Pain in the tailbone

In our lives, some people often feel pain in the coccyx. When patients experience pain in the coccyx, they must pay attention. It is likely caused by spondylitis. Spondylitis is divided into ankylosing spondylitis and tuberculous spondylitis. Both are very harmful to the patient's body, and the condition is very similar. So what is the cause of pain in the coccyx?

1. Sacroiliac joint pain

The patient has acute sacroiliac joint injury or a history of chronic strain. The affected side has pain in the sacroiliac joint, which often radiates to the buttocks and lateral thigh, and sometimes even radiates to the lateral calf, and there is spasm of the sacrospinalis muscle on the affected side. The trunk tilts toward the affected side, the affected limb dares not bear weight, walking is unsteady, and even cannot walk upright alone. The patient often supports the lower side of the body and uses the palm of the hand to protect the sacroiliac part of the affected side to barely walk. The affected lower limb cannot support body weight, so the healthy lower limb should move first when going up or down stairs. Uncomfortable lying down and difficult to turn over. The pain worsens when standing and bending over. Patients often sit on a stool with their healthy buttocks. If the pain is severe, they need to support both sides of the stool with both hands to relieve the pain, but it is not very painful when bending over while sitting. The lumbar spine may have scoliosis and convex toward the healthy side. The following are the causative factors

Acute injuries: slipped waist or falling on the buttocks, or walking too fast, taking too big steps, etc.

Chronic injury: Long-term bed rest, spinal anesthesia, etc., cause the muscles and ligaments near the sacroiliac joint to become loose, increase body weight and lumbar lordosis, and cause chronic strain.

Anatomical variation: such as sacralization of the transverse process of the fifth lumbar vertebra, especially in the case of unilateral sacralization of the transverse process, it can often lead to unbalanced force in work and daily life, causing acute sprain or chronic strain of one side of the sacroiliac joint.

2. Coccyx pain is caused by direct or indirect violence that causes ligament tearing around the sacrococcygeal joint, damage to the tendons and veins in the sacrum, poor circulation of qi and blood, and stagnation, which causes pain. The main symptoms are pain and swelling in the tail, obvious tenderness, difficulty walking, and inability to use the tail to support oneself when sitting or lying down. This disease should be differentiated from coccyx fracture. Coccyx fractures have an obvious history of trauma and are accompanied by significant tenderness. If the fracture is obviously displaced, the angular deformity can be felt during palpation and can be confirmed by X-rays.

3. Ankylosing spondylitis is a slowly progressive disease that primarily affects the spine and is a typical representative of seronegative spondyloarthropathy. Its characteristic is that it starts from the sacroiliac joint and gradually spreads upward to the joints of the spine, causing bony ankylosis. The clinical manifestations are: ① Discomfort, pain, and deep tenderness in the sacroiliac joint area of ​​the buttocks; sacroiliac joint imaging shows joint sclerosis, erosion, and even fusion or disappearance of the joint space. ② The lesion gradually develops toward the cervical spine, causing symptoms of pain and stiffness, which are especially obvious at night and in the morning, and improve after activity. The lumbar lordosis becomes flattened, the thoracic expansion decreases, the cervical vertebrae fuse and flex, and the spinal movement is restricted and deformed. Typical spinal imaging shows bamboo-like changes in the spine. It gradually manifests as hunchback, and is prone to complications such as lung infection, dyspnea, chest pain, etc. ③The hip, knee and shoulder joints may be affected. Due to the presence of myofasciitis, there may be heel pain, sole pain and thigh pain. In addition, there are manifestations of other systems such as uveitis, aortitis, pulmonary fibrosis and nervous system.