This is one of the most common problems that people suffer from today. The causes can be as wide ranging as the symptoms and intensity of pain. Statistics show that 80% of people will suffer from ‘non-specific low back pain’ in their life. Often this resolves itself, however, if this repeats itself, even once it is worth getting your back assessed by a professional who should be able to tell you what is causing the problem (a diagnosis) and the best course of action; whether that be treatment, referral, stretches and/or pain management.
Non specific low back pain – Low back pain can often be caused by chronically poor posture which places the muscles and joints under more strain. Over time this can bring on early stage arthritis of the joints in the back, known as spondylosis
Facet Joint irritation – These are the paired joints that run up the length of the spine. There main function is to transfer weight. They are also used a lot to relay message to the brain about the spine position in space, also known as proprioception. Due to the high density of nerves they are often very painful and limited range of movement in the back but the symptoms do not last very long
Disc Injury – Discs separate the vertebrae and are the spines shock absorber. They are usually damaged through poor posture whilst lifting/carrying, twisting movements to end range or over time as the disc height reduces with age. The variety of damage can be from a small strain (annular strain) to a full prolapsed disc which can then cause nerve irritation in the leg (sciatica). There are several tests that can be done to rule out certain things and imaging (x-rays and MRIs) may help to diagnose the problem
Muscle Spasm – there are small intrinsic muscle of the spine which are responsible for our posture. If these become strained or irritated they can go into an acute spasm. These can be very painful, restrict most ranges of movement and cause a change to your posture i.e. bent in a certain direction
If there is any change to your bowel or bladder habits whilst you have back pain; i.e. you are suffering bowel incontinence or bladder retention then you should visit A+E immediately.
The coccyx or as it’s commonly known as the tailbone is located at the end of your spine as is made up of 3-5 vertebrae. Although many think that the coccyx is fused, very rarely is this in one block (less than 10%). More commonly it will be separated over 2-3 segments each with an articular disc between them.
Coccyx also vary massively in size and shape; below are some examples of the variety.
Causes of Coccyx Pain (Coccydynia)
Firstly pathology must be ruled out; this is uncommon but is essential!
Through evolution we have lost certain muscles and ligaments that were used to control and move our tails. So now we lack the ability to manipulate our coccyx back into the correct position and must be done so by an external force that I shall explain more later.
But first, here are common reasons for injuring ones coccyx: falls onto your coccyx, impact sports, winter/extreme sports, horse riding, child birth/pregnancy.
Investigations and Treatment
A physical examination is usually performed by your practitioner. This can involve both internal and external examination of the coccyx, sacrum and surrounding muscles and ligaments.
A local anesthetic can also be used to make sure that it is the coccyx that is causing the pain and is not being referred from another structure, such as the low back.
Active x-rays can be performed comparing the seated and standing positions, however, many Dr are not aware of this test and it is rarely used.
Orthopaedic specialists will often use local steroid injection into the coccyx or in extreme cases remove the coccyx.
As an osteopath, manual therapy has moved to be very effective at easing and relieving coccyx pain. We use both external and (less commonly) internal techniques to take the coccyx back into extension and reverse the affects of any falls that the coccyx has felt. We also work on the surrounding muscles and ligaments to ease the pressure being placed on the coccyx.
Some exercises to extend the back through Yoga or through a lumbar extender have been shown to ease the pain. Also suitable coccyx pillows can help to control the tenderness whilst sitting.
If you feel like this is affecting you then please feel free to give us a call.
This is caused by ‘wear and tear’ of your joints. As this happens, your cartilage (smooth surface covering joints) begins to be removed leaving bone to rub on bone. When this happens the body lays down new boney growth called osteophytes. This process causes pain and inflammation at the joints surface, decreased range of movement at the joint and can have massive effects on the person’s life.