Clinical Syndrome Coccidin
Coccidin is a common syndrome characterized by pain localized in the coccyx. Women are affected more often than men. Most often, it is caused by a kick or a fall directly on the coccyx (coccyx it occurs directly after trauma. Coccidin can also occur after a difficult vaginal delivery. Stretching of the sacrococcygeal ligament and sometimes a fracture of the sacrum bone can cause this result. Less common as a rule, it can be caused by arthritis of the sacrococcygeal joint. On physical examination, patients show excessive sensitivity. With the movement of the coccyx, the pain increases. Sitting exacerbates the pain, and patients often have to avoid pressure, he tries to sit sloping down on one hip.
The course of conservative treatment is analgesics, nonsteroidal anti-inflammatory drugs. In cases where there is no response to conservative treatment, injection is a reasonable next step. To treat the pain of coccidinin sacrococcygeal joint injections can be performed. A large area of skin is prepared with antiseptic solution so that all signs can be palpated aseptically. After determining the location of the sacrococcygeal joint, a 10-12 cm, 25-gauge it is inserted through the skin with a needle into the sacrococcygeal joint and ligament region at an angle of 45 degrees. If the ligament is entered, a “pop” will be felt, and the needle should be pulled back through the ligament. When the needle is inserted, 5 mL of 1% preservative are applied to the needle it is inserted into an injector containing lidocaine and 40 mg of methylprednisolone, which does not contain it. A gentle aspiration is performed to identify cerebrospinal fluid or blood. If the aspiration test result is negative, the contents of the injector should be injected slowly it was. After the injection, the needle is removed and a sterile pressure dressing and ice pack are applied to the injection site. In patients with chronic pain, ganglion impar blockade should be carefully considered. Symptoms of the patient severe exercise should be avoided, as it will aggravate it. Simple analgesics and NSAIDs can be used simultaneously with the injection technique.