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Diagnosis is based on symptoms and examination. [2] If there is infection, treatment is generally by incision and drainage just off the midline. [1] [2] Shaving the area and laser hair removal may prevent recurrence. [1] [4] More extensive surgery may be required if the disease recurs. [1] Antibiotics are usually not needed. [2]
The age that people develop spinal stenosis is correlated with change in the joint's biomechanics. [33] Because of this, there has been a recent increasing trend seen by physicians, of lumbar spinal stenosis being more commonly diagnosed in older patients. Low back pain accounts for 17% of all physician visits of people aged 65 and older. [37]
In a study of 146 patients with lumbar spinal stenosis (mean age, 68 years, 42% women) who did not undergo surgery, followed up for 3 years, the study reported that approximately one-third of participants indicated improvement; approximately 50% reported no change in symptoms; and approximately 10% to 20% of patients condition worsened. [41]
After age 50 or 60, osteoarthritic degeneration (spondylosis) or spinal stenosis are more likely causes of low back pain or leg pain. 4.8% of males and 2.5% of females older than 35 experience sciatica during their lifetime. Of all individuals, 60% to 80% experience back pain during their lifetime. In 14%, pain lasts more than two weeks.
In some, the x-ray findings may correspond to symptoms of back stiffness with flexion/extension or with mild back pain. [2] Back pain or stiffness may be worse in the morning. [4] Rarely, large anterior cervical spine osteophytes may affect the esophagus or the larynx and cause pain, difficulty swallowing [5] [6] or even dyspnea. [7]
Symptoms for spinal tumors may vary due to factors such as the type of tumor, the region of the spine, and the health of the patient. Back pain is the most common symptom and it can be a problem if the pain is severe, has a time frame that lasts longer than it would for a normal injury, and becomes worse while laying down or at rest.
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A study of 2000 cases of back pain referred to hospital found that 2.7% were diagnosed as coccydynia. [9] This type of pain occurs five times more frequently in women than in men. It can occur at any age, the mean age of onset being around 40. [1] There are no ethnicity or race associations with coccydynia.
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