Diagnosis
Depending on the localization and a detailed anamnesis (questioning) of the affected person, the specialist can often make an initial tentative diagnosis regarding the cause of the pain when sitting. In order to be able to confirm or reject this, different examinations are offered depending on the case. For example, if a urinary tract infection is suspected, a “U-Stix” can be performed, in which a special paper strip is dipped into the patient’s urine and can confirm or rule out an infection relatively accurately.
In the case of an infection, a urine culture can then be prepared to identify the causative pathogen and thus enable targeted antibiotic treatment. If the cause is more likely to be suspected in orthopedics/accident surgery, the diagnosis is usually based on imaging (X-ray, MRI) in addition to the patient’s medical history and physical examination. This can not only confirm or disprove the suspected diagnosis, but can also serve as preparation for a possibly necessary surgical intervention. Gynecological (e.g. pelvic inflammatory disease) or urological causes (e.g. orchitis), on the other hand, are usually diagnosed by means of a palpation examination and ultrasound.
Treatment
The treatment options are obviously very different depending on the cause of the pain when sitting. Basically, a distinction can be made between conservative (mainly medicinal) and surgical therapy. If the complaints are based on an inflammatory process (e.g.
urinary tract infection or chronic prostatitis), conservative therapy is usually initiated with medication.This should include a pain and anti-inflammatory component (e.g. ibuprofen, diclofenac) and, if necessary, a component directed against the respective pathogen (e.g. antibiotics). The latter should of course only be taken after medical consultation.
Conservative treatment is also the method of choice in the case of incorrect or excessive strain (e.g. coccygodynia): Here, above all occupational medicine (e.g. ergonomic office chairs) or orthopedic (e.g.
inserts to compensate for knee malpositions) as well as physiotherapeutic (e.g. compensation for shortening of the thigh muscles) measures can have an effect. Some other causes (e.g. inguinal hernia or herniated disc in the lumbar spine) may require surgical therapy. This is particularly the case when dangerous complications are imminent, such as the loss of urinary and fecal continence or paralysis of the leg in the example of a herniated disc.
