Ely: Coccygodynia

Journal of the American Medical Association.

44: 968-969. 1910

Leonard W. Ely. M.D.

201 West Fifty-fifth Street, New York

Coccygodynia — pain in the coccyx — is an annoying, painful and fairly frequent affection, occurring usually in women and caused almost invariably by a fall in which the patient lands in a sitting posture and injures the coccyx. The injury as a rule is a fracture. It is followed by pain at the seat of the injury, worse on sitting, on rising from sitting and on defecation. The pain may be severe and is wont to be accompanied by various neuroses.

The diagnosis is made by pressure on the coccyx with the examining finger, or with the finger in the vagina or rectum and the thumb on the coccyx. This pressure elicits pain. The coccyx may or may not be movable; it may be in its proper relation with the sacrum, or it may be bent forward at an angle.

The ordinary treatment by a rubber cushion to sit on, or even by a resection, is highly unsatisfactory. For years I have treated these cases by a method that is almost uniformly successful, but appears to be not gen¬erally known. I do not think it is original, but I have used it for so long that I forget where it was obtained.

It consists of massage of the coccyx by means of the forefinger in the vagina and the thumb on the outside, holding the bone between them. The bone is moved backward and forward, and the soft parts are moved about on the bone. The manipulation is begun very lightly and gradually increased in force as the patient becomes less sensitive. Usually two or three treatments at intervals of two or three days will suffice for a cure. The improvement is almost instantaneous.

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