Comments from Dr Paolo Marchettini about treatment of coccydynia

To treat this pain I have applied electrical stimulators (produced by Medtronics USA), on the sacral roots. The patient has control of the system: it is possible to switch it on, off, or to modify the intensity. I had 3 excellent results out of 4 patients treated. The patient who had no benefit had the electrode easily removed.

In the patient who had no improvement with the spinal stimulator, I applied a catheter for spinal infusion of drugs (local anaesthetics and morphine). This solution has been effective and I now receive post cards from all around the world from this gentleman who before could not even sit at his desk.

The wire is positioned from the spine downward, toward the sacral roots, not around the coccyx itself. This treatment is also used for urogenital and anal pains, besides pain in the coccyx. The procedure is moderately invasive, may be performed under local anaesthesia, it does not imply any destruction of tissue, and it is completely reversible. If the patient has no benefit the electrode is easily removed, without harm or sequel. The international protocol requires a trial period with the electrode connected to an external battery, for the patient to evaluate the effects, followed by the implantation of the subcutaneous permanent battery. I consider this treatement before any destructive procedure (unless there is clear cut indication, before removal of the coccyx for example).

Since your website is in English and many of the readers are Americans, I may recommend Dr Kenneth Alo in Houston, Texas, who performs the same procedures.

Paolo Marchettini, Centro di Medicina del Dolore, Scientific Institute San Raffaele, Milano, Italy. Email: marchettini.paolo@hsr.it

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