The positive part of the pathology of dysfunction is that it remains a treatable condition even after years. What type of treatment is available after so many years of suffering?
In his book about the healthy and the diseased vertebral column, Junghann, described in 1968 that injections with Novocaine can give good results. He also injected the anterior aspect of the tailbone.
When the tailbone hurt and was considered of no use anyway, it was sometimes cut out. The results were seldom good and mostly as disappointing as in other areas with similar conditions, such as the calcaneal spur. The structure which was too tense, the soft tissue, was irritated additionally by scar tissue, remaining tense and often more painful. [but see note at end]
The only book I found in my library which dedicated more than a page to the tailbone was Manipulative Therapy in the Rehabilitation of the Motor System by Professor Karel Lewit. He describes in 1979 the manipulation/mobilisation of the sacrococcygeal synchondrosis per rectum, with consequent relaxation of the whole area.
Professor Hans Tilscher from Vienna, in his book about infiltration therapy, describes meticulously, the technique of injecting lignocaine in M gluteus maximus, M levator ani and M coccygeus (a part of the sacro-tuberal ligament). The patient lies prone with the heels extremely rotated to relax the big pelvis muscles. Even those without a musculoskeletal education can carry out this infiltration therapy. Tilscher describes that the local anesthetic not only has a local effect but also influences the autonomous nervous system, increasing circulation locally and decreasing tension locally. This therapy applied repeatedly may have the same relaxation effect as manipulation.
Myofascial Release Another Option
I myself have done this and the manipulation effectively for 25 years. Recently we learned a new relaxation technique, myofascial release, from a teacher of manual medicine, Professor Johannes Fossgreen of Denmark (see New Zealand Doctor 24th June 1998 and 22nd July 1998). I tried it on five patients who all relaxed nicely without the painful injection technique and the painful (rectal) manipulation. This is a good result but observation with many more cases is necessary.
