Transactions of the American Proctological Society
1914, Volume 16, p. 67-75.
New York Polyclinic
Trauma is the causal factor in the greater number of cases of coccygodynia. Why a painful condition should follow such injury is evident. The coccyx is a small bone but gives insertion to the levator ani (in part) and coccygeus muscle on its anterior surface, and the gluteus maximus (part of origin) on its posterior surface, while the sphincter ani is inserted into its tip. The sacrosciatic ligaments are also attached to it. Thus the coccyx is surrounded by dense structures, largely fibrous, which the delicate network of nerves penetrates. If these structures are bruised, an inflammatory reaction naturally results with proliferation and subsequent contraction of the new fibrous tissue and compression of the nerves.
Seven cases are reported. The treatment proposed by the writer is an application of the principle of injection of sensory nerves with 70 to 80 per cent. alcohol, thereby causing their degeneration. The point of maximum tenderness is carefully identified, most commonly found just below the tip of the coccyx. This point is injected slowly with 10 to 20 minims of alcohol. Three to five injections are given at weekly intervals. Treatment was successful in all seven cases, with follow-up from one month to four years.
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