Injections then Spinal Cord Stimulator

Kay

Posted 2019-04-28

I was living in Alexandria, LA and had had coccyx pain for a year when my primary doctor referred me to Dr. Sean Stehr for help (see Doctors and specialists in the USA, Louisiana). He offered ganglion impar injections by fluoroscopy. I responded well to two injections a few weeks apart for several months, anyway. I found him to be very compassionate and knowledgeable. He believed he could see arthritis on my tailbone from mri images I brought to him (had an injury several years prior).

We moved to Ruston, LA the following year (last year) and the journey began in finding a new Doctor to help me with my pain. Even with referrals, it was a difficult process. Finally, I was accepted by Dr. Navneet Sharma (see Doctors and specialists in the USA, Louisiana)., who continued my back to back steroid injections because of good results from Dr Stehr. He also added a pain med for the harder days and sent me for pelvic floor therapy. He is very interested in looking for more solutions for me in the future even to consulting with some medical personnel at larger institutions. His staff is also incredibly compassionate.

Update, 2020-05-17

I am now 3 years 8 months into the journey of coccydynia and still receive medical support from Dr. Sharma in Ruston, LA. I received my last ganglion impar injections from him in May and June of 2019. The May injection did not bring the slightest relief and at the last second at the second injection in June, I abruptly asked him if he would consider doubling the normal 40 mg injectable solution to 80 mg. Without hesitation, he changed the order to his nurse and that’s what I received.

I seemed to have the worst pain for two months following that injection so I added 2 more things to my tailbone pain arsenal. I began wearing a tens from morning to night and requested a prescription of amitriptyline, which was prescribed for me at the low dose of 25 mg. The amitriptyline's action is to change how the brain reacts to pain signals just as the tens does. At that point, I felt almost pain free, with continued control over my sitting time, of course. I am one year out from that last injection of 80 mg and will not be requesting another one any time soon. I have no idea which of these three things: the double dose injection, the tens or the amitriptyline or if it is a combination of the three but I'm thankful for the relief.

Also, I am soon to undergo the trial of a Boston Scientific Spinal Cord Stimulator at my request. If you are Medicare age, you have to undergo a psychological test to be approved to have the trial. Because I know I get a good bit of relief from my tens, I felt like I might be a good candidate for the SCS and want to give it a go. Because of COVID, this has been postponed but hopefully soon, will get it back on schedule. This will also be performed by Dr. Sharma.

Update, 2021-06-20

Dr. Sharma performed my Spinal Cord Stimulator trial in July 2020. It was a very difficult week. The entry punctures for the leads going up the spine stayed painful. The generator was strapped and taped to my waist in the back and there was an immeasurable amount of tape securing everything down. I met my SCS rep there after surgery and he set it all up and handed me a remote to control programs. The week to follow was all quite uncomfortably distracting to the degree of causing a struggle to distinguish how well the SCS works. So, I set one goal per day of things I normally found impossible to do with coccydynia, such as riding in a vehicle for a few hours, sitting in a recliner to watch a movie, etc. and I felt it passed all of these tests.

So, after a week, it was all removed and I was referred to Dr John Reeves, neurosurgeon in Shreveport/Bossier City to have the permanent implant surgery. Again, there were more delays (personal, hurricane, etc) before getting a consultation with him the first of September. My SCS implant surgery was scheduled for September 14. A "pocket" is made for the generator in the upper buttock area on the side you prefer and the leads are placed up your spine and secured. Post op was 10 days later when my SCS rep programmed it, personalizing it for my tailbone pain.

It is quite different from a tens, which I honestly got a lot of relief from. The tens targets only the area where you place the pads whereas the SCS is more widespread because it effects more nerves than the area that is being targeted, such as midriff, etc. But oh my, no more wires that can pull out of pads to shock you, wires to the unit hanging out, and a bulky unit to carry. So, the SCS gives so much more freedom. The rep will meet with you anytime to help define the programs for your needs. I have not seen Dr Sharma for my pain since my implant. I have recently weaned myself off of the amitriptyline and use ibuprofen when needed. Yes, I still have pain or get uncomfortable (almost 5 years in now) but it is minimized.

Tip: Your personal doctor typically uses a certain SCS company and there are many out there. I haven't heard negatives of any of them over others. My suggestion would be to not have your Pain Management physician do the permanent implant but have a neurosurgeon do that as he is more professionally trained in all areas of the spine. I have heard of poor results from not having a neurosurgeon do the permanent implant.