Causes of Coccydynia

Tailbone Pain in Women

Tailbone pain (coccydynia) is not an uncommon condition. It is sometimes just passed off as low back pain or buttock pain or in women as menstrual pain. Coccydynia is more common in women since the female pelvis is wider and the coccyx is therefore exposed. Very thin women are at even greater risk since the fat padding of the buttock is minimal and does not cushion the coccyx when sitting. These days coccydynia has become more common as the modern lifestyle has become largely sedentary and involves sitting for long periods of time.

Tailbone Pain During and After Pregnancy

During pregnancy, the high levels of hormones causes the sacrococcygeal joint to become more flexible. This is necessary for childbirth. However, the coccyx serves as an important site for the attachment of certain ligaments and muscles via tendons. With increased flexibility there may be abnormal movement of the coccyx thereby increasing the tension on these tendons and ligaments. With prolonged labor, the coccyx may also run the risk of dislocation despite its increased flexbility. These are important possible causes of tailbone pain during and after pregnancy.

General Causes of Tailbone Pain

Coccydynia does not only occur in women. Men are also at risk of developing tailbone pain although it is more common in women. Possible causes of and risk factors for tailbone pain in men, women and even children include :

• Injury, particularly impact to the buttock like a kick or falling on the buttock.
• Fracture of the coccyx.
• Excessive pressure on the coccyx with prolonged sitting and long distance cycling.
• Neuritis, especially of the pudendal and sciatic nerves.
• Pilonidal cyst
• Meningeal cyst
• Tumor
• Piriformis syndrome

Many cases of coccydynia occur for no known reason (idiopathic).

Signs and Symptoms of Coccydynia

Tailbone pain (coccydynia) is a symptom itself and not a disease. It is a pain felt between the “cheeks” of the buttock (intergluteal cleft). The pain is worse when sitting backwards and eases with sitting or stooping forward. Bowel movements and intercourse may exacerbate or even trigger the pain in severe cases. Other signs and symptoms apart from the pain may vary depending on the cause and any other underlying conditions of the buttock, vertebral column or pelvis and perineum.

Treatment of Coccydynia

Tailbone pain itself can be treated conservatively with a seat cushion, reducing the sitting time or at least sitting in an appropriate position that reduces weight on the coccyx. Physical therapy may also be helpful.NSAIDs help to reduce the inflammation and control pain. In more severe cases corticosteroid and even anesthetic injections may be necessary. Although extremely rare, surgical removal of the coccyx (coccygectomy) may be considered for patients with severe tailbone pain who do not find relief with other therapeutic measures.

]]> http://www.phaa.com/tailbone-pain-coccydynia-in-women.htm/feed 0 http://www.phaa.com/period-pain-dysmenorrhea-location-causes-remedies-treatment.htm http://www.phaa.com/period-pain-dysmenorrhea-location-causes-remedies-treatment.htm#comments Sun, 04 Sep 2011 19:10:28 +0000 Dr. Chris http://www.phaa.com/?p=448 Period pain is frequent occurrence for more than half of all girls and women in their menstruating years. It typically occurs for 1 to 2 days at the start of the period or sometimes just before the onset of menstruation. Period pain is a result of cramps in the uterus hence it is also known as menstrual cramps. The medical term for period pain is dysmenorrhea. Most women who do experience pain, have only mild pain but in a minority of cases, it can be severe. The pain can be debilitating and affect a woman’s ability to continue with daily activities and even lead to depression.

Some women will experience period pain on its own with no other signs or symptoms. However, there are other symptoms that can sometimes accompany period pain. This may include nausea and/or vomiting, headaches, dizziness, changes in bowel movement and irritability. It is important to have this investigated further as some of these symptoms may be unrelated to menstruation entirely and could be associated with gynecological, pelvic or even systemic diseases.

Location of Period Pain

Most women will experience pain located in the lower abdomen, involving the lower back and extending to the inner thigh. It can sometimes extend outwards to the pelvic bones or even radiate upwards into the central abdomen. The pain is typically described as a cramping or aching pain. Sharper pain may be associated with underlying disorders. Period pain occurs at around the time of menstruation and must be differentiated from mid-cycle pain, also referred to as ovulation pain or Mittelschmerz.

Causes of Period Pain

Dysmenorrhea is a result of cramping in the muscular uterus. Normally there are contractions to facilitate the expulsion of the menses but sometimes these contractions can become painful cramps. It is believed to be due to prostaglandins secreted from the inner uterine lining (endometrium) which causes the muscular layer (myometrium) to contract strongly and also reduces blood flow to the uterus. Period pain that occurs without any underlying gynecological disorder is known as primary dysmenorrhea. However in some cases, the period pain is associated with pathology in the reproductive organs or pelvic cavity. This is then known as secondary dysmenorrhea. Some of the more common causes includes pelvic inflammatory disease (PID), endometriosis and uterine fibroids.

Treatment and Remedies

Certain conservative measures may be sufficient to  reduce and even relieve the period pain. Many women find relief from placing a hot water bottle or heat pad over the lower abdomen. Other measures may involve plenty of rest, eating many small light meals, drinking plenty of fluids, avoiding strenuous activity, using calcium, magnesium or B-complex supplements and even relaxation techniques like yoga or meditation.

However these measures may not be sufficient for every woman suffering with period pain. Medical treatment is therefore advisable. It may involve the use of anti-inflammatory drugs or analgesics (painkillers) – either over-the-counter (OTC) or prescription medication. Oral contraceptives are often recommended particularly in women with menstrual irregularity. Antidepressants may be necessary, not only for depressed women, but also for chronic pain management.

Causes of Stomach (Abdominal) Cramps

• Appendicitis
• Infection of gall bladder (cholecystitis), with or without gall stones (cholelithiasis)
• Bowel obstruction
• Chronic constipation
• Viral gastroenteritis (stomach flu)
• Excessive gas, heartburn or indigestion
• Gastritis
• Ulcers
• Irritable bowel syndrome
• Food allergy or food poisoning
• Urinary tract infection
• Kidney or ureteric stones
• Crohn’s disease
• Ulcerative colitis
• Twisted ovarian cyst
• Dysmenorrhea or menstrual cramps
• Endometriosis
• Mittelschmerz or mid-cycle menstrual pain
• Ectopic pregnancy
• Spontaneous abortion
• Uterine fibroid
• Uterine cramps during pregnancy
• Pelvic inflammatory disease
• Abdominal muscle strain

Menstrual cramps (Dysmenorrhea)

While, in a woman, any of the above causes for abdominal cramps may be present, dysmenorrhea or menstrual cramps is one of the most common and debilitating cause. Itt may occur on a regular basis and may interfere with her daily routine, depending on the severity and duration.

Types of Dysmenorrhea

1. Primary dysmenorrhea is menstrual pain without any underlying abnormal condition and it may start soon after menarche (first menstrual cycle).
2. Secondary dysmenorrhea may be due to  some underlying gynecological problem (such as endometriosis, fibroid, or pelvic inflammatory disease) is associated with this type of pain and it usually develops later on. The pain may occur on its own or be accompanied by other signs and symptoms, like vaginal discharge with or without a bad vaginal odor, excessive bleeding or large clots during menses.

Causes of Menstrual Cramps

• Every month, the inner lining of the uterus (endometrium) is prepared for possible pregnancy by the action of hormones such as estrogen and progesterone. If pregnancy fails to occur, the estrogen and progesterone levels fall, leading to break down of the endometrium, which is shed during menstruation. When the endometrium breaks down, compounds called prostaglandins are released, which cause contraction of the uterine muscles, resulting in menstrual cramps. Depending on the level of prostaglandins, cramps may be mild or severe.
• Narrow cervical canal, causing difficulty in passage of the dead endometrial tissue during menstruation.
• Retroverted or backwards-tilted uterus.
• Other factors such as lack of exercise, chronic constipation, and emotional stress are also associated with menstrual cramps.

Treatment of Menstrual Cramps

• Adequate rest
• Regular exercise, such as walking
• Avoiding constipation
• Heating pad or hot water bottle applied to the abdomen
• Ideally, medicines should be started before the pain becomes severe, or in anticipation of the pain, it may be started one or two days before the onset of menstruation, to give best results. For mild pain, aspirin or acetaminophen can be used, but for moderate to severe pain, medicines such as ibuprofen, ketoprofen, naproxen, or mefenamic acid are more effective.
• Low-dose oral contraceptives and insertion of IUD containing small amounts of the progesterone levonorgestrel may be effective in managing severe cramps.
• Dilatation and curettage (D and C), or endometrial ablation (burning away of the endometrial lining).
• Hysterectomy or surgical removal of the uterus is the most extreme measure to get relief from menstrual cramps.
• For secondary dysmenorrhea, the underlying cause should be identified and treatment done accordingly.

A larger bust is often portrayed as key to feminine beauty and an indication of a woman’s appeal to the opposite sex. In the search for larger breasts, many women undergo breast augmentation, opting for implants rather than accepting their natural form. breast enlargement creams, push up bras and even vibration belts for the breast continue to sell globally as less ‘well endowed’ women grasp onto the hope that one of these methods will be the answer. However breast size can significantly impact on the spine, hip and major muscles and nerves of the body and this should always be taken into consideration before opting for breast augmentation.

Why do large breasts affect the back and spine?

large breasts usually cause a significant shift in the center of gravity resulting in a number of effects on the body’s musculoskeletal system. The additional weight extending beyond the center will add up to 10 times its weight in pressure on the spinal column due to the action of gravity. Over time, this can affect the spine and cause long term back problems, initially experienced as back pain. Over time, the altered gait and posture may complicate to other spinal complications and nerve problems like a ‘pinched nerve’ or ‘bulging disc’ (herniation).

How do larger breasts change the posture?

Women with large busts change their posture, unconsciously, to compensate for the additional weight. The upper back (thoracic spine) is pulled back, often appearing like the chest is being pushed out further. The lower back then adjusts accordingly by arching, distributing some weight to the front (slightly protruded belly) and the rest to the back, resembling a protruding buttock or ‘big bottom or bum’. These changes in the spine does give temporary relief to the weight distribution associated with large breasts but over time, it is difficult to maintain this posture without affecting the spine and causing back pain.

What are the effects and complications of large breasts on the back and spine?

The obvious change in the curvature of the spine leads to a host of back problems that affects the vertebrae (back bones), back skin, muscles and nerves. A large bust often needs better support with an appropriate bra, the straps of which keep ‘digging’ into the skin causing bruising of the skin of the back and under the breast. This can contribute to chaffing (intertrigo) which could result in a breast fungus over time. The increased curvature of the spine to compensate for the additional weight may lead to lordosis which causes neck and back pain on the upper and lower back. This often occurs as a combination of back muscle spasm (cramps) and ‘pinched nerve’ syndrome. The disordered weight distribution in the upper torso is compensated by the lower body with the hips tilting to distribute the weight appropriately to both legs. This change in posture may affect the gait giving some women with very large breasts a characteristic ‘duck walk’ which causes long term muscle and spinal problems.

Opting for larger breast sizes through breast augmentation should only be conducted once a woman considers the possible complications of an enlarged bust. Many women want to go as ‘big’ as possible when considering breast enlargement and many unscrupulous practitioners are willing to assist without explaining the host of problems associated with bigger breasts. Consider your options carefully before considering a significant enlargement through breast augmentation and if you have a naturally large bust, speak to your doctor about some of the symptoms you may be experiencing as a result of your bust size.