Pain in the sacrum
Pain in the sacrum is provoked by lesions of the sacrum itself, sacroiliac joints, surrounding soft tissues, nerve structures and pelvic organs. It can be acute, dull, pressing, aching, pulling, constant, periodic, weak or intense. Sometimes there is a connection with the level of physical activity, menstrual cycle and other circumstances. To determine the cause of pain in the sacrum, a survey, an objective examination, radiography, CT and other studies are carried out. Before the diagnosis is made, rest is recommended, in some cases, the use of painkillers is allowed.
Why does the sacrum hurt
Traumatic injuries
Diseases of the spine
Neurological pathologies
Sacroileitis
Women’s diseases
Other pelvic diseases
Other diseases
Diagnostics
Treatment
Assistance at the pre-hospital stage
Conservative therapy
Surgical treatment
Prices for treatment
Why does the sacrum hurt
Traumatic injuries
Pain in the sacrum after injury is more often caused by hematomas and bruises of soft tissues. With a bruise, the pain syndrome is moderate, disappears within a few days. The swelling is small, the movements are limited slightly, the condition is satisfactory. With a hematoma above the sacrum, a painful tumor-like formation is detected, which either gradually resolves over 2-3 weeks, or turns into a cavity with liquid contents.
Sacral fractures are extremely rare, usually combined with multiple fractures of the pelvic bones. Occur after a high-energy injury: a road accident, a fall from a height, etc. The pain syndrome is very intense, movements are sharply limited, the condition is severe. Bruising may be detected in the sacrum and pelvic bones, and pathological mobility is possible.
Diseases of the spine
The cause of pain in the sacrum area is often caused by diseases of the lower parts of the spinal column. The pain may be local, spread to the lower back and buttocks. With degenerative-inflammatory processes, muscle overstrain, painful sensations aching or pulling, increase after exertion, with a change in the weather. When squeezing nearby nerve structures, the pain becomes shooting, radiating into the legs, significantly limiting mobility.
Pain syndrome is observed in the following pathologies of the spine:
Degenerative: intervertebral hernias, disc protrusion, osteochondrosis, spondyloarthrosis.
Anomalies of development: lumbalization, sacralization.
Curvature of the spine: scoliosis, kyphoscoliosis, pathological kyphosis and lordosis, flat back.
Inflammatory: spondylitis.
Oncological: primary tumors and metastatic lesions of the lower spine and spinal cord.
Polyethological: spondylolisthesis.
In addition, pain syndrome is detected in all types of osteoporosis, including juvenile, senile, postmenopausal and idiopathic. Pain in osteoporosis, as a rule, is insignificant, increasing after exertion and prolonged stay in an uncomfortable position. An increase in the intensity and duration of pain with a decrease in bone strength may indicate the presence of a pathological fracture.
Pain in the sacrum
Neurological pathologies
Burning, shooting pains that are given to the legs or buttocks, combined with disorders of sensitivity and movement, are characteristic of such neurological disorders as:
lumbosacral plexitis;
ponytail syndrome;
radicular syndrome.
Sacroileitis
Inflammation of the sacroiliac joint is more often unilateral, but it can also be bilateral, observed in many diseases, manifested by pain on the side of the sacrum. The characteristics of the pain syndrome are determined by the type of pathology:
Purulent. Rapidly increasing sharp pains, increasing with the extension of the limb. Combined with a forced body position, chills, hyperthermia, severe intoxication.
With tuberculosis. The pain is indeterminate, without a clear localization. Palpation of the articulation is moderately painful. Stiffness, local hyperthermia are observed. Over time, swelling often forms on the hip.
With brucellosis. The pain is short-term, insignificant or moderate, increases with movements. Persistent pain syndrome is less common.
For rheumatic diseases. It is detected in Bekhterev’s disease, psoriatic arthritis. The painful sensations are not intense, they increase at rest, weaken with exertion, are complemented by morning stiffness.
Women’s diseases
Pain in the projection of the sacrum is observed in gynecological and obstetric pathologies. More often, non-intense, dull, aching, supplemented with pain in the lower abdomen. When chronic processes persist for a long time, they are often combined with chronic pelvic pain syndrome in women. They are found in the following diseases and conditions:
During pregnancy: spontaneous termination of pregnancy, low placenta location.
In childbirth: pathological preliminary period of labor, discoordinated labor activity.
Violations of the position of the uterus: hyperanteflexia, retroflexia.
Congenital anomalies: doubling of the uterus, aplasia of the uterus, one-horned and two-horned uterus, “baby” uterus.
Inflammatory: oophoritis, metritis, metroendometritis.
Related to menstruation: dysmenorrhea.
Tumors and tumor-like formations: paraovarial cyst, uterine fibroma, cervical cancer, uterine body cancer.
After gynecological operations: abortions, curettage, plastic surgery.
Other pelvic diseases
Ordinary or radiating pain in the sacrum is also detected in diseases of other pelvic organs:
Urological: interstitial cystitis, bladder cancer.
Andrological: prostatitis, prostate cancer.
Proctological: rectal cancer.
Others: adhesive disease, varicose veins of the pelvic veins.
Simultaneously with pain in the sacral region in chronic andrological pathologies, chronic pelvic pain syndrome in men is often diagnosed.
Other diseases
Sometimes the following diseases become the cause of pain in the sacrum:
Myalgia and myositis. Pain occurs against the background of overload, acute infectious diseases.
Coxarthrosis. Pain can be provoked by a non-physiological load on the spine.
Mental disorders. Psychosomatic pains are noted in hysteria, neurasthenia, depression. They do not fit into the picture of a certain disease, often differ in an unusual character.
Diagnostics
Patients with sacral pain often turn to a neurologist or orthopedic traumatologist. In diseases of the internal organs, patients are examined by doctors of the appropriate profile. The following procedures may be prescribed as part of the examination:
Neurological examination. It is required for diseases of the spinal column, damage to nervous structures. It is carried out to study reflexes, sensitivity, coordination of movements and muscle strength.
Gynecological examination. It is indicated for diseases of the female reproductive system. It is performed to detect developmental abnormalities, inflammatory and tumor processes.
Finger rectal examination. Depending on the symptoms, it provides for the examination of the prostate or rectum to assess the condition of the organ, the detection of volumetric formations.
ultrasound. It is necessary for diseases of the pelvic organs. Ultrasound of the female genital organs, ultrasound of the prostate and bladder, or ultrasound of the rectum with a rectal sensor can be performed.
Radiography. X-rays of the sacrum, lumbar region and pelvis show fractures, degenerative and inflammatory changes, and bulky formations.
Other visualization methods. To detail the information obtained during radiography, if necessary, tomographic studies are performed. CT allows you to assess the condition of solid structures, MRI is used to study soft tissues.
Functional research. Patients with neurological pathology are prescribed electroneurography and the study of evoked potentials.
Laboratory tests. Studies of blood, urine and feces, microbiological and histological analyses are performed in gynecological, andrological, proctological and rheumatic pathology, inflammatory processes.
Manual techniques for sacral pain
Manual techniques for sacral pain
Treatment
Assistance at the pre-hospital stage
In case of bruises and bruises, rest should be provided. A suspected fracture of the sacrum is an indication for immediate hospitalization. The patient must be laid on a shield, given an anesthetic. For non-traumatic pathologies of the spine and neurological disorders, warming, anti-inflammatory and local analgesics are effective.
With dysmenorrhea, an analgesic is allowed. If other gynecological pathologies are suspected, especially those that suddenly arise and are accompanied by increasing pain, self–medication can be dangerous. An urgent examination by a gynecologist is required.
Conservative therapy
The plan of conservative measures is determined by the nature of the pathology. The list of used therapeutic techniques includes:
Protective mode. It is recommended for injuries, diseases of the spine and nervous tissue. It may provide for bed rest, load limitation, the use of orthopedic devices.
NSAIDs. They are indicated for rheumatic pathology, chronic pain caused by damage to the musculoskeletal system. They are prescribed in the form of tablets, injections and topical medications.
Chondroprotectors. They are used for degenerative diseases to restore cartilage tissue.
Physical therapy. Physiotherapeutic measures are carried out for pain in the sacrum that is not associated with volumetric processes. Electrophoresis, heat therapy, magnetotherapy, laser therapy are used. For many pathologies, the treatment regimen includes massage, physical therapy, acupuncture.
Chemotherapy, radiation therapy. They are necessary for oncological lesions. They can be carried out as an independent treatment or as a supplement to the operation.
Surgical treatment
The tactics of surgical treatment depends on the localization of the pathological process:
Diseases of the spine: nucleoplasty, microdiscectomy, discectomy, facetectomy, laminectomy, sequestrectomy, removal of tumors.
Women’s diseases: removal of a paraovarial cyst, hysterectomy, pangisterectomy, supravaginal amputation of the uterus, amputation of the cervix, instrumental removal of the fetal egg, etc.
Urological and andrological pathologies: tumor removal, bladder resection, cystectomy, prostatectomy, cryoablation and FUZZ-ablation of the prostate gland.
In the postoperative period, rehabilitation measures are carried out. In some pathologies, reconstructive interventions are subsequently carried out.
