Definition
Coccygodynia is a painful syndrome affecting the coccyx and / or surrounding area and is caused by a chronic inflammatory process.
This type of syndrome is very common in women, but can also affect men.
Causes
As mentioned, coccygodynia is caused by chronic inflammation localized in the coccyx area and in areas in its vicinity.
The causes triggering inflammation can be multiple: traumas and falls, childbirth, the overload of the sacro-coccygeal region due to certain types of sports or work, postural defects and wear - due to age - of cartilage discs that hold the coccyx in place.
Furthermore, in some cases, coccygodynia may be due to the onset of a neoplastic disease or to the expansion of metastatic cancer.
Furthermore, overweight individuals are at greater risk of developing coccyginia than those of normopathy.
Symptoms
The characteristic symptom of coccyginia is the pain in the coccyx and surrounding areas. Other symptoms that can occur in patients with coccyginia are muscle pain in the back, legs, buttocks and hips, pain during or before evacuation, stomach pain and perception of pain during sexual intercourse (this last symptom, however, it is quite rare).
Furthermore, in women with coccyginia, the pain caused by the disease may increase in conjunction with the menstrual cycle.
Information on Coccigodinia - Drugs and Coccygodynia Treatment is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Coccigodinia - Drugs and Coccigodynia Treatment.
drugs
The drugs most commonly used for the treatment of coccyghinia are analgesics and NSAIDs (non-steroidal anti-inflammatory drugs), possibly used in combination with muscle relaxants to reduce the muscle stiffness that could arise. Usually, the drug therapy just described is sufficient to control the milder cases of coccyginia.
In cases of coccygodynia characterized by particularly severe pain, the doctor may decide to use opioid analgesics to relieve the patient.
Another therapeutic approach that can be taken into consideration is that based on corticosteroid injections, often in association with local anesthetics.
Even the use of chiropractic, osteopathy or physiotherapy can relieve the pain caused by inflammation.
Surgical treatment, on the other hand, is reserved only for very serious cases of coccygodynia in which conservative therapy has proved ineffective.
NSAIDs
NSAIDs constitute the first therapeutic approach that is undertaken for the treatment of coccyginia, in fact - being endowed with anti-inflammatory properties - they contribute to reducing the inflammation that characterizes this syndrome. Furthermore, NSAIDs also have good analgesic activity.
Among the drugs most used in therapy, we recall:
- Ibuprofen (Brufen ®, Moment ®, Nurofen ®, Arfen ®, Actigrip fever and pain ®, Vicks fever and pain ®): ibuprofen is available in different pharmaceutical formulations suitable for different routes of administration. When administered orally the maximum daily dose should not exceed 1, 200-1, 800 mg of active ingredient. The exact amount of drug to be used must be determined by your doctor.
- Naproxen (Momendol ®, Synflex ®, Xenar ®): when naproxen is administered orally, the usual dose is 500-1, 000 mg of drug per day, to be taken in divided doses every 12 hours.
If, on the other hand, naproxen is used in the form of gel or cream for cutaneous use, it is recommended to perform two applications per day, directly on the affected area.
Of course, the indications just given concerning the doses of active ingredients usually used in therapy are indicative. The exact dosage of each medicine, in fact, should always be established by the doctor.
Muscle relaxants
For the treatment of coccyginia, in addition to NSAIDs, the doctor can also prescribe muscle relaxants, in order to reduce the excessive muscle contraction that can occur.
An example of a muscle relaxant that can be used is constituted by thiocolchicoside (Miotens ®, Muscoril ®). This drug is available for oral and parenteral administration.
When taken orally, the dose of thiocolchicoside usually used is 8 mg, to be taken twice a day at twelve-hour intervals. It is important never to exceed the maximum daily dose of 16 mg of drug. The duration of the treatment should not exceed 7 consecutive days.
When administered parenterally, however, the maximum recommended dose is 8 mg per day, to be administered intramuscularly in two divided doses at a distance of twelve hours from each other. In this case, the duration of the treatment should not exceed 5 consecutive days.
Painkillers and opioid analgesics
Analgesic drugs are used to relieve the pain caused by coccygodynia.
The most widely used painkiller is:
- Paracetamol (Tachipirina ®, Efferalgan ®, Panadol ®). It is a drug that can be administered through different routes, since it is available in numerous and different pharmaceutical formulations.
When administered orally, the usual dosage is 500-1000 mg, to be taken as needed for a maximum of 3-4 times a day. An interval of at least 4-6 hours must elapse between one administration and another.
If the pain caused by coccygodynia is particularly intense, the doctor may decide to prescribe opioid analgesic drugs. However - due to the side effects they can cause - the use of these medicines is reserved only for particularly serious cases.
Among the opioid analgesics that can be used, we recall:
- Tramadol (Contramal ®, Patrol ®): tramadol is available for oral, rectal and parenteral administration. Generally, the initial dose of tramadol that is administered is 50-100 mg. Later - if deemed necessary - the doctor may decide to increase the amount of active ingredient to be used, until the optimal dosage is identified which allows adequate control of the painful state.
Corticosteroids
Corticosteroid injections alleviate both inflammation and the pain caused by coccygodynia. Injections can be performed both in the coccyx at the intra-articular level and in the surrounding tissues.
This practice is very delicate and should only be performed by specialized personnel. Furthermore, corticosteroid administrations should not be performed frequently, as there is a risk of causing damage to the coccyx and lower back.
Among the corticosteroids that can be used in the treatment of coccyginia, we recall:
- Methylprednisolone (Depo-Medrol ®): in this case, methylprednisolone can be used in combination with lidocaine (a local anesthetic). When administered intra-articularly, the dose of drug used varies from 4 mg to 80 mg, depending on the severity of the disease.
If, on the other hand, methylprednisolone is administered intramuscularly, the dosage used is 40-120 mg, depending on the severity of the inflammation.
- Triamcinolone (Kenacort ®): the usual starting dose of triamcinolone is 2.5-15 mg. The exact dosage must be established by the doctor on an individual basis for each patient, depending on his condition and the severity of coccyginia.
