Exhausting pain in the sacrum is often without much thought attributed to the most common diseases. Meanwhile, at the first diagnostic examination quite often an unexpected diagnosis is established, which has an official name and two medical terms at once – sacralgia and sacrodinia. This disease is characterized by strong stable painful sensations, disorders of the bone and cartilage tissue of a degenerative, dystrophic nature, as well as the presence of a focus of the inflammatory process. Despite the whole complex of pathological facts with this ailment, it is quite treatable.
Why does the pain in the sacrum appear?
Pain in the sacrum is much more common in the female part of the population. Men go to doctors 10-12 times less often with complaints of painful symptoms in this part of the back. This is due to the structural composition of the bone tissue of the female body. The bones of women are more fragile and less durable.
Due to the natural or pathological loads created, patients experience deformation faster, a violation of the structural integrity of the pelvic bones. And already as a result of these changes there is pain in the sacrum.
This area of the spine is a fused complex of five small vertebrae adjacent to the coccyx.
As in other parts of the spinal column, they have a similar structure:
- Directly the vertebrae themselves, formed by bone tissue;
- Cartilage creating cushioning during movement or exertion;
- Synovial bursa with fluid for lubricating articular elements;
- Soft tissue;
- Blood vessels;
- Nerve root receptors.
The main pathological changes in pain in the sacrum are taken over by the cartilage tissue. As it is thinning and dystrophic changes, vertebral bones begin to suffer, forming a tight connection and forming osteophytes – bone growths. They, in turn, create pressure on the nerves, blood vessels and soft tissues, provoking severe pain in the sacrum. It is believed that soreness in this disease is the most powerful and palpable.
Pain in the sacrum can occur in a chronic or acute form, with a favorable or cautious prognosis. The key to effective disposal of pathology is timely and correct diagnosis, as well as a productive course of treatment with complex methods.
Diagnostic procedures, the appointment of an effective course of treatment, the study of the clinic of the disease are within the competence of specialized doctors: a vertebrologist, orthopedist or neurologist.
Among female patients, the most common cause of this pathology is the load on the entire axis of the spine during pregnancy. The extra mass created by the fetus and amniotic fluid presses on all vertebrae. Static load is naturally transmitted to the lowest part of the spine. Given the small intervertebral gap, the small size of the articular elements and the fragility of their tissues, it is here that pathological changes are primarily noted.
Similarly, the development of the disease in women due to menstruation occurs – during the cycle, tension is created, which is transmitted to the coccyx and radiates to the sacral area.
Other causes of pain in the sacrum can be:
- Anatomical abnormalities of the structure of the spinal column. In some cases, such pathologies apply to all vertebrae, more often – problems with the sacral zone;
- The development and progression of osteochondrosis;
- The formation of intervertebral hernias;
- Tumors and neoplasms of a malignant or benign nature;
- Diseases of the circulatory system in the pelvic area – thrombophlebitis, blockage of capillaries and veins, decrease in the intensity of blood microcirculation;
- Pathologies of metabolic processes, due to which the bone tissue of the vertebrae lacks the necessary mineral components. Especially these disorders are manifested with a lack of phosphorus compounds, components of calcium, magnesium and potassium;
- Inflammation of the urinary tract;
- Reproductive system diseases;
- Frequent and severe hypothermia of the whole body or zone of the sacral region;
- Excessive body weight and obesity.
- For women, typical causes of sacrodinia may be problems with gynecology. Any neoplasms, cysts, inflammations of the reproductive organs lead to the development of pain in the sacral part of the back.
- Men suffer from this disease due to the chronic development of inflammation of the prostate gland.
Another common cause of pain in the sacrum (sacralgia) is sacroileitis – an inflammatory process in the ileo-sacral joint. This pathological condition is accompanied by a number of abnormal changes in the anatomy of this section of the back, as well as a violation of its physiological functions.
The rare causes are the consequences of bone tuberculosis, some infections transmitted through sexual contact, as well as the formation of metastases.
Signs of pain in the sacral region may differ depending on the nature of the course of the disease and its causative factors. However, in almost all episodes, clinical symptoms common to all forms of pathology are noted:
- Soreness in the lower back;
- The appearance of swelling in the coccyx;
- Feeling of creeping goosebumps in the lower part of the spine;
- Stiffness and discomfort during movement and during physical exertion.
Patients have difficulty turning the torso, and a slight crisp sound may be felt during movement. In many cases, symptoms appear in the pelvic area and in the physiology of the urinary and reproductive systems. There are difficulties with urination, reduced desire for intimacy, deteriorating reproductive capabilities.
At the same time, it is easier to diagnose the nature of pain in the sacral region based on the causes of their occurrence. In most cases, it is they who dictate the nature and intensity of the symptoms.
- With osteochondrosis, pain increases with bending, and is dull aching in nature. Strong stiffness during bends and increased physical activity is noted. In the absence of appropriate therapeutic measures, these sensations arise even in a state of physical rest. The patient feels a constant tension in the entire back, calves;
- During pregnancy in women, the pain is usually dull, periodic, other pathological signs are rare. And the pain itself passes quickly if you take a lying position on your side;
The menstrual cycle may be accompanied by periodic undulating pains. They often give discomfort to the groin and legs.
- With malignant neoplasms in the female body, soreness appears on one side of the sacrum, where the tumor appeared. The pains are strong, become more frequent as the tumor develops;
- Similar signs in men with prostatitis – sensations occur on the left or right side;
- Pathologies of the circulatory system with thrombophlebitis or obstruction of the iliac veins and capillaries are accompanied by an extensive zone of pain in the sacrum or lower back;
- Causes of an infectious nature are characterized by stable pains of moderate intensity, which can persist even in the absence of stress and at rest;
- The formation of a hernia in the vertebrae – such a pathology is characterized by severe pain. They have extensive localization, spreading to the groin, pelvic organs, legs, sacral zone of the spine. With hernias, soreness is of a special nature – it manifests itself as severe starting pain after a night’s rest, gradually fading by the second half of the day, provided that light or medium physical activity is maintained;
- Injuries, mechanical damage – these causative factors provoke severe pain of an acute, stable and paroxysmal nature.
In addition, most of these episodes are characterized by symptoms such as unnatural posture of the body in sleep and pathological postures while awake. Often there is shortness of breath, hoarseness, the work of the heart and the hematopoietic system is disrupted.
Methods of modern diagnostics
To establish a correct diagnosis, it is necessary that the patient, even at the first sign, consult a doctor for a clinical examination. In the future, complex diagnostic procedures will be prescribed, including laboratory tests and hardware-instrumental methods:
- General clinical blood tests – biochemical analysis, detailed analysis, study of the state of blood fractions and components for the concentration of mineral components, oxygen and external impurities;
- CT scan;
- Ultrasound of the inguinal zone and the sacral section;
The first step to getting rid of sacral pain is the elimination of etiological factors – only by removing the causes, you can continue to struggle with the symptoms and consequences.
To eliminate pain, analgesics are prescribed, non-steroidal anti-inflammatory drugs, which also have anesthetic effect. Corticosteroid drugs are also indicated. At the discretion of the attending physician, prescriptions for the following medicines can be prescribed:
To speed up the process of pain relief and faster recovery, local blockades are prescribed with the intramuscular injection of the drugs Hydrocartisone, Lidocaine, Diprospan, Deximethasone. Together with them are introduced the components of B vitamins.
Physiotherapy procedures will help to fix the result:
- Impact by sinusoidal currents;
- Shock wave therapy;
- Paraffin baths;
- Acupuncture and manual methods.
To prevent pain in the sacrum, a healthy lifestyle is recommended, nutrition with the content of mineral components also contribute to maintaining health in this part of the back.
In no case should you load your spine with exorbitant weights or create an increased load when running, walking.
As symptoms develop, consult a doctor immediately. Many doctors recommend not waiting for the first signs and undergo a preventive examination. Doing this is enough 1-2 times a year. Considering that the diagnosis of pain in the sacral region of the spinal column does not require an impressive amount of money and proceeds quickly enough, such measures will not become a burden, but will prevent possible risks. And one more tip to conclude – you should never make a diagnosis based on your own considerations. And even more so, self-treatment is unacceptable.
Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.
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