Pilonidal Cyst Archives

Pilonidal /Antibiotics/Complicating matters

[ Pilonidal Cyst Archive ]
[ Main Archives Page ] [ Glossary/Index ]
[ FAQ ] [ Recommended Books ] [ Bulletin Board ]
   Search this site!
 
        

Pilonidal /Antibiotics/Complicating matters

Posted by Painful on November 29, 2002 at 10:39:41:

I've got a pilonidal cyst that is starting to get sore. I'm soaking with hot rags - but pain is still there. No redness nor swelling, no drainage, just pain. I feel I tiny lump next to the midline which is the source of the pain. I had this sinus scraped out 25 years ago, but it has returned apparently. I'm thinking at this stage that an antibiotic might be helpful, before it gets out of hand and the antibiotic wouldn't help. I am trying to stave off any immediate problems (surgery) as my wife is traveling to Italy shortly and won't be around and there is no one else to help. Dr.Stoll, is there a particular antibiotic you might recommend that would be more effective than others? (I have rheumatoid arthritis and take methotrexate (15mg/week) and have impaired glucose tolerance to complicate matters further). Also, since I have those 2 problems, what are the odds that I would heal effectively if I ever did have this surgery? I know those 2 factors can complicate matters.

Thanks,
Painful



Re: Pilonidal /Antibiotics/Complicating matters (Archive in functional anatomy.

Posted by Walt Stoll on November 30, 2002 at 07:46:08:

In Reply to: Pilonidal /Antibiotics/Complicating matters posted by Painful on November 29, 2002 at 10:39:41:

Hi, Painful.

In MY experience and training antibiotics are worthless in such a situation. The reason is that the pain is caused by the area being blocked from the circulation (the definition of a cyst) and since it takes circulation to get the antibiotic to the area..........

You may need to get it lanced to relieve the pressure.

Walt



Re: Pilonidal /Antibiotics/Complicating matters (Archive in functional anatomy.

Posted by Painful on December 01, 2002 at 13:19:39:

In Reply to: Re: Pilonidal /Antibiotics/Complicating matters (Archive in functional anatomy. posted by Walt Stoll on November 30, 2002 at 07:46:08:

What if there is no real visible lump or redness, just pain? What would they lance? I can see lancing something like a boil but they just go down into any small lumpy looking area with a needle? And hot compresses - what are there function? I assume to increase circulation, but how does that eliminate infection - by bringing more white blood cells to the area?

Thanks!



Re: Pilonidal /Antibiotics/Complicating matters

Posted by Painful on December 01, 2002 at 13:39:28:

In Reply to: Pilonidal /Antibiotics/Complicating matters posted by Painful on November 29, 2002 at 10:39:41:

Dr Stoll:
Regarding the use of hot compresses over my sore pilonidal area, I noticed the following on the site below.

Heat should not be used over open wounds or areas of suspected infection.

Heat should not be used over an area that has moderate or severe swelling (edema).

Heat should not be used over skin conditions.

Heat should not be used with acute inflammation.

Wouldn't the above comments apply to a painful pilonidal cyst area? I can understand that heat would make a boil soften and then burst, but if there is no boil, only this lump under the skin that is neither red nor visibly swollen, just painful, is the application of heat really such a good idea? It had occurred to me previously that wouldn't this just increase the edema that is causing the pain? Curious,

Thanks!



Re: Pilonidal /Antibiotics/Complicating matters (Archive in functional anatomy.

Posted by Walt Stoll on December 02, 2002 at 08:34:43:

In Reply to: Re: Pilonidal /Antibiotics/Complicating matters (Archive in functional anatomy. posted by Painful on December 01, 2002 at 13:19:39:

Hi, Painful.

You said there was a "tiny lump" where the pain was located. Since the pilonidal problem can be right on the bone (under the lining--periosteum) a tiny swelling would be very painful: there is no room for swelling there.

The physician would have to understand this and puncture the lump with a very small and pointed blade.

Walt

Follow Ups:


Re: Pilonidal /Antibiotics/Complicating matters

Posted by Walt Stoll on December 02, 2002 at 08:38:04:

In Reply to: Re: Pilonidal /Antibiotics/Complicating matters posted by Painful on December 01, 2002 at 13:39:28:

Hi, Painful.

I guess you are just going to have to decide who to believe. This list was, in MY opinion, compiled by someone who knew very little about inflammation.

Perhaps a good medical book?

Walt



Re: Pilonidal /Antibiotics/Complicating matters

Posted by Happygal on December 02, 2002 at 09:10:29:

In Reply to: Re: Pilonidal /Antibiotics/Complicating matters posted by Walt Stoll on December 02, 2002 at 08:38:04:

Hey,

I went to that website written by a PT, glanced at the whole thing, and that's EXACTLY what we were taught in massage school. It seems to be the common knowledge.

However, I didn't think that what we were taught about temperature therapy entirely made sense. Some of it seemed contradictory.

I have wondered how hot compresses could work so effectively as described on this BB when it seems to be so different from the commonly taught instructions.

Does anyone know of a better source of understanding about the therapeutic use of heat and cold? I'd love to read and learn more.

Best wishes,
Happygal



Re: Pilonidal /Antibiotics/Complicating matters

Posted by Painful on December 02, 2002 at 22:32:43:

In Reply to: Re: Pilonidal /Antibiotics/Complicating matters posted by Walt Stoll on December 02, 2002 at 08:38:04:

Dr. Stoll,
Well, i certainly know that for boils and things like that that have surfaced and are red and swollen and above skin level that moist hot heat will help them come to a head. In the case of a pilonidal cyst that isn't swollen above the skin but is painful to sit on, I was just wondering if the heat would increase the edema that must be going on in the cyst (isn't that what is causing the pain?). Or in this case is it acted upon differently by increasing circulation to the area and thus bringing more white cells into the area to combat the infection and thus wipe it out? (I believe that is what you are saying will happen, but I don't want to put words into your mouth). I'm not sure I understand why the physical therapist who wrote that claimed all those statements were true either. As a lay person, it does make it tough for me, as I have to evaluate 2 different philosophies and I'm not sure how I will determine who is correct. So for now, I'm going on the assumption that the heat will help reduce the infection, even if it temporarily increases the swelling (could that be why sometimes after soaking, it can actually feel a bit more swollen and painful in that area? During the soak, it of course feels good, it is only some 1/2 hour or so later that the pain seems to come back a bit stronger).



Re: Pilonidal /Antibiotics/Complicating matters (Archive in functional anatomy.

Posted by Walt Stoll on December 03, 2002 at 08:34:37:

In Reply to: Re: Pilonidal /Antibiotics/Complicating matters posted by Happygal on December 02, 2002 at 09:10:29:

Hi, Happygal.

Simple physics and physiology.

Most of the healing and immunological substances come to a 'site via the circulation and heat dilates the blood vessels which are also needed to carry away damaged tissue and necrotic material. Heat also speeds up all chemical reactions and so even the locally produced materials that are used for healing damage are more effective.

Infections need all the immunity the body can transport to the site and the circulation does that transportation. That is why heat always helps.

Since the first 24 hours after any injury, blood and tissue fluids are still leaking from the injury, cutting down the circulation (ice) is helpful to avoid too much damaged tissue from accumulating. After the 24 hours, the heat allows the circulation to carry away that material faster. ALL damaged tissue retards healing and the faster it can be carried away the better.

Hope this helps.

Walt



Re: Pilonidal /Antibiotics/Complicating matters (Archive in functional anatomy.

Posted by Happygal on December 03, 2002 at 10:08:53:

In Reply to: Re: Pilonidal /Antibiotics/Complicating matters (Archive in functional anatomy. posted by Walt Stoll on December 03, 2002 at 08:34:37:

Thanks, Walt.

I get it -- use heat as long as it is not inflammation in an acute condition (first 24 hours). Cysts probably hang out for quite a while so heat would be indicated.

So a cyst doesn't qualify as one of the contraindications mentioned in that article: "a skin condition, an area of suspected infection or an area with moderate or severe swelling." Got it.

Thanks.

Namaste`
Happygal

Follow Ups:


Re: Pilonidal /Antibiotics/Complicating matters

Posted by Walt Stoll on December 03, 2002 at 10:53:15:

In Reply to: Re: Pilonidal /Antibiotics/Complicating matters posted by Painful on December 02, 2002 at 22:32:43:

Thanks, Painful.

What works will convince you who is right. I know what I woudld do for myself in this instance. I hope those who say otherwise do what they recommend :o).

You understand what I am saying pretty well. You have had the "cyst" for a while and it had no symptoms. The fact that it now HAS symptoms is most likly due to bacteria getting in there and causing swelling. However, it IS possible that the cyst just finally got to the size where it is stretching the area snd causing pain. In the latter situation (the less common) the heat will make the pain worse until the cyst ruptures to the outside (self-lancing).

If it is the germs, the most likely scenario, the heat will likely quiet it down and save you more immediate trouble.

Hope this helps.

Walt

Follow Ups:


[ Pilonidal Cyst Archive ]
[ Main Archives Page ] [ Glossary/Index ]
[ FAQ ] [ Recommended Books ] [ Bulletin Board ]
   Search this site!