Kobayashi Reon, Okano Ichiro, Taketomi Asae, Hara Eiko, Mera Hitoshi
Anesthesiology, Showa University School of Medicine, Tokyo, JPN.
Orthopaedic Surgery, Showa University School of Medicine, Tokyo, JPN.
Cureus. 2024 Nov 27;16(11):e74564. doi: 10.7759/cureus.74564. eCollection 2024 Nov.
Usually, coccydynia cases are caused by herniated discs, with lower back pain and sciatica as initial symptoms. However, whether lumbar disc herniation causes coccydynia without back pain remains unclear. We report a case of lumbar disc herniation diagnosed as the underlying cause of coccydynia by discoblock. A woman in her mid-20s was treated for coccydynia experienced during sitting, for several years. There was no coccyx tenderness upon palpation. As the location of the pain could not be identified, it was not possible to perform a block at the site of the pain. Magnetic resonance imaging showed a herniated L5/S1 lumbar disc, without lower back pain and sciatica. Following discoblock, coccydynia was diagnosed as associated pain due to the herniated L5/S1 lumbar disc that was treated with percutaneous discectomy. After surgery, coccydynia was relieved while sitting; no medication was required.Discoblock was used to diagnose lumbar disc herniation as the cause of coccydynia. Percutaneous discectomy was effective for coccydynia without back pain, thus lumbar disc herniation should be considered as a differential diagnosis. Discoblock can be useful for differentiation.
通常，尾骨痛病例由椎间盘突出引起，最初症状为下背痛和坐骨神经痛。然而，腰椎间盘突出是否会导致无背痛的尾骨痛仍不清楚。我们报告一例经椎间盘阻滞诊断为尾骨痛根本原因的腰椎间盘突出病例。一名25岁左右的女性因久坐时出现的尾骨痛接受了数年治疗。触诊时尾骨无压痛。由于疼痛部位无法确定，无法在疼痛部位进行阻滞。磁共振成像显示L5/S1腰椎间盘突出，无下背痛和坐骨神经痛。经椎间盘阻滞后，尾骨痛被诊断为由L5/S1腰椎间盘突出引起的相关疼痛，并接受了经皮椎间盘切除术治疗。手术后，久坐时尾骨痛缓解；无需药物治疗。椎间盘阻滞用于诊断腰椎间盘突出为尾骨痛的病因。经皮椎间盘切除术对无背痛的尾骨痛有效，因此腰椎间盘突出应被视为鉴别诊断。椎间盘阻滞有助于鉴别诊断。
