Coccygodynia and Homoeopathy

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COCCYGODY

NIA ANDHOMOEOPA

THYMiasmatic aspects of

Coccygodynia

Dr. Rajneesh Kumar Sharma MD(Hom)


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Coccygodynia and Homoeoapthy

Coccygodynia and

Homoeopathy Dr. Rajneesh Kumar Sharma M.D. (Homoeopathy)

Dr. Swati ishnoi !.H.M.S.

Homoeo Cure " Research #nstitute

$H %&' Moradaad Road' Kashipur (ttarancha*)

#$D#+ ,in- 2&&%/ ,h. 01&%- 230/2%' 4%341&

5. mai*- drrajneeshhom6hotmai*.com

www.treatmenthomoeopathy.comwww.homeopathictreatment.org.in

www.homeopathywor*dcommunity.com

ContentsDenition................................................................................................2

Synonyms...............................................................................................2

History....................................................................................................

!natomy.................................................................................................

"ony #andmar$s.................................................................................

%oints...................................................................................................

#igaments...........................................................................................

!ttachments........................................................................................

&ncidence................................................................................................'

Causes....................................................................................................'

Symptoms..............................................................................................'

Cinica eauation..................................................................................*

Di+erentia diagnosis..............................................................................,

-reatment...............................................................................................,

Homoeopathic treatment.......................................................................

"i/iography...........................................................................................0

Dr. Rajneesh Kumar Sharma
mailto:[email protected]://www.treatmenthomoeopathy.com/http://www.homeopathictreatment.org.in/http://www.homeopathyworldcommunity.com/http://www.treatmenthomoeopathy.com/http://www.homeopathictreatment.org.in/http://www.homeopathyworldcommunity.com/mailto:[email protected]


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&nde1....................................................................................................

Denition($o$s34go4din5e46) pain in the coccy1 and neigh/oring region7 triggered /y sittingor /y rising from a seated to a standing position often radiating to the sacrum7

um/ar spine7 and /uttoc$s7 and thighs (Causa occasionais8 9sora).

SynonymsCoccygodynia7 coccyagia7 coccydynia7 tai/one pain7 coccydynia7 coccycodynia7coccygea neuragia.

History-he term :as rst introduced /y Simpson in ;*07 /ut accounts of coccygea paindate /ac$ to the ,thcentury.

!natomy-he coccy1 is a estigia set of /ones corresponding to the tai of many mammas.&t is the set of fused7 tapered7 rounded /ones7 '4* in num/er7 that articuate :iththe sacrum. &t is the most dista aspect of the erte/ra coumn.


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Anteror sacrococc!"eal l"a#ent ? a continuation of the anteriorongitudina igament of the spine7 and so connects the anterior aspects ofthe erte/ra /odies.

Deep posteror sacrococc!"eal l"a#ent $connects the posterior sideof the *th sacra /ody to the dorsa surface of the coccy1.

%uper&cal posteror sacrococc!"eal l"a#ent $attaches the mediansacra crest to the dorsa surface of the coccy1.

'ateral sacrococc!"eal l"a#ents $run from the atera aspect of thesacrum to the transerse processes of Co.

Interartcular l"a#ents $stretch from the cornua of the sacrum to thecornua of the coccy1.

!ttachments-he $ey functions of the coccy1 is as an attachment point for arious structures.-he guteus ma1imus and eator ani musces attach to the coccy17 the atter/eing a $ey component of the peic >oor. ! thin7 /rous igament7 the

anococcygea raphe runs from the coccy1 and heps support the position of theanus.

&ncidence-he femae8mae incidence ratio is *@.* due to a more posteriory situatedsacrum and coccy1. Due to onger coccyges reatie to men7 femaes hae a

greater chance of deeoping coccygodynia.&t is more common in o/esityA a /ody4mass inde1 ("M&) of 2.' in femaes. "M&more than 20.' in maes increases the chance of deeoping coccygodynia.

CausesBature of coccygea pain is mutifactoria. -he idiopathic form comprises ess than of a non4traumatic disorders of the erte/ra coumn7 :hie the main cause/eing coccygea injuries.



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Most tai/one injuries are caused /y trauma to the coccy1 area as4 ! fa onto the tai/one in the seated position7 usuay against a hard surface

(Causa) ! direct /o: to the tai/one7 as occurring during contact sports (Causa)

-he coccy1 can /e injured or fractured during chid/irth (Causa)

Congenita deiations can aso cause compaints during ong sitting(Syphiis)

Repetitie straining or friction against the coccy1 as in /icycing or ro:ing7can injure the coccy1 (Causa8 9sora)

Sometimes7 the cause of coccy1 injuries is un$no:n (9sora8 Sycosis8Syphiis)

"one spurs7 compression of nere roots7 injuries to other parts of the spine7oca infections7 and tumors (9sora8 Sycosis8 Syphiis)

Symptoms

Coccygodynia is much ess common than o: /ac$ pain. &t is often reatieyseere and persistent7 causing signicant compromise of the patients a/iity toperform or toerate arious actiities. &ts main features are4

Seere ocaiEed pain and tenderness may /e fet in the tai/one area.

! /ruise may /e isi/e in coccygea area.

-he pain is generay :orse :hen sitting for proonged periods of time7 or:ith direct pressure to the tai/one area.

"o:e moements and straining are often painfu.

Some :omen pain during se1ua intercourse.

Cinica eauationCoccygodynia can /e diagnosed during a physica e1amination. 9atients may ta$ea guarding seated position7 in :hich one /uttoc$ is eeated to shift :eight fromthe coccy1 and to preent and8or minimiEe discomfort and pain. Fith referred orradiated pain7 the pain :i aso arise during um/ar moements. Coughing ispainfu. 9hysica e1amination :i sho: an increased pain during a straight egraise test. -here may /e radiating pain around the /uttoc$s and going to the /ac$of the thighs. Fomen may hae pain during menstruation. 9apation at thesacrococcygea junction :i eicit a tender point and :i /e painfu. Main points todiagnose are4



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Borma sacrococcygea joint

Hypomo/iity of sacrococcygea joint

Hypermo/iity of sacrococcygea joint

Su/u1ation of sacrococcygea joint

#u1ation of sacrococcygea joint

Disocation of sacrococcygea jointPain Measures

'4 &tem 9ain &ntensity Measure (9')

"rief 9ain &nentory 4 Short Gorm

Bumeric 9ain Rating Scae

Short4form Mci 9ain Iuestionnaire

Jisua !naogue Scae

Condition Specic

9eic Goor Distress &nentory (9GD& 4 2)

9eic irde Iuestionnaire (9I)



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Di+erentia diagnosis #um/osacra joint dysfunction and8or sacroiiac joint 1ation :ith peic

o/i=uity #um/ar and sacra /iomechanica dysfunction as a cause of pain in the

tai/one 9iriformis Myofascia 9ain

9iriformis trigger points or L:aet neuritis as a cause of pain in the tai/one

#oca coccygodynia

-raumatic coccygodynia

&diopathic coccygodynia

Referred or radiated coccygodynia

9sychogenic coccygodynia

Chronic proctagia

Chronic peic pain and pudenda neuragia

-reatment Donut cushion

Diathermy

Cryotherapy

Spina manipuation

Coccygea manipuation Myofascia treatment

Radiotherapy

Manipuation of coccy1 under anesthesia

Hot /aths

9sychotherapyPhysical Therapy Management



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9atients :ith coccygodynia are initiay adised to aoid stimuating factors. &nitiatreatment incudes ergonomic adjustments such as using a donut4shaped pio: orge cushion :hen sitting for a ong period of time. -his reduces oca pressure andimproes the patients posture.Mo/iiEations can /e used to hep reaign the position of the coccy1. -he rst

choice for mo/iiEation is postero4anterior centra erte/ra pressure (rst gentyosciating). ien that there is tenderness to papation7 it might /e /est to start:ith rotation mo/iiEation. &t is adised to /egin mo/iiEing ony one side at onetreatment.!nother option for manua therapy is to appy deep transerse frictions (D-G) tothe a+ected igaments. -he patient ies in prone position :ith a pio: under thepeis and the egs in sight a/duction and interna rotation. -he therapist paceshis thum/ on the a+ected spot7 and7 depending on the ocation of the esion(direction D-G)7 the D-G are administered.

Manipu*ation o7 coccy8



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-he coccy1 is $ept in hypere1tension7 :hich stresses the sacrococcygea andintercoccygea igaments7 stretches the eator ani musces and reduces jointmisaignments.Manipuation of the coccy1 can /e performed intrarecta :ith the patient in ateraposition. Fith the inde1 nger7 the coccy1 is repeatedy >e1ed and e1tended. -his

is performed for ony one minute7 to aoid damage or irritations of the rectamucosa.Massage of the eator ani musce and coccygeus musces has aso /een found toreiee pain. Intrarectal Manpulaton of Cocc!xDaiy utrasound foo:ed /y t:o :ee$s of short4:ae diathermy is often/enecia.

Homoeopathic treatmentCoccy17 coccygodynia etc... aesc. agar. agn. a4s. aum. aumin4p. aumin4si. am4c. !M4M. ant4c.!B-4-. !9&S arg4n. arn. ars4i. ars4s4f. ars. !RNM4-. asaf. /am/4a. "


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"!CK 4 9!&B 4 coccy17 coccygodynia ? eft cann4s."!CK 4 9!&B 4 coccy17 coccygodynia 4 ying7 :hie 4 /ac$7 on "


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#PCPMP-PR SOS-4ac. Graph. Hyper. $ai4/i. $ai4c. $ai4i. Kreos. ac4c. Lach. o/. mag4c. Mag-p. Merc.Par. petr. phos. Rhus-t. si. Tarent. tet. 1an. Einc.

"i/iography

Chapter 11. Pain in the ac!" #ec!" and $%tremities & Coccydynia 'dams ( )ictor*s Principles of #eurology" 1+e

Chapter 11. Pain in the ac!" #ec!" and $%tremities & Coccydynia 'dams ( )ictor*s Principles of #eurology" 1+e

Chapter 11. Pel,ic Pain & Chronic Pain -illiams ynecology" /e ... Degenerati,e joint disease 0umar ,erterae compression

Dis! herniation or rupture Coccydynia Spondylosis...

Chapter 11. Pel,ic Pain & 0ithotomy -illiams ynecology" /e ... coccydynia" is suspected. 'ssessment of the uterus may re,eal an

enlarged uterus" often 2ith an irregular...

Chapter 11. Pel,ic Pain & Pel,ic Muscle Trigger Points -illiams ynecology" /e

Chapter 34. 'norectal Pain & Ca,eats The Patient 5istory6 'n $,idence7ased 'pproach to Differential Diagnosis ... rief

episodes of rectal pain 2ithout other significant symptoms or signs. Coccydynia fre8uently...

Chapter 34. 'norectal Pain & Diagnostic 'pproach 9:ncluding 'lgorithms; The Patient 5istory6 'n $,idence7ased 'pproach toDifferential Diagnosis ... or le,ator ani syndrome. Depending on the trigger" other conditions to consider are endometriosis" coccydynia...

Chapter 34. 'norectal Pain & Differential Diagnosis The Patient 5istory6 'n $,idence7ased 'pproach to DifferentialDiagnosis ... Referred Pain


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Chapter BB. uttoc!" 5ip" and Thigh Pain & Coccydynia" sciatica 92ith radiation do2n leg;" piriformis syndrome 5ip> steoarthritis 5ip...

Chapter AA. Diseases and Disorders of the Male enitalia & Dermatologic #ondisease" Dysesthesia" and Chronic Pain Syndromes


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&nde1A

!nterior sacrococcygea igament.......

B

"M&.....................................................'

C

Chronic peic pain.............................,Chronic proctagia...............................,Co.....................................................Coccydynia...................................07 Coccygea...........................................,Coccygea manipuation......................,Coccygodynia.....................27 '7 *7 ;7 0Coccy1............................................7 0Cryotherapy........................................,

D

Deep posterior sacrococcygea...........Diathermy...........................................,Disocation of sacrococcygea joint.....*Donut cushion.....................................,D-G.....................................................

H

Hot /aths............................................,Hypermo/iity of sacrococcygea joint *Hypomo/iity of sacrococcygea joint..*

I

&diopathic............................................,&nterarticuar igaments......................

L

#atera sacrococcygea.......................#eator ani........................................

#um/ar...........................................,7 0#u1ation of sacrococcygea joint.........*

M

Manipuation of coccy1...................,7 Mo/iiEations.......................................Myofascia treatment..........................,

P

9eic Goor Distress &nentory............*9eic irde Iuestionnaire.................*9iriformis.............................................,9iriformis Myofascia 9ain....................,

9sychogenic coccygodynia.................,9sychotherapy....................................,

R

Radiotherapy......................................,

S

Simpson..............................................Spina manipuation............................,Su/u1ation of sacrococcygea joint....*Supercia posterior sacrococcygea...

T

-raumatic............................................,

V

Jisua !naogue Scae.........................*


Coccygodynia and Homoeopathy

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