Pain when standing up. Lower Back Pain When Standing: Causes, Treatments, and Prevention Strategies

04.07.202314.06.2023 by alexxlab

What causes lower back pain when standing. How can you treat lower back pain at home. What exercises help alleviate lower back pain. When should you see a doctor for lower back pain. What are the best sleeping positions for lower back pain. How does posture affect lower back pain. What lifestyle changes can reduce lower back pain.

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Understanding the Prevalence and Impact of Lower Back Pain

Lower back pain is a widespread health issue that affects millions of people worldwide. According to the National Institute of Neurological Disorders and Stroke, approximately 80% of adults in the United States experience lower back pain at some point in their lives. This staggering statistic highlights the importance of understanding the causes, treatments, and prevention strategies for this common ailment.

Why is lower back pain so prevalent? The lower back, or lumbar region, bears a significant portion of our body weight and is involved in nearly every movement we make. This constant stress and strain make it particularly susceptible to injury and wear and tear over time. Additionally, our increasingly sedentary lifestyles and poor posture habits contribute to the high incidence of lower back pain.

Common Causes of Lower Back Pain When Standing

Lower back pain when standing can be attributed to various factors. Understanding these causes is crucial for effective treatment and prevention. Here are some of the most common reasons:

Postural stress
Muscle strains and sprains
Spinal stenosis
Degenerative disc disease
Sciatica
Herniated or bulging discs
Arthritis
Skeletal irregularities

Postural Stress: A Primary Culprit

Postural stress is perhaps the most common cause of lower back pain when standing. When we stand for extended periods, especially with poor posture, it increases pressure on the spine. This added stress can cause the lower back muscles to tighten and spasm, resulting in pain and discomfort.

How does poor posture contribute to lower back pain? When we stand with improper alignment, it disrupts the natural curvature of the spine, placing uneven pressure on certain areas. This can lead to muscle imbalances, tension, and ultimately, pain. Maintaining proper posture distributes weight evenly across the spine, reducing the risk of pain and injury.

Muscle Strains and Sprains

Muscle strains and sprains are another frequent cause of lower back pain. A strain occurs when a muscle or tendon is stretched or torn, while a sprain involves the stretching or tearing of ligaments. These injuries can result from sudden movements, lifting heavy objects improperly, or overuse of the lower back muscles.

Effective Home Treatments for Lower Back Pain

Fortunately, there are several at-home treatments that can help alleviate lower back pain. These methods are often effective for mild to moderate cases and can provide significant relief:

Rest and relaxation
Over-the-counter pain relievers
Gentle exercises and stretches
Proper posture maintenance
Supportive footwear and orthotics
Heat and ice therapy
Weight management

The Role of NSAIDs in Pain Management

Nonsteroidal anti-inflammatory drugs (NSAIDs) are a popular choice for managing lower back pain. These over-the-counter medications, such as ibuprofen (Motrin, Advil) and naproxen (Aleve), work by reducing inflammation and alleviating pain.

How do NSAIDs work to reduce lower back pain? NSAIDs inhibit the production of prostaglandins, which are substances in the body that cause inflammation, pain, and fever. By reducing inflammation, NSAIDs help to decrease pain and improve mobility. However, it’s important to use these medications as directed and consult with a healthcare provider if pain persists or worsens.

Exercise and Stretching: Key Components in Lower Back Pain Relief

Regular exercise and stretching play a crucial role in managing and preventing lower back pain. However, it’s essential to approach exercise cautiously and consult with a healthcare professional or physical therapist before starting any new routine.

What exercises are beneficial for lower back pain? Some effective exercises and stretches include:

Hamstring stretches
Pelvic tilts
Cat-Cow stretches
Partial crunches
Wall sits
Press-up back extensions
Bird dog
Knee-to-chest stretches

It’s important to note that certain exercises, such as toe touches and full sit-ups, can exacerbate lower back pain and should be avoided. Always listen to your body and stop any exercise that causes pain or discomfort.

The Importance of Proper Posture and Ergonomics

Maintaining proper posture is crucial for preventing and managing lower back pain. Good posture ensures that your body weight is evenly distributed, reducing strain on your muscles and ligaments.

How can you improve your posture? Here are some tips:

Stand with your weight evenly distributed on both feet
Keep your shoulders back and your chest open
Engage your core muscles
Avoid locking your knees
When sitting, keep your feet flat on the floor and your back supported
Use ergonomic furniture and equipment at work and home

Ergonomics also plays a significant role in preventing lower back pain. Ensure that your workstation is set up correctly, with your computer screen at eye level and your chair providing adequate lumbar support.

The Role of Supportive Footwear and Mattresses

The right footwear and sleeping surface can make a significant difference in managing lower back pain. Supportive shoes and orthotics help maintain proper alignment of the feet, legs, and spine, reducing strain on the lower back.

What features should you look for in supportive footwear? Consider shoes with:

Good arch support
Cushioned soles
Proper fit (not too tight or loose)
Low heels (high heels can exacerbate back pain)

Similarly, a supportive mattress is crucial for maintaining proper spinal alignment during sleep. A mattress that’s too soft can cause the spine to sink, while one that’s too firm can create pressure points. Look for a medium-firm mattress that provides adequate support while conforming to your body’s natural curves.

Optimal Sleeping Positions for Lower Back Pain

Your sleeping position can significantly impact lower back pain. What are the best sleeping positions for those with lower back pain?

On your back with a pillow under your knees
On your side with a pillow between your knees
In the fetal position

Avoid sleeping on your stomach, as this position can strain your lower back. If you must sleep on your stomach, place a thin pillow under your pelvis to reduce the arch in your lower back.

Alternative Therapies for Lower Back Pain Relief

In addition to conventional treatments, several alternative therapies have shown promise in managing lower back pain. These include:

Massage therapy
Acupuncture
Chiropractic care
Yoga and Pilates
Mindfulness and meditation
Biofeedback

The Benefits of Massage Therapy

Massage therapy can be particularly effective in relieving lower back pain. How does massage help with back pain? Massage can:

Increase blood flow to tense muscles, promoting healing
Release endorphins, the body’s natural pain relievers
Reduce muscle tension and spasms
Improve flexibility and range of motion
Promote relaxation and reduce stress

Both general relaxation massages and targeted structural massages can be beneficial for lower back pain. However, it’s important to consult with a healthcare provider before starting any new treatment regimen.

Lifestyle Changes to Reduce Lower Back Pain

Making certain lifestyle changes can significantly reduce the risk and severity of lower back pain. These changes include:

Maintaining a healthy weight
Quitting smoking
Staying hydrated
Getting adequate sleep
Managing stress
Practicing good posture
Avoiding prolonged periods of sitting or standing

The Impact of Weight Management on Lower Back Pain

Maintaining a healthy weight is crucial for reducing strain on the lower back. Excess weight, particularly around the midsection, can shift your center of gravity forward, increasing the arch in your lower back and putting additional stress on the lumbar spine.

How does weight loss help alleviate lower back pain? Losing excess weight can:

Reduce pressure on the spine and supporting structures
Improve posture and balance
Increase mobility and flexibility
Reduce inflammation in the body
Improve overall cardiovascular health, which can benefit back health

A combination of a balanced diet and regular exercise is the most effective approach to weight management. Consult with a healthcare provider or registered dietitian for personalized advice on achieving and maintaining a healthy weight.

When to Seek Medical Attention for Lower Back Pain

While many cases of lower back pain can be managed at home, there are instances when professional medical attention is necessary. When should you see a doctor for lower back pain?

If the pain is severe or worsening
If the pain persists for more than a few weeks
If you experience numbness, tingling, or weakness in your legs
If you have difficulty controlling your bladder or bowels
If the pain is accompanied by fever, unexplained weight loss, or other concerning symptoms
If the pain results from a traumatic injury, such as a fall or car accident

A healthcare provider can perform a thorough examination, order necessary diagnostic tests, and develop a comprehensive treatment plan tailored to your specific needs. This may include physical therapy, prescription medications, or in some cases, surgical intervention.

Diagnostic Procedures for Lower Back Pain

When you visit a healthcare provider for lower back pain, they may recommend various diagnostic procedures to determine the underlying cause. These may include:

X-rays to check for bone problems
MRI or CT scans to examine soft tissues, nerves, and discs
Electromyography (EMG) to assess nerve and muscle function
Blood tests to check for inflammatory conditions
Bone scans to detect fractures or tumors

These tests help healthcare providers develop an accurate diagnosis and create an effective treatment plan. Remember, early intervention can often prevent minor issues from developing into more serious conditions.

Lower Back Pain When Standing: Causes and Treatments

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Medically reviewed by Gregory Minnis, DPT, Physical Therapy — By Scott Frothingham — Updated on April 20, 2023

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Back pain facts and statistics. (n.d.).
acatoday.org/Patients/Health-Wellness-Information/Back-Pain-Facts-and-Statistics
Do you have lower back pain while standing? (n.d.).
joionline.net/trending/content/do-you-have-lower-back-pain-while-standing
National Institute of Neurological Disorders and Stroke. (2018). Low Back Pain Fact Sheet [Fact sheet].
ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet
Prevent back pain. (2017).
healthfinder.gov/HealthTopics/Category/everyday-healthy-living/safety/prevent-back-pain
UNC School of Medicine. (2009). Chronic low back pain on the rise: UNC study finds ‘alarming increase’ in prevalence [Press release].
med.unc.edu/www/newsarchive/2009/february/chronic-low-back-pain-on-the-rise-unc-study-finds-alarming-increase-in-prevalence

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Current Version

Apr 20, 2023

Written By

Scott Frothingham

Edited By

Heather Hobbs

Jul 30, 2018

Medically Reviewed By

Gregory Minnis, DPT

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Medically reviewed by Gregory Minnis, DPT, Physical Therapy — By Scott Frothingham — Updated on April 20, 2023

Low Back Pain When Standing

At times you can feel pain from simply walking or standing for long periods. You may believe you are doing everything correctly. Still, the discomfort is there as a daily reminder that something is not quite right.

What Causes Lower Back Pain while Standing?
The lower back is made up of vertebral bones that are assembled to support the body in an upright position. A jelly-filled disk is located between each of these bones to cushion them and offer stability. Also located on each side of these back bones are joints called facet joints. These joints allow your back to be flexible when you have to twist or bend down.
If the disk and facet joints become inflamed, they may produce pain in the lower back when standing.

Does Standing for Long Periods of Time Cause Pain in the Lower Back?
As we age, the disks and facet joints may begin to deteriorate. This often produces lower back pain when standing during normal daily activity. When you are standing, the spine has a curvature, which may intensify contact between the facet joints. When there is inflammation in these joints, standing for long periods of time may worsen the inflammation and cause lower back pain.

Potential Causes

- Stress. Walking or standing for long periods of time puts pressure on your lower back. If you are standing a lot at a high-demand job, your back muscles may tense; thus, increasing the pain.
- Poor posture. Having poor posture for many years will affect the anatomy of your spine. The joints, disks, muscles, nerves, ligaments, and blood vessels in your back will experience additional stress.
- Being overweight. Did you know that for every pound of extra weight places an additional four pounds of stress on your joints, including the facet joints in your back.
- Sedentary lifestyle. Inactivity leads to what’s called Disuse Syndrome. If your lifestyle is inactive, you could unintentionally be causing the deterioration of your musculoskeletal system. Consequently, you’ll experience a long list of health conditions, including chronic lower back pain.

How Can I Stand with Back Pain?
Here are some tips to try if you are one of the people who have more pain in standing:

Try placing one foot on a step. This limits too much spine curvature in standing.
Stand for shorter periods.
Stay away from high heels! High heels force the lower spine into increased curvature and can squeeze the facet joints.
Consider a desk that adjusts from sitting to standing.

Many people with low back pain describe increased pain when sitting instead of standing. This pain is caused by flexion of the spine. Flexion happens in the seated position and increases compression on the lumbar disks. In this case, standing may reduce symptoms and control the excessive forces on the disks. This may help to reduce lower back and hip pain.

What Should I Do If I Can’t Make My Lower Back Pain When Standing Stop?
If the low back pain suggestions listed above do not help, it may be worth seeing a orthopedic specialist so that they may find out what is causing your back pain. Orthopaedic Associates of St. Augustine has a team of experts with world-class experts who can help you!

Causes of pain in the coccyx in women and men, treatment of pain in the coccyx

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Pain in the coccyx is a common problem, it can bother for a long time, intensify with a change in position body or movement. It interferes with a normal life. Pathology occurs equally often in both women and men.

If your tailbone hurts when you sit, sign up for a consultation at the Temed clinic, our specialists will determine the cause of the pain and select effective methods of treatment.

This article is advisory in nature. Treatment is prescribed by a specialist after consultation.

Types and causes of pain in the coccyx

The coccyx is the lower part of the spine, it consists of 4-5 fused vertebrae. Ligaments, tendons, muscles of the pelvis and lower extremities are attached to it. Damage to any of these structures results in severe pain.

Pain in the coccyx area is called coccygodynia. There are two types of it:

Primary coccygodynia due to trauma or other pathology of the coccyx. Pain brings discomfort, but is not a serious threat to life and health
Secondary coccygodynia is more common and is associated with diseases of the pelvic organs. For example, with diseases of the bladder, uterus and appendages, prostate, intestines. In this case, the source of pain is not the coccyx, but the affected organs and tissues. With secondary coccygodynia, there are often other symptoms that help identify the underlying disease.

Pain in the coccyx can be caused by various reasons: from bruises to inflammation and tumors. Let’s consider them in more detail.

Injuries
Traumatization is a common cause of acute or aching pain in the coccygeal region. The intensity of pain depends on the degree of damage to bone and soft tissues.
- Coccyx bruising is accompanied by severe but tolerable pain. Sometimes there is local edema and hematoma
- Fracture of the coccyx is manifested by a sharp pain. The victim cannot sit, walks, leans and turns with difficulty, there is local edema and hematoma
- Dislocation of the coccyx causes discomfort when sitting and standing up
Coccyx can be injured when falling or in a car accident. Especially high risk of injury in women during natural childbirth. With a narrow pelvis, a large fetus and insufficient mobility of the coccyx, fractures, dislocations, and sprains are possible.
Inflammatory processes
A common cause of pain in the coccyx area is inflammation caused by an infection. Pathogenic microorganisms penetrate through damaged skin or through the blood, causing retrorectal paraproctitis or osteomyelitis.
- Infection may involve the coccyx itself or nearby soft tissues. Due to the large number of nerve endings in this area, a pronounced pain syndrome occurs. Due to the proximity of internal organs, primarily the rectum, the inflammatory process can result in dangerous complications
- Retrorectal or retrorectal paraproctitis. A form of paraproctitis is inflammation of the soft tissues and subcutaneous fat behind the rectum. Manifested by deep arching pain in the coccyx, rectum. It sharply increases during defecation and in the sitting position, accompanied by intoxication: fever, weakness
- Osteomyelitis is an infectious inflammation of the bone. Post-traumatic osteomyelitis can develop in people of any age after open injuries of the sacrococcygeal zone. Often occurs in children after a bruise or spreads through the blood from other areas. Usually affects the coccyx, sacrum and sacrococcygeal joint. Begins with symptoms of intoxication, severe pain in the sacrum, coccyx
Tumors, fistulas and cysts
Pain in the coccyx can be caused by cysts, benign and malignant tumors, developmental anomalies.
- Primary neoplasms of the coccygeal region, such as coccygeal cyst and epithelial coccygeal passage, are rare and have a benign course. Malignant lesions of the coccyx can be caused by the spread of neoplasms from neighboring organs – metastases
- Sacrococcygeal teratomas are tumors that grow from embryonic cells. They occur in utero and are diagnosed at birth. Small teratomas are asymptomatic for a long time and remain undetected. When the tumor grows, there are slight dull pains in the sacrum and coccyx, combined with pain in the perineum and lower abdomen, stool and urination disorders appear
- Benign tumors. For a long time they develop asymptomatically. Non-intense pain occurs with an increase in the size of the tumor in the coccyx
- Epithelial coccygeal passage. This is a defect in the form of a subcutaneous canal. For a long time it can exist asymptomatically. With injuries of the coccygeal region and non-compliance with the rules of personal hygiene, inflammation occurs, which is manifested by pain in the coccyx
Diseases of the pelvic organs
In women:
- 13
- diseases of the cervix
- diseases rectum
In men:
- prostate diseases
- intestinal diseases
Chronic pelvic pain 9004 3
If the patient is fully examined and there is no evidence of any disease, then we are talking about chronic pelvic pain. In this case, the severity of the pain syndrome exceeds the severity of the underlying disease, or there is no underlying disease at all. In this case, the patient is prescribed not only medication, but also psychotherapy.

Symptoms

The most frequent complaints of patients with coccygodynia:

physical activity, during prolonged sitting, especially on a hard surface
pain when getting up from a sitting position
discomfort and pain when pressing on the coccyx

Pain is most pronounced in the lower surface of the coccyx – its apex, sometimes in the anus. The pain can spread to the buttocks, genitals, thighs. Unpleasant sensations sometimes bother during intercourse and during bowel movements. To reduce pain, the patient sits sideways, leaning on one buttock, moves slowly and smoothly.

Diagnosis

At the first sign of damage to the coccyx, contact a specialist immediately. At the initial appointment, the doctor will clarify the time and circumstances of the onset of pain, its nature and dynamics, ask about chronic and hereditary diseases, medications taken, and injuries. Then the specialist will conduct a visual examination of the coccyx area, its palpation. These data will help establish a preliminary diagnosis.

An additional examination is required to determine the exact cause. Depending on the proposed diagnosis, the doctor may prescribe one or more tests:

X-ray – helps to detect injuries, dislocations of the coccyx
MRI and CT – allow to detect cysts, fistulous passages, suppuration of soft tissues near the coccyx, and also better visualize fractures, cracks, pelvic organs
Ultrasound of organs abdominal cavity — detects pathologies of internal organs that provoked pain in the coccyx area
Sigmoidoscopy — examination of the mucous membrane of the rectum and the lower part of the sigmoid colon using a sigmoidoscope. Allows to exclude pathologies of the rectum, as well as to check for the presence of tumors
Scintigraphy – carried out in case of suspected oncology to find areas of inflammation or metastases in bones and soft tissues In rare cases, when the diagnosis needs to be clarified, additional diagnostic methods are prescribed:
Irrigography – X-ray examination of the intestine with a preliminary introduction of a contrast agent – barium sulfate. The study is carried out to determine the violation or pathology in the structure of the intestine, whether there are neoplasms or other diseases of this organ
Defecography is an x-ray examination that can be used to evaluate the process of defecation by introducing a contrast agent into the intestines
Manometry is a measurement of pressure in the examined organs of the digestive tract
Despite the large number of diagnostic methods, all studies are not necessary. At the Temed Clinic, the doctor will refer you only to the necessary examinations in order to establish an accurate diagnosis.
Which doctor to contact
Pain in the coccyx can hide serious diseases that require special investigations and specific treatment. At the first stage, visit a therapist or neurologist, then you may need to consult an orthopedic traumatologist or other narrow specialists: a urologist, gynecologist, proctologist.
You can call the Temed Clinic and we will advise you on all issues. Our specialists have been using the most effective methods of treating back pain for 14 years.
Make an appointment with a neurologist
Appointment lasts 60 minutes, includes diagnostics, analysis of your MRI and preparation of a treatment plan, takes place both in person and online.
Coccyx pain treatment
The Temed Clinic mainly uses conservative methods to treat tailbone pain. We individually approach each patient and select the most effective combination of drug treatment and physiotherapy.
Treatment package includes:
medication
physiotherapy
massage
9 0002 Acupuncture
From medicines used: non-steroidal anti-inflammatory drugs (NSAIDs) in tablets or injections, muscle relaxants to relax muscles. In chronic pain in the coccyx, antidepressants and anticonvulsants are effectively used for a long time.
Physiotherapy is selected individually, it relieves pain, relieves inflammation and local swelling. Our clinic uses magnetotherapy and laser therapy. These methods are effective, safe and painless. As a result, pain syndrome decreases, metabolic processes in tissues improve, which means that recovery occurs much faster.
Acupuncture has also been shown to be effective for coccyx pain. It involves the stimulation of biologically active points with sterile needles, resulting in reduced pain and inflammation.
Massage is used for chronic pain, to improve the mobility of the spine, to relax the muscles of the back.
The operation is carried out only in extreme cases, when other methods of treatment have not brought the expected result for a long time. During surgery, the coccyx is completely or partially removed.
During an exacerbation, some treatments are contraindicated. Therefore, they should not be used without consulting a doctor.
Consequences
Episodic and chronic forms of cluster headache can pass one into another. Prolonged attacks can lead to depression and significantly reduce the quality of life of patients.
In most patients, the frequency of attacks with chronic fascicular pain decreases with age. What this is connected with is unknown. If the disease debuted at the age of 50 years and older, or the frequency or intensity of attacks increased, then this indicates an organic pathology.
It is not yet clear whether cluster headaches can be completely cured. With this diagnosis in neurology, the emphasis is on the prevention of new cluster seizures, but 100% effective therapy has not yet been developed.
Analgesics do not help with cluster headache: they act too slowly, the attack peaks too quickly. You need to contact a neurologist as soon as possible for help. The earlier treatment is started, the higher its effectiveness.
Prevention
Proper prevention and a healthy lifestyle reduce the risk of coccyx pain and its recurrence.
When sedentary, exercise every 30-40 minutes. Do morning exercises to strengthen your spine muscles
Eat a varied and balanced diet
Lose excess weight
Sit less on a hard surface
Women need regular examinations and timely treatment by a gynecologist, as many diseases of the female reproductive system lead to pain in the coccyx.
If you have problems with defecation, urination, pain in the pelvis or coccyx, contact a specialist: urologist or proctologist. Golubenko E.O., Silina E.V., Orlova A. S. Personalized approach in the treatment of pain syndromes. Modern Science: Actual Problems of Theory and Practice. Series: Natural and technical sciences. 2017;7–8:107–112. [Golubenko E.O., Silina E.V., Orlova A.S. Personalized medicine in pain management. Sovremennaya nauka: aktual’nye problemy teorii i praktiki. Seriya: Estestvennye i tekhnicheskie nauki. 2017;7–8:107–112 (in Russ.)].
Kadyrova L.R., Akarachkova E.S., Kerimova K.S. Multidisciplinary approach to a patient with chronic pain. breast cancer. 2018;7:28–32.
Parfenov V.A., Isaikin A.I. Pain in the lower back: myths and reality. – M.: IMA-Press, 2016. – 104 p.

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Anococcygeal pain syndrome (coccygodynia) – Avicenna Klinik

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cygodynia)

What is the coccygeal bone and where is it located on the spinal column ?

The coccyx is the closing part of the spine. The two to five bony segments that form the coccyx are most often firmly connected to each other to form a triangular bone. As the lowest part of the spine, the coccyx serves as an attachment point for the muscles, tendons, and ligaments of the pelvis. Although the coccyx itself is small, it can have a big impact on how we feel. The coccyx doesn’t have the best reputation. Especially since most people are only aware of having a coccyx after they’ve fallen on it once. And it doesn’t matter if it’s on wet autumn leaves, icy sidewalks or slippery stairs.

Like the lower leg, the coccyx is surrounded only by a thin, sensitive periosteum that provides little protection. From the point of view of the developmental history, the coccyx is a rudimentary part of the caudal skeleton. When walking or standing, the coccyx does not move. On an x-ray in a sitting position, it can be determined that the coccyx has mobility up to 20 degrees forward and backward. The so-called coccygodynia is a term for pain in the coccyx (Os coccygis). Coccyx injuries are often painful and long lasting. Even years after falling on the coccyx, you remember well where you were when the stabbing, pulling, excruciating pain pierced your entire body.

Anococcygeal pain syndrome affects women more often than men

The reason is simple: pregnancy and especially childbirth put a lot of stress on the coccyx. Here are some more facts that will interest and perhaps surprise you: The most common cause of tailbone pain is sitting for too long. In fact, an office worker spends 80,000 hours during his professional life at the level of an office chair. In Western countries, staying in a sitting position, even for an active and mobile person, often reaches 10-14 hours a day. 14 million schoolchildren and students study mainly sitting. The average German sits 9,6 hours a day. This not only distorts the holding muscles and leads to back pain, but also contributes to vascular diseases such as Pilonidal Sinus. A coccyx bruise is much more common than a coccyx fracture.

Anococcygeal pain syndrome has various causes

Why pain in the coccyx occurs cannot be precisely determined in each specific case. Pain in the coccyx is often the result of falls on the buttocks, for example, with sports injuries. Bruises or fractures cause severe pain, which you feel especially when sitting, climbing stairs, with a bowel movement, and even during sexual intercourse. Other causes include difficult labor, irritation where a muscle or tendon attaches to a bone (stretch pain), tumors in the coccyx, or congenital anomalies of the coccygeal bone. Even sitting on a soft surface (such as a sofa) for long periods of time can cause tailbone pain in some people. Therefore, in English, coccygodia has the epithet televisionbottom, which means “television seat”. Other possible causes of pain in the coccyx are inflammation of the periosteum, curvature of the coccyx, coccygeal fistula, deformity of the coccyx, trauma in the pelvic area, lumbago (eg, lumbago), herniated disc, surgical interventions, nerve irritations, gynecological diseases (eg, endometriosis).

A typical symptom is a stabbing burning pain in the coccyx area

Not all diseases have typical symptoms that give unambiguous indications of a problem. With pain in the coccyx, everything is different. A typical symptom is a stabbing, burning pain in the coccyx. Also, the pain can spread to other areas, to the hips, lower back and anal area. The biggest problem: Patients suffering from coccyx pain usually cannot sit on hard surfaces for long periods of time. Pain can occur immediately when sitting, only when sitting for a long time, or only when standing up. Such complaints occur mainly after inflammation of the periosteum (periosteum). In addition, there may be paroxysmal pain in the nerves. They are caused by the fact that the nerve plexus of the lower part of the sacrum and coccyx is damaged. In general, it does not matter for what reason, but the victims usually cannot sit for days, weeks, sometimes even months without suffering. Attention! Those who do not seek help from a specialist should understand that tailbone pain will become (may become) chronic.

Diagnosis Anococcygeal pain syndrome

A prerequisite for a convincing diagnosis is the so-called history taking interview. Here the patient describes in detail his course of the disease. After that, the initial medical examination begins. If the pressure on the coccyx is painful, then this speaks quite confidently about coccygodynia. Clinical examination and imaging complete the diagnostic procedure. Important to know: Imaging techniques (eg, x-ray of the coccyx, computed tomography, magnetic resonance imaging) usually do not detect visible changes. But they should still be done to rule out local inflammation or swelling. Much more significant is magnetic resonance imaging (MRI), which allows you to better judge bone injuries, fractures and injuries to adjacent soft tissues.

Tumors are also clearly visible on MRI scans. If inflammation or a tumor is indeed suspected, the doctor will administer a contrast agent during imaging to further represent the affected area of the body. Further examinations are carried out from the inside: through the rectum, the doctor can feel how mobile the coccyx is, detect tension in the pelvis or changes in internal organs. If this examination – palpation of the coccyx – causes pain in the patient, the suspicion of the syndrome is justified.

Treatment includes physical therapy and pain relief

Acute coccygodynia can be alleviated with general treatment. Conservative therapies, such as pain medication and local injections, are already able to relieve pain. However, many people are afraid of chronic pain in the coccyx because of their duration. If no cause is found, local infiltrations with corticoids or anesthetics may be placed at the junction between the sacrum and the coccyx. Painkillers can also be added to the treatment plan. Additional measures may include gymnastics/physiotherapy, certain exercises, and an orthopedic seat ring.

In addition to conservative treatments for tailbone pain, options include infiltration and denervation. During denervation, the doctor, under the control of the image converter, inserts a special cannula exactly at the place where the irritated nerves (branches of the spinal nerve) are located. A small nerve is irritated (stimulated) with a needle to see if the right place is found (neurostimulation). After that, the laser passing through the glass fiber in the needle is directed directly to the affected area. The heat of the laser energy soothes irritated nerve fibers (denervation).

Surgical removal of the coccyx (coccyx surgery) is considered for long-term tailbone pain, but is really only necessary in the rarest of cases.

Prediction – you need to learn the right behavior for your back

Do you know the phrase: “As long as people demand not movement, but sitting places, it is difficult to rid them of the negative consequences of sitting”? This means that after treatment of the coccyx, you, as a patient, must learn long-term correct behavior in everyday life and in your free time, especially with regard to sitting, and begin to strengthen your muscles. In plain text: Integrate more movement throughout the day. For example, cycling to work, walk as short distances as possible in the office (for example, to the printer …), walks at lunchtime. First of all, we are talking about how to protect the coccyx.

And three more tips: It would be ideal to replace your office chair with an ergonomic office chair or an ergonomic stool. A circle pillow for the coccyx is useful, on which the coccyx is almost without pressure. You will be more than surprised how much relief this brings. And one more thing: get out of the vicious circle of sitting. This is certainly possible in your workplace. Live by the 40-15-5 rule. That means: 40 minutes sitting, 15 minutes standing, 5 minutes walking. Integrate gymnastic exercises into your daily life, they allow you to strengthen the muscles of the back and pelvic floor and at the same time relieve the coccyx.

Author
Dr. honey. Munter Sabarini
Specialist, neurosurgery

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