The pelvic portion of each sympathetic trunk is situated in front of the sacrum, medial to the anterior sacral foramina. It consists of four or five small sacral ganglia, connected together by interganglionic cords, and continuous above with the abdominal portion. Below, the two pelvic sympathetic trunks converge, and end on the front of the coccyx in a small ganglion, the ganglion impar, also known as azygos or ganglion of Walther.
Physicians at New Jersey Medical School specializing in physical medicine and rehabilitation have published that sometimes even just a single local nerve block injection at the ganglion impar can give complete relief of coccydynia (tailbone or coccyx pain), when performed under fluoroscopic guidance.
- Munir MA, Zhang J, Ahmad M. (2004) "A modified needle-inside-needle technique for the ganglion impar block." Can J Anaesth. 2004 Nov;51(9):915-7.
- "Ganglion Impar Injections to Treat Tailbone Pain" at www.TailboneDoctor.com
- "Treatment of coccydynia by injection of local anesthetic to the ganglion impar", at coccyx.org
- figures/chapter_32/32-6.HTM: Basic Human Anatomy at Dartmouth Medical School
- Tailbone pain (coccyx pain, coccydynia) Peer-reviewed medical article online at eMedicine (Medscape)