Coccyodynia - operation - recovery

Medical times and Gazette

1860 Volume 1, number 512. Page 393

Hicks, JB, Bryant.

Guy's Hospital, London

A. B., a leucophlegmatic woman, aged 25, applied to Mr. Bryant for relief on account of a constant pain in the region of the coccyx for upwards of four months. In the last two it had much increased in intensity, rendering her quite unfit for all occupation. The pain, although constant, was much aggravated on attempting to rise from the sitting posture, and from the dread of exciting it, she had consequently almost always maintained the erect position. When at rest the pain was of a dull aching character, but it became acute on any movement. She remembered some years since falling on her sacrum, which gave rise to some pain; but this disappeared, and she had been free from all inconvenience up to the present attack. Believing that some uterine affection might be the cause of all her symptoms, Dr. Braxton Hicks examined her with only a negative result, and the character of the case became tolerably evident, being one of coccyodynia.

The parts about the coccyx were thickened and somewhat tender on firm manipulation; the coccyx was slightly out of the median line, tending towards the left side. All remedies having been tried and failed, Mr. Bryant, on December 16, 1859, in presence of Dr. Hicks, finally divided the whole of the muscles attached to the bone on both sides by means of a subcutaneous section, the point of his knife entering at the apex of the bone. No bleeding followed, and the patient was confined to her bed for a few days. At the end of a week, the soreness, the result of the operation, having disappeared, the patient stated that she had lost her old pain, and at the end of a fortnight she was allowed to assume the erect posture. Some little stiffness, etc., was experienced, but all old sensations had disappeared, and from this time she rapidly recovered. As far as her original disease is concerned she is now convalescent, having resumed her occupation, and can walk and sit as well as ever without the slightest pain or inconvenience.

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