Symptoms
In the presence of an inflammation of the coccyx, the typical signs of inflammation can be observed. However, the symptoms of coccyx inflammation depend on the underlying disease. The affected patients usually experience early stabbing or pulling pain.Depending on the causative disease, this pain can radiate into the buttocks and/or lumbar spine.
If the inflammation on the coccyx is caused by a coccyx fistula, the symptoms usually occur in the form of sudden pain, swelling and redness in the gluteal fold. In these cases, the entire coccyx region is highly sensitive to pressure. The patients affected may experience such severe symptoms that sitting and walking is only possible to a limited extent.
In many cases, lying down is also only possible in the prone position. Furthermore, in the course of the fistula-related inflammation of the coccyx, purulent and bloody fluid may leak from the fistula opening. An inflammation of the periosteum of the coccyx, on the other hand, usually shows less pronounced symptoms.
In these cases, the affected patients also experience stabbing or pulling pain, but extensive swelling and redness are rare. Traumatic changes in the bony coccyx often involve injuries to the buttocks or in the area of the vascular fold. In addition, bruising in this area after external force is not uncommon.
Diagnosis
Patients suffering from long-lasting or regularly occurring pain in the gluteal fold area should immediately consult a suitable specialist. Only this specialist can determine the causal disease and then initiate appropriate treatment. The most important step in the diagnosis of an inflammation of the coccyx is the detailed doctor-patient consultation (anamnesis).
During this conversation, both the intensity and the quality of the perceived pain should be revealed. The temporal relationship between physical activity and the first occurrence of the pain can also provide an initial indication of the underlying disease. Traumatic events in particular can lead to inflammation of the coccyx.
In addition, other complaints play a decisive role in the diagnosis of coccyx pain. This doctor-patient consultation is usually followed by an orienting physical examination. During this examination, particular attention is paid to skin symptoms (such as bruises and injuries), pain triggers and possible malpositioning of the body axis.
Subsequently, imaging of the buttocks region is performed by means of magnetic resonance imaging or computer tomography. In patients where the inflammation on the coccyx is caused by a coccyx fistula, surgical removal is considered the only promising treatment measure. In the classic procedure, the fistula is marked with a special dye (methylene blue) before the actual removal.
In this way, the entire inflamed tissue can be completely removed. Since the coccyx fistula tends to recur repeatedly (so-called recurrence), the surgeon should cut down to the periosteum of the coccyx during the operation and additionally scrape off the bone. The surgical removal of the coccyx fistula, which leads to inflammation of the coccyx, is usually performed under general anesthesia.
Only in particularly mild cases can surgery under local anesthesia be considered. This possibility exists especially if it is a small fistula that has not yet led to inflammatory processes. The reason for this is that inflammatory tissue often responds less well to local anesthetics, so surgery would be extremely painful for the patient.
In the case of a pronounced coccyx fistula, which causes extensive inflammation of the coccyx, a hospital stay of three to four days is often necessary after surgical removal. In addition, open wound treatment (secondary wound healing) often has to be performed after complete removal of the inflamed tissue. This means that the opened areas on the coccyx are not treated with sutures.
For the affected patient, this form of wound healing results in your long period of illness. Depending on the size of the fistula and the extent of the inflammation at the coccyx, healing can take several months. In some cases, however, primary wound healing (i.e. wound healing after the surgical site has been closed with a suture) can also be chosen for coccyx fistula. This form of wound healing usually ensures a comparatively short healing period.
