The sacrum is a wedge-shaped bone located at the lower end of the spine.
Main causes of sacrum pain
What can be to blame? Often the reason is a poor posture of the person concerned when sitting while working.
When a person sits for many hours, the muscles in the lower part of the back and the flexor muscles of the hip stiffen.
Pregnancy
During the last trimester of pregnancy, the ligaments slacken.
This is caused by the presence of various hormones in the blood (relaxin).
The pain is also caused by the muscles: towards the end of pregnancy, the muscles tire a lot.
The weight of the child and the altered gait tire the muscles of the pelvis and hips.
During labor, muscles and ligaments can overstretch. The result is pain in the sacrum and coccyx, which can last for months.
Musculoskeletal disorders
Pain of the sacrum can be caused by diseases of the spine.
The pain in the sacrum occurs sharply and suddenly with incorrect movement of heavy weights, when the muscles of the backbone fatigue.
The sacrum can also hurt when strengthening exercises for the abdominal muscles are done without a mat on the floor.
Pain of the musculoskeletal system is distinguished from other types, because they occur:
- when the patient sits down,
- when he rises from the chair,
- on the bike, when riding uphill by mountain bike or road bike,
- after the patient has sat for a while.
Usually, the symptoms pass when walking or in bed.
Pain in the sacrum is very rare in children.
Natural remedies include:
- postural gymnastics,
- arnica ointment,
- in the first two days after the trauma cold packs, after which heat is better to promote recovery,
- Shoe heels are useful when they are low, sneakers are most suitable.
- Massage of lumbar region and gluteal muscles.
Sacrum fracture
What are the causes of a fracture of the sacrum?
The sacrum fracture is caused by:
- a hard blow (trauma) to the back,
- intense physical activity such as long-distance running,
- road accident,
- Fall from a height (Denis et al. – 1988).
What are the signs and symptoms of a sacrum fracture?
- lumbosacral pain, pain in the buttocks or hip (Silva et al. – 2006),
- pain at the front of the thigh,
- groin pain,
- bruising or hematoma,
- swelling in the sacrum area at the lower end of the back,
- intestinal problems,
- bladder problems (Rawlings et al. – 1988),
- problems with sexual intercourse,
- Muscle weakness on the legs.
Metabolic diseases of the bone (osteoporosis or osteomalacia) can consist of loss of mineral salts from the bone without symptoms.
Contrary to popular belief, a bone affected by osteoporosis does not cause back pain unless there is a fracture.
Treatment of the sacrum fracture consists of bed rest and magnetic therapy.
The doctor may prescribe painkillers if the patient has major discomfort, for example, analgesics such as acetaminophen (ben-u-ron) or nonsteroidal anti-inflammatory drugs such as diclofenac (Voltaren).
Strenuous activities
Pain in the sacrum can worsen during or after physical activity, for example after some exercises in the gym (especially squats and leg press).
This happens because the functional overload causes a stretching of the recto-uterine ligaments.
Spondylolisthesis
The pain in the upper part of the sacrum is a symptom of spondylolisthesis of the fifth lumbar vertebra.
This disease consists in the fact that the vertebra L5 slides forward with respect to the sacrum.
Ligaments and nerves
The pain may be caused by pressure of the ligaments (ligaments) on the sciatic nerve. In this case, it radiates into the thighs, into the leg and up to the foot.
The ligament that connects the sacrum to the sac spine (sacrospinal ligament) and the one that connects it to the large sit-bone hump (sacrotuberal ligament) are the main culprits.
The posterior uterine ligament (ligamentum sacrouterinum) causes very severe chronic pain originating from organs of the pelvis.
Gynecological diseases
Low back pain often occurs in gynecological diseases. In external endometriosis, the symptoms are in the area of the uterosacral ligaments or behind the cervix (in the abdomen).
The pain caused by endometriosis is cyclical and increases before the menstrual cycle (in the days preceding menstruation).
Pain in the sacrum due to urological or gynecological diseases
In the pelvic area, there are diseases that cause pain in the sacrum.
Possible causes are:
- uterine prolapse,
- Varicose veins in the pelvis.
Circulatory
Pain can also be caused by thrombophlebitis of the iliac and pelvic veins (Kogias et al. – 2011).
Tumour
Bone metastases are the most common malignant tumors of the sacrum.
The tumor cells originate from the primary tumors.
Metastases of a tumor can affect the sacrum, for example if they are caused by cancer in one of the following areas:
- Mammary gland
- Lung
- Prostate
- Thyroid
- Nephritic
- Lymphoma (not Hodgkin) (Raque et al. – 2001).
The clinical examination is not always successful: sacrum tumors are asymptomatic for a long time. The most common initial symptom is local pain.
At night, the pain may worsen.
Tumor on the sacrum
A tumor on the sacrum is rare (Quraishi et al. – 2012).
Primary tumors of the sacrum (benign and malignant) can have their origin in the bone marrow.
Pilonidal cyst
The pilonidal cyst is a small sac on the lower coccyx margin (Khanna et al. – 2011) containing hair, sebum or other liquid or solid material.
A pilonidal cyst can occur due to an ingrown hair and infection of the hair follicle in the sacrococcyneal region.
An infected cyst turns into a pilonidal abscess.
In the first phase, it presents itself as an abscess in the sacro-coccygeal zone.
The evolution of the abscess consists in the formation of an fistula.
Chronic prostatitis
This disease is diagnosed in men as dysfunction of the prostate.
The main symptoms are:
- sensation of burning after urination,
- frequent urination,
- potency reduction,
- dull pain on the coccyx.
The prostate tumor
As the tumor size increases, swelling between the back and buttocks can be detected.
The patient has to urinate more or has a burning sensation when urinating.
Misconceptions
Many people think that pain in the coccyx and sacrum is caused by hemorrhoids or rhagades because they often feel it during or after bowel movements. But there is no connection to this.
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