The sacrum is one of the most important bones in the lower part of the spine. From above, it connects to the lower lumbar vertebra, and from below – with the coccyx. Any pain that occurs in this area signals that there have been disturbances in the body’s work. It is important to maintain its healthy state and performance.
Pain in the sacrum restricts a person’s movement, impairing his ability to work and livelihoods. It bothers women more often than men. This is due to the fact that female vertebrae are less durable and harder to cope with physical exertion.
What is the sacrum?
The sacrum is triangular in shape, consists of five vertebrae fused together. It is represented by two surfaces – front and back, base and apex of two edges on the sides. Together with a pair of pelvic bones forms the upper pelvic part. On the one hand, it connects to the coccyx, and on the other, with the last vertebra of the lower back. The front cross part is called the pelvic. Five vertebrae of the sacrum fuse together in the form of four cross lines. Nerve endings along with arterial veins, vessels and capillaries penetrate the pelvic region in four places.
Doctors diagnose pain in the sacral region as a result of a more serious disease. Symptoms that arose in the sacrum are commonly called sacrodinia (from Latin os sacrum – sacrum). They can be activated due to damage to bone structures or progressive diseases of the internal organs.
Causes of exacerbation and symptoms
Various factors can cause pain in the sacral region, but the main one is the displacement that patients receive at birth or injuries. Displacements are divided into two groups:
- in the area of the right bones of the pelvis;
- in the area of the left bones of the pelvis, the symptomatology is different for each side.
In the case of an injury in the left part, there are irregularities in the blood flow in the left leg, swelling and severe pain, periodic bouts of seizures, unstable cardiac and respiratory systems, constipation and overweight are possible. In the case of an injury in the right side, pain occurs in the right leg, short-term convulsions, digestive system disorders, carrying and significant weight loss.
General malaise and acute pain in the coccyx and sacrum can be caused by injuries experienced in the past – a fall, a blow, a bruise, that is, an injury to the spine, as a result of which nerve pinched. Pain – strong enough, cramping or aching. In the absence of serious damage, the pain disappears on its own after some time, subject to rest. Sometimes pain symptoms may appear later.
Usually after a course of treatment and rehabilitation, pain in the sacrum resulting from an injury disappears. If painful sensations persist even after therapy, you should consult your doctor.
Sacrodinia can be triggered by:
- prolonged stay in a sitting position (office work);
- physical activity;
- stress and emotional strain;
- digestive problems;
- blood clots;
- premature varicose veins.
Dr. Alekseev in the video:
Diseases related to pain in the sacrum
In both women and men, pain in the right side and simultaneously behind can indicate serious diseases, the treatment of which requires surgical intervention (hepatitis, pyelonephritis, pneumonia and others). There are various reasons that do not have a direct connection with the sacrum, but can manifest themselves as pain in this area. Among them are the following:
- osteochondrosis caused by displacement of the vertebral plates provokes complications in the form of pinching of the nerve endings and a significant narrowing of the vertebral canals – stenosis. The pain occurs after physical exertion, overwork and recedes after rest. Ailments are usually observed in the sacrum and tailbone, since they have a direct connection with the vertebra;
- spondylolisthesis and hernia of the lower back vertebrae. If the pain is pulling or aching, this is the first alarm signal for a possible displacement of the intervertebral discs. Periodic dull aching pains in the lumbar region may indicate a hernia between the vertebrae. In such cases, the pain is localized in the sacrum and gives in the groin or leg. Her character is intermittent – attacks begin suddenly as a result of a sharp movement, with prolonged physical exertion;
- abnormalities of the spine. Destructive processes in the spinal column can be congenital or acquired in nature. Anomaly – improperly formed lumbosacral and transitional vertebrae. This may be the formation of a new vertebra (lumbarization), non-closure of the vertebral arch, fusion of the vertebrae with a decrease in their number (sacralization). Factors that affect the violation in the structure of the spine – prolonged exposure to the wrong position of the body, sedentary work. Pain in such disorders is periodic;
- clogged veins in the pelvic and iliac vessels. The neglected stages of vascular pathologies, thrombophlebitis, and internal varicose veins – in these conditions pain may appear in the sacral region. Symptoms may include high body temperature, blue skin, and severe swelling in places where a blood clot has formed;
- inflammatory diseases of the abdominal cavity and retroperitoneal space are accompanied by pain in the sacrum. Painful sensations also extend to the abdomen, give to the lower half of the back. The inflammatory process can affect the menstrual cycle, the functioning of the nervous system, heart and blood vessels. In addition to pain, other symptoms are possible: fever, chills, headache;
- infectious diseases, for example, tuberculosis, staphylococcus. They are provoked by bacteria and are accompanied by pains that do not subside even after resting and taking painkillers. Attacks of a sacrodinia amplify at the slightest movements and loads;
В некоторых случаях появление болей в крестце у женщин может быть единственным проявлением заболевания и сигналом развития рака молочных желез или матки, поскольку опухоль может развиться бессимптомно.
- эндометриоз. Боли в нижней части поясницы у женщин могут вызывать гинекологические проблемы, одна из которых – эндометриоз. Патология возникает из-за разрастания эндометрия – внутреннего слизистого эпителия тела матки – за ее пределы. В таком состоянии у женщины проявляются ноющие боли внизу живота и в крестце, которые усиливаются во время менструаций, нарушается менструальный цикл;
- parametritis is another common “female disease”. This pathology is characterized by the infectious and inflammatory process of parametria – the connective tissue surrounding the uterus. Its development is provoked by past operations, unsuccessful abortions and postpartum complications. The disease is accompanied by sharp pains, stitching pains in the lower abdomen, extending to the sacrum and lower back. It leads to menstrual irregularities, accompanied by fever, trembling in the body and migraines;
- menses. Pain on critical days are paroxysmal in nature, can give to the lower extremities;
- gastrointestinal tract diseases. Digestion, small bowel disease, the appearance of heaviness in the stomach – all this can affect the appearance of sacrodinia. Other side symptoms of such pathologies are stool disorders (constipation or diarrhea), increased gas formation, intestinal colic.
Pregnancy as a cause
Pain below the lower back right in a woman is most often observed during pregnancy. Due to the increase in weight, the spinal column and smooth muscles of the back have a heavy load. Gradually growing belly shifts the center of gravity, the expectant mother has to bend her back in the lower back. This negatively affects the sacral spine and provokes the occurrence of sacrodinia.
Unpleasant sensations during gestation are also explained by hormonal imbalance, fetal pressure on the sacrum or with a change in the position of the baby in the womb. After birth, the pain should go away on their own.
The appearance of any painful sensations in the sacrum is an occasion to consult a doctor. Since the causes of sacrodinia are quite diverse, a full examination is necessary. Need consultation of narrow specialists: traumatologist, neurologist, orthopedist, urologist and gynecologist. A physical examination with a medical history is required: clarification of the localization of pain, the nature, strength and intensity of the pain, where it gives, when it intensifies and decreases, the presence of concomitant symptoms.
Laboratory and instrumental tests with sacrodinia are as follows:
- general and detailed blood and urine tests;
- radiography to determine the condition of the bone structures of the spine, detect hernias, displacements of the discs and other pathologies;
- magnetic resonance imaging is usually prescribed to identify gynecological pathologies;
- computed tomography of the pelvic organs, lumbosacral spine and pelvic bones is necessary for their detailed study, identification of tumor formations;
- ultrasound examination of the pelvic organs;
- densitometry to determine bone density.
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What to do when it hurts below the lower back in women? Therapeutic therapy of sacrodinia should eliminate the source of pain. Self-medication is not recommended. The course of treatment should be drawn up by the attending physician taking into account the established diagnosis, the presence of concomitant diseases and the general condition of the patient.
The main elements of therapy include:
- taking medication. In the form of tablets or injections, analgesics, anesthetizing novocaine blockades (for severe attacks), NSAIDs, drugs for relieving muscle cramps, antibiotics, sedatives, group B vitamins, hormonal drugs are prescribed;
- local exposure. The use of medical plasters reduces muscle cramps, relaxes muscles, relieves swelling and pain;
The course of taking medications and local ointments is selected strictly by the doctor after finding out the cause of the pain below the lower back in women.
- physiotherapy. UHF-therapy, Bernard currents, electrophoresis with hydrocortisone, massage, acupuncture, Lyapko applicator. These procedures reduce the intensity of pain, relieve muscle tension, suppress the inflammatory process, improve blood flow, restore the correct position of the pelvic organs, strengthen the immune system;
- physiotherapy. It is prescribed only after relieving acute lower back pain, when the patient needs complete rest. A set of exercises for pain is selected individually by the attending physician and includes exercises for the development of the lumbosacral region;
- orthopedic corset. This design is a supporting brace for the spine, which limits its mobility and reduces the load on bone and cartilage structures;
- surgical intervention. Painful pain in the sacrum, which cannot be eliminated by taking analgesics and drug blockades, requires a more serious approach – surgery. During the intervention, the affected part of the lumbar, coccyx compound is restored or bone and cartilage structures and tissues are completely replaced.
The treatment of pain in the lumbosacral should not be limited to the use of painkillers and topical agents. In most cases, sacrodinia is a symptom of more serious pathologies that require timely diagnosis and therapy. Then we can hope for a favorable outcome and the elimination of painful sensations.
General recommendations for the treatment of injuries
- Immediately after injury, apply a cold compress to the site of damage. This will prevent the development of the inflammatory process.
- Exclude physical activity, limit the mobility of the injured area.
- As a medical treatment, use painkillers and anti-inflammatory drugs. The use of local ointments and rectal suppositories based on NSAIDs is allowed.
- As pain decreases, after 3-4 days, lung exercises from the exercise therapy course are allowed to warm up the lumbosacral.
If the injury did not have fractures, then after 2-3 weeks a full recovery occurs: the pain goes away and the person returns to his usual life.
Traditional methods of treatment
Using alternative medicine without the consent of your doctor is strictly contraindicated, since serious health damage can be inflicted. If there are no contraindications and the cause of pain in the sacrum is determined, herbal medicine can be used.
- Mix 1 tsp. dry flowers of immortelle and calendula, leaves of fireweed, shoots of heather, melilot grass, meadowsweet, motherwort, horsetail and dandelion root.
- From the collection, take 8 g and grind into powder.
- Pour 400 ml of boiling water, simmer on the fire for 3 minutes and insist 1,5-2 hours under a towel.
- Filter and drink 100 ml half an hour before meals.
- The course of treatment is 2 months.
Composition “Avicenna” for grinding
- Place 96 razor blades in 15% vinegar essence.
- Insist 2 weeks to completely dissolve.
- Then mix the purified turpentine, camphor and ammonium chloride (50 g each).
- Add 5 g of birch tar, 100 ml of 96% wine alcohol and 100 ml of already prepared vinegar essence with iron to the mixture.
- Use for grinding the lumbosacral region, previously shaking.
Tincture for grinding
- In 1 liter olive oil add 300 g of leaves and flowers of lilac.
- Insist for a month on the windowsill, filter.
- Rub the lower back twice a day for a month.
- 100 g of eucalyptus leaves pour ½ liter of alcohol (alk. Not less than 40%).
- Insist 7-10 days.
- Use for grind.
Tincture for compresses
- 5 tbsp. mix black radish juice with 1 tbsp. warm honey, ½ tbsp. alcohol (40% alk.) and 1 tbsp. l steamed salt.
- Shake well.
- Rub the painful area by applying compress paper on top for 2 hours.
Bay leaf infusion
- Grind the bay leaf, top with vegetable oil so as to completely cover the dry raw materials.
- Insist 2 weeks at room temperature.
- Use for compresses, withstanding from 3 to 6 hours. Repeat every other day for a month.
- 500 g of pine buds pour 5 liters of water and cook for 10 minutes, filter.
- Pour into a bath, diluting with water, to get a temperature of no higher than 37 degrees.
- Take a bath for 20 minutes every other day.
Aromatic bath with essential oils
- Mix 8 drops of chamomile, ginger and lemon oil.
- Add to the mixture ¼ Art. milk or cream.
- Add the composition to a bathtub filled with water with a temperature of 37 degrees.
- Take a bath for 20-30 minutes 3 times a week.
Without a preliminary examination by a doctor, it is not recommended to perform the following procedures at home:
- warm the area of pain localization, because if its cause is an inflammatory process;
- independently adjust the vertebrae;
- take pain medication.
To prevent sacrodinia, it is recommended to follow simple preventive measures:
- lead a healthy lifestyle;
- adhere to a balanced diet, which is very important for strengthening muscles and bones. Especially useful are foods containing calcium, vitamins and minerals – dairy products, herbs, nuts, fresh vegetables and fruits;
- in the event of any painful discomfort in the sacral department, one cannot make sudden movements, engage in physical activity and sports;
- avoid stress, relax more;
- pay attention to working conditions, adjust physical and sports loads, monitor posture;
- regularly visit doctors and timely diagnose.
The appearance of debilitating pain in the lower part of the lower back in women is due to various pathologies. Therefore, in the event of such disorders, do not delay in seeking medical help. It is extremely important to correctly determine the etiology of pain and take measures to treat the disease. After all, a timely detected disease is a guarantee of successful therapy and a favorable outcome.
Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.
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