COCCYALGIA (coccygodynia; lat. coccyx coccyg [is] tailbone + grech, dyne pain; synonym coccygeal pain) — the syndrome which is shown pristupoobrazno the arising or constant pains in proctal and coccygeal area. It is for the first time described in 1859 by J. Y. Simpson.
Due to the anatomic features of a structure of bodies of a small pelvis To. by 2 — 3 times meets at women more often. Age of patients with To. the most various, but is more often — from 40 to 60 years.
Most of domestic and foreign authors connect an origin of pains in the field of a tailbone with pathology of sacral and coccygeal textures or consider as result of periosteal and periartikulyarny changes after acute or hron, injuries of sacrococcygeal area. Posttraumatic To. in one cases it is caused by the shift or dislocation of a tailbone, in others — cicatricial process in cellulose of a small pelvis, a miositis of levators, a coccygeal muscle which quite often are followed by the shift or dislocation of a tailbone. At patients To. pain amplifies in a sitting position or at the time of a rising; besides, characteristic irradiation of pains in a crotch, a rump is noted and on an inner surface of a hip are the pains limited to limits of distribution of a coccygeal texture.
For specification of the diagnosis To. full inspection of patients is necessary: manual research of a rectum and tailbone, X-ray analysis of sacrococcygeal department of a backbone, rektoromanoskopiya; patients shall be examined according to indications by the urologist, the gynecologist, the neuropathologist.
Complex of conservative therapy To. includes first of all the large volume of physiotherapeutic procedures: darsonvalization introduction of an electrode to a rectum; ultrasound with analgesic mix or a hydrocortisone, paraffin applications to lay down. dirt, ozokerite, underwater extension etc. In stationary conditions the good effect is rendered by presakralny novocainic blockade according to Vishnevsky, novocainic and alcohol blockade across Aminev. Spirtonovokainovy epidural and sacral blockade are applied at the most persistent pains. The good effect renders a combination of presakralny novocainic blockade to massage of levators and a coccygeal muscle. With success the method of impact on biologically active sites of integuments — acupuncture, electroacupuncture is applied (see. Acupuncture ).
Operational treatment To., as a rule, does not give relief by the patient. Koktsigektomiya is shown only at a fracture or dislocation of a tailbone. Other operations (a resection of a coccygeal texture, removal of nodes of presakralny department of a sympathetic trunk, crossing of 5 sacral roots by a laminectomy) at this disease are not recommended.
Bibliography: Barkan M. B. Clinic and diagnosis of a coccyalgia, Vestn, hir., t. 98, No. 4, page 83, 1967; Of e of l of l of e r A. N. Koktsigodiniya and her treatment, Klin, hir., No. 3, page 34, 1972; Diagnosis and treatment * ano-coccygeal pain syndrome, Me Tod. recommendations, sost. Yu. V. Dultse^ and Yu. B. Kugayevsky, M., 1977; Perov Yu. A. and Uglova M. V. About a condition of the sensitive nervous device in an eye-lokopchikovoy of fabric at a coccyalgia, Works Kuybyshevsk. medical in-that, t. 54, page 123, 1969; Rivkin V. L., etc. A proctal and coccygeal pain syndrome, Questions of classification, diagnosis and treatment, in book: Diagn. and to lay down. having got sick, direct and colonic guts, under the editorship of A. M. Aminev, etc., page 88, M. — Kuibyshev, 1974; Yumashev G. S., etc. A syndrome of a coccyalgia at osteochondrosis of lumbar department of a backbone, Klin, medical, t. 48, JSfc 6, page 116, 1970; With u z z u p o 1 i F. e M o s e 1 1 i M. Considerazioni etiopato-genetiche e clinico-statistiche in tema di coccigodinie, Arch. Sci. med., y. 126, p. 100, 1969; Simpson J. Y. Letter on removal of the coccyodynia, Med. times Gaz., v. 1, p. 317. 1861.
Yu. V. Dultsev, Yu. B. Kugayevsky.