Coccygodynia and Homoeopathy
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Transcript of 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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Coccygodynia and Homoeoapthy
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 $ey component of the peic >oor. ! thin7 /rous igament7 the
anococcygea raphe runs from the coccy1 and heps support the position of theanus.
&ncidence-he femae8mae incidence ratio is *@.* due to a more posteriory situatedsacrum and coccy1. Due to onger coccyges reatie to men7 femaes hae a
greater chance of deeoping coccygodynia.&t is more common in o/esityA a /ody4mass inde1 ("M&) of 2.' in femaes. "M&more than 20.' in maes increases the chance of deeoping coccygodynia.
CausesBature of coccygea pain is mutifactoria. -he idiopathic form comprises ess than of a non4traumatic disorders of the erte/ra coumn7 :hie the main cause/eing coccygea injuries.
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Coccygodynia and Homoeoapthy
Most tai/one injuries are caused /y trauma to the coccy1 area as4 ! fa onto the tai/one in the seated position7 usuay against a hard surface
(Causa) ! direct /o: to the tai/one7 as occurring during contact sports (Causa)
-he coccy1 can /e injured or fractured during chid/irth (Causa)
Congenita deiations can aso cause compaints during ong sitting(Syphiis)
Repetitie straining or friction against the coccy1 as in /icycing or ro:ing7can injure the coccy1 (Causa8 9sora)
Sometimes7 the cause of coccy1 injuries is un$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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Coccygodynia and Homoeoapthy
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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Coccygodynia and Homoeoapthy
-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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Coccygodynia and Homoeoapthy
"!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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Coccygodynia and Homoeoapthy
#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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Coccygodynia and Homoeoapthy
&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.........................*
Dr. Rajneesh Kumar Sharma