in the coccyx, which is located much lower down.
It is very difficult to make a statement about the duration of a coccyx fracture. Too many factors such as the location of the fracture, strain, malpositions, displacements, age of the person affected or concomitant diseases influence the healing of a coccyx fracture. However, healing takes between two and six weeks on average.
The first weeks of bone healing are particularly critical, when the newly formed bone is still very tender and unstable. Depending on the profession and intensity of the pain, incapacity to work can exist over this period. Many affected persons still have problems in the coccyx area years after the fracture or bruise.
The previous injury leaves behind damage such as myogeloses or trigger points on surrounding muscles and connective tissue. These then cause permanent pain despite healed bones. Myogeloses and trigger points are thickenings caused by hardened muscles, which are very sensitive to pressure and painful. Due to the permanent tension of the muscles and connective tissue, the periosteum also very easily enters a permanent state of irritation, which makes the painful conditions last longer. In order to avoid the long-term consequences described above, it is very important to get through the resting and healing period for a sufficiently long time and not to put too much strain on the coccyx again too soon.
