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尾骨痛——发病机制、诊断与治疗。文献综述

Coccygodynia - pathogenesis, diagnostics and therapy. Review of the writing.

作者信息

Dampc Bogumiła, Słowiński Krzysztof

机构信息

Centrum Terapii Manualnej, Sierosław, Tarnowo Podgórne, Polska.

出版信息

Pol Przegl Chir. 2017 Aug 31;89(4):33-40. doi: 10.5604/01.3001.0010.3909.

Abstract

Coccygodynia is a problem with a small percentage (1%) of the population suffering from musculoskeletal disorders. This pain is often associated with trauma, falling on the tailbone, long cycling, or by women after childbirth. The reason for the described problem can be the actual morphological changes. Idiopathic coccygodynia causes therapeutic difficulties to specialists of many fields. Unsatisfactory treatment, including coccygectomy tends to seek new solutions. They belong to them techniques exploited in the manual therapy which in their spectrum hold: direct techniques - per rectum as well as indirect techniques taking into account distant structures of the motor organ, remaining in dense interactions with the coccygeal part. Idiopathic coccygodynia is a result perhaps from exaggerated tension the muscle of the levator ani, coccygeus and gluteus maximus as well as from irritating soft tissue structures surrounding the coccyx: of sacrococcygeum, sacrospinale, and sacrotuberale ligament. Unfortunately we can't see them in objective examinations so as: the RTG, MR or TK, therefore constitute the both diagnostic and therapeutic problem. For describing the problem a writing of the object was used both from the field of the surgery and of manual therapy. Detailed and multifaceted knowledge about causes of the described problem allows more accurately to categorize the patient to the appropriate group and helps to select the best procedure of treatment.

摘要

尾骨痛是一个问题,有一小部分(1%)的人口患有肌肉骨骼疾病。这种疼痛通常与创伤、尾骨着地、长时间骑行或产后女性有关。所述问题的原因可能是实际的形态变化。特发性尾骨痛给许多领域的专家带来治疗困难。包括尾骨切除术在内的不满意治疗往往寻求新的解决方案。它们属于手法治疗中所采用的技术,其范围包括:直接技术——经直肠,以及间接技术,后者考虑运动器官的远处结构,与尾骨部分保持紧密相互作用。特发性尾骨痛可能是由于提肛肌、尾骨肌和臀大肌的过度紧张,以及尾骨周围的软组织结构(骶尾骨、骶棘肌和骶结节韧带)受到刺激所致。不幸的是,在诸如X光、磁共振成像或计算机断层扫描等客观检查中我们看不到这些情况,因此这构成了诊断和治疗上的问题。为了描述这个问题,我们从外科手术和手法治疗领域对该对象进行了记录。关于所述问题原因的详细且多方面的知识能够更准确地将患者归类到合适的组,并有助于选择最佳的治疗方案。

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