Middle Cluneal Nerves and Coccydynia

nevadanervesurgery.org/condit...
Tailbone pain or Coccydynia can be caused by damage to the Middle Cluneal Nerves.
In this video, Peripheral Nerve Surgeon Dr. Tim Tollestrup talks about how a simple surgical procedure to denervate the Middle Cluneal Nerves can provide permanent relief and help the patient avoid more invasive surgery.
Transcript:
The middle cluneal nerves are an interesting set of peripheral nerves because these are the nerves that come out of the backside of the sacrum. If these nerves are damaged, it can produce a sensation of low back pain, people can complain of pain in the sacral area, and the very lowest of these nerves can cause tailbone pain or coccygeal pain. There's lots and lots of patients out there who are diagnosed with coccydynia or tailbone pain. This can be after some kind of traumatic injury, like a fall, or just prolonged chronic sitting I think sometimes irritates these nerves and causes them to be pain generators.
Most of the time, the doctors don't really understand where this pain is coming from. They're removing the coccyx thinking that the coccyx is the source of the pain when in reality it's these little damaged nerves. These nerves are quite small nerves, and you really have to know where to look for them. That's very often a procedure which does not give them good pain relief, and in a situation where the pain is actually coming from these damaged nerves, it could make it worse because now you've added another surgery and more trauma and scarring and stuff around these nerves.
The way to really diagnose this accurately when somebody has coccydynia would be to undergo diagnostic blocks of the lower sacral and coccygeal nerves and see if that resolves the pain. If it does, then you know you could undergo a procedure where these little nerves are removed on an outpatient type basis. Really the recovery is very quick and you don't sacrifice the structural importance of the coccyx.
Very often patients will have pain in the SI joint area or the upper sacrum that is most of the time actually confused with SI joint pain, or it might be confused as a spine problem. Rather than having a very morbid fusion of the SI joint, it would be good to check and see what the true source of the pain is. Even in cases where there's a lot of arthritis in the SI joint and that's the source of the pain, you might be able to do an SI joint denervation by removing some of these little nerves and cutting the pain pathway instead of putting a screw across your SI joint.

[@karentoner3870]

So glad I found you! Will send my paperwork to you tomorrow! I had called 20 years ago on my tail bone. Tried everything to fix the pain. Nothing worked. So had it partially removed 6 years ago. Still in so much pain. I sure home you can help me. See you 2nd week of November. 🙏🙏🙏🙏🙏

[@pparry]

Any chance you offer a fellowship or visiting surgeons opportunity? I am extremely grateful for your fantastic videos. I am a neurosurgeon and would very much like to see first hand some of your peripheral nerve procedures.

[@mikisenx]

This sounds like me. I am on year 5 of chronic pain around the coccyx. Ablation of ganglion helped a little but there is still pain around the coccyx that these cluneal nerves sound like a more plausible explanation for.
I live in Sweden though and doctors here just do not know these things. I can only imagine how expensive it would be to fly to Vegas a few times and have a few procedures 😅 It really is frustrating that so few doctors are are knowledgeable and willing to help.
We need more like you, thank you for putting this out there, it gives me a little hope.

[@saucerecords606]

Hi Doc. I'm alittle desperate for help. I'm in Florida and got a VATS robotic rib resection surgery 6 weeks ago for TOS after an MRA showed venous obstruction with my arms overhead.
I've been getting a decent amount of nerve type pain in my ribs and chest from surgery, and have noticed none of my TOS type symptoms have gotten better.
I have pain behind my shoulder blade, in my tricep, elbow and hand.
It's not extremely severe but it's making me start to think the scalenectomy or brachial plexus decompression is an important part of treatment that I havent addressed.
In your opinion should I explore a 2nd opinion and possible brachial decompression? I'm only 31 and this is ruining my life. I'm in Orlando, Fl.
I really hope to hear back from you.

[@colleenpellant1484]

I had a tailgut cyst removed from the presacral space but need my coxxyx removed. My Orthopedic Surgeon is performing this procedure but I'd like to know how safe is intubation in the prone position?

[@khshur2]

Hi dr , do i need a usa visa to go to your clinic ? Or there is other ways .. do you know who is specilize in your field here in israel ?
Thanks alot

[@rosepink2773]

Please which doctor do specific like you I live in Illinois… help me please I’m suffering a lot !!

[@mmueller1473]

Did you find a Dr in Illinois who was able to do it? That’s where I’m at and have thi problem, Tysm and I hop you’re feeling better!

[@arbulonrexhepi]

So the only way to know that the middle cluneal nerve is the problem that you are having coccyx pain is to do a local anesthetic and see if it decreases the pain

[@TimTollestrupMD]

Yes. You need to put those nerves to sleep and see if it makes your pain go away.

[@tinkuchaudharyrj1110]

I need coccy surgery recovery time ???