Roger Coletti presents breakthrough treatment of chronic pain at national meeting

Pain from chronic muscle spasm afflicts millions of people and has led to overuse of pain medications with addiction and deaths from overdose. Dr. Roger Coletti of Lewes was able to identify what keeps the muscles in chronic spasm, and he has developed a treatment that turns off the spasm and lets the muscles return to normal function. The trigger that locks the muscles in spasm had not been recognized by other physicians and had been thought to represent simply "noise" in the electrical evaluation of muscle and nerve function.

What Coletti found was that this “noise” represented electrical instability of the muscle, keeping the muscle in a state of chronic contraction. He believes that the electrical instability takes place after an initial spasm that choked off the normal blood supply to the muscle causing what is called "membrane instability."

This the same sort of thing that happens in the heart muscle, and as a cardiologist Coletti recognized it as the obvious cause of chronic contraction of the muscle. Just as ventricular fibrillation of the heart leaves the heart in a state of quivering, muscle fibrillation, which he calls "myofibrillation," leaves the muscle in a state of chronic contraction.

Having found the apparent source of chronic muscle spasm, Coletti then set out to develop a treatment that would return the muscle to normal function. He used a device called an EMG which is the equivalent of an EKG but used to measure electrical activity of nerves and muscles. He researched the work of others in the field of muscle spasm and found several failed attempts which led him to try to complete the work others had abandoned. Initially he found a way to use a very dilute concentration of BOTOX, injecting muscle while looking for the "noise" in the muscle with the EMG.

This seemed to work reasonably well but the full effect took weeks to occur and the high cost of BOTOX was never covered by insurance. He then found another medication, phenoxybenzamine, that had been tried for use in chronic muscle spasm and had received three U.S. patents. However, the neurologist who had received those patents ultimately abandoned them without further publication of his work.

In the history of medicine, physicians have not uncommonly tried new treatments on themselves before attempting to treat others. As a cardiologist with decades of wearing heavy lead aprons in hospital X-ray rooms, Coletti had plenty of chronic muscle spasms to treat on himself. Working closely with a sterile compounding pharmacy and their advisors, he came up with an appropriate dose concentration of this abandoned medication.

After many tries, he incorporated other short-term medications into the injection mix to minimize discomfort and improve outcome. The medication is FDA approved for treating high blood pressure but it had been found in the past to bind to muscle and block electrical activity. Its use as an injection is what is considered an "off-label use."

As he has continued to develop his treatment, Coletti has submitted his findings to the medical community. His work has been published in the highly respected, peer-reviewed journal Muscle and Nerve, and he has presented his findings at national meetings of the American Association of Neuromuscular and Electrodiagnostic Medicine.

This year at the September meeting, he presented the results of patient satisfaction and assessment surveys documenting long-term relief of pain from chronic muscle spasms lasting over 10 years. It was his method of identifying the presence of chronic muscle spasm that was the title of his presentation. Identifying the muscles that are in chronic spasm is what is required in order to make use of this new method or treatment.

His findings have been placed in the public domain so no patent or restriction of use can occur. He is seeking a trademark for this procedure as CMECD, so physicians who take on this treatment will be following a specified treatment protocol. CMECD is the contracted form of "Coletti Method of Emg guided ChemoDenervation."

Coletti has now treated hundreds of patients and believes the treatment protocol is mature enough to teach to other physicians. Treatment requires injection of the muscle in chronic spasm but in most cases only a single treatment is required. His work represents a major advance in trigger point therapy treatments. Patients who have had chronic spasms that had lasted for decades get immediate relief and the spasms do not return. Nearly half of his treated patients have had prior back surgery without relief. As he puts it, the surgeon may have done a good job, but the muscles never got the memo.

Many of his patients suffered from car accidents and even without broken bones suffered for years. Here again a single treatment has been enough to reset or as one says these days "reboot" the muscle back to normal function. Common conditions treated resulting from chronic muscle spasm include overuse and overtraining from sports, sciatica, IT Band Syndrome, Piriformis Syndrome and the most common complaint of chronic low back pain.

It is anticipated that as more physicians learn about and make use of this treatment, further insights into its use will be achieved. In an era of cost containment, outcome-based payments and opioid excess, experience to date indicates that its use will likely rapidly increase as pain management physicians gain experience. In most cases the treatment is fully covered by insurance. A few insurances do not cover the medication and a $50 fee may be required.

Coletti’s office is at 16529 Coastal Highway in Lewes. For more information, go to www.InterventionalHealth.com or call 302-645-1500.