Sacral bone (sacrum) anatomy
Five sacral vertebrae grow together in an adult into a single bone - the sacrum. Fusion of the sacral vertebrae occurs relatively late: at the age of 18-25. After 15 years, the fusion of the three lower vertebrae begins, and by 25 - the two upper sacral vertebrae. The sacrum in men is longer, narrower, and more curved than in women.
In the case of incomplete fusion of the sacral vertebrae with congenital developmental anomalies - spina bifida, sacralization, or lumbarization, splitting of the vertebral arch with the formation of meningocele or meningomyelocele can be detected. The lateral surfaces of the sacrum have ear-shaped articular surfaces (ear-shaped joints), with the help of which the sacrum articulates with the surfaces of the iliac bones of the same name.
The sacroiliac joint is a rigid formation that is often called as the sacroiliac junction.
Sacrodinia (pain in the sacrum)
Sacrodynia is a pain in the sacral region. This pain in the sacrum can occur with osteochondrosis of the lumbosacral spine, spondylolisthesis (instability of the spine with the displacement of the vertebral bodies), with anomalies in the development of the lumbosacral spine - sacralization, lumbarization, non-closure of the arches of the vertebrae (spina bifida).
Also, inflammation of the peri-uterine tissue (parametritis), compaction of the sacro-uterine ligaments, and other pathological processes in the adjacent areas of the pelvic organs can lead to pain in the sacrum (sacrodynia). Frequent pain in the sacrum (sacrodynia) is also after gynecological manipulations and operations. The pain increases when sitting, getting up quickly, bending the body forward, lifting weights. Pain can also radiate to the lower back and sacrum at the same time.
Diagnosis of pain in the sacrum (sacrodinia)
Diagnosis of sacrodynia is based on the exclusion or confirmation of the sources of pain in the sacrum - pathology of the lumbosacral spine and diseases of the pelvic organs. Sacrodynia in a patient should be distinguished from traumatic injuries of the sacrum, sacroiliitis (inflammation of the sacroiliac joint), osteomyelitis, and tumors of this localization.
Computed tomography (CT) of the lumbosacral spine and pelvic bones helps to exclude sacroiliitis or arthrosis of the sacroiliac joint (articulations). Also, computed tomography of the pelvic bones and lumbosacral spine makes it possible to exclude the oncological nature of the lesion of the pelvic bones or vertebral bodies in the patient.
Treatment of pain in the sacrum (sacrodinia)
Treatment of sacrodynia is similar to that in osteochondrosis of the lumbosacral spine in the case of exclusion of gynecological pathology from the pelvic organs.
Depending on the severity of the manifestations and the causes of pain in the sacrum with sacrodynia in the patient, the following therapeutic actions are possible:
- drug therapy (NSAIDs, analgesics, hormones)
- therapeutic injections - injection of drugs into the cavity of the sacroiliac joint (joint), spinal canal, trigger points in the muscles
- manual therapy (muscle, articular and radicular technique)
- physiotherapy (UHF, TENS, etc.)
- surgical treatment
Wearing a semi-rigid lumbosacral brace helps to limit the range of motion in the lumbar spine. This helps to reduce pain in the area of inflammation of the sacrum during sacrodynia and relieve excessive protective tension and spasm of the muscles of the back and buttocks.
In such brace, the patient can move independently at home and on the street, sit in the car, and at the workplace. The need to wear a corset disappears as soon as the pain in the sacrum with sacrodynia passes.
There are several types of semi-rigid lumbosacral braces. All of them are selected in size and can be used repeatedly in case of recurrence of pain in the sacrum region.