Roger Coletti: Cardiologist turned pain manager

Injections help calm chronic muscle spasms
August 23, 2012

Dr. Roger Coletti knows about back pain caused by sciatica.

An interventional cardiologist practicing in New Jersey and Lewes, Coletti said he often had pain from standing and performing everyday tasks.

"I found the pain was caused by muscle spasms," Coletti said. "It is this ongoing electrical instability within the muscle that leads to chronic spasm which breaks down and causes pain."

Coletti, 66, tried massage and other therapies, but nothing cured the spasm, and the pain continued.

"I knew many of my patients and friends had similar muscle spasms, so I decided to see if there was any research," Coletti said.

What keeps a muscle in spasm?

Coletti found two other researchers looking into injections for muscle spasms, but no one else was actively practicing the technique. Using chemicals such as lidocaine, movocaine, novacaine, dibenzaline and Botox, Coletti was able to make injections directly into the muscle to halt the muscle spasms for varying periods of time.

After purchasing an EMG machine to measure the electrical activity of muscles, Coletti practiced taking the measurements and making the injections on himself. The miniature electrical monitoring machine shows bright strikes of green signaling chaotic electrical activity when a muscle is in chronic spasm.

"I was very surprised to find spontaneous electrical activity in my thigh muscles," Coletti said. "That led me to Botox. I learned how to use it on myself, then on my family and longtime patients. It was successful."

Coletti said it was going well - he was treating people and they were feeling relief - until he realized how expensive Botox was and that insurance companies would not pay for it.

"I was losing money because Botox wasn't being reimbursed," Coletti said.

Coletti worked with a New Jersey pharmacy that was licensed to mix chemicals to come up with a solution, which would also be cheaper.

He discovered a combination of dibenzaline and lidocaine worked just as well as Botox but was less expensive.

"I did a phone survey of my patients and found I had a long-term success rate of about 80 percent," Coletti said. "My most impressive result is in cases of sciatica."

Coletti said when he treated himself with the dibenzaline compound, he felt relief from pain for the first time in years.

"Patients seldom need to be treated more than once unless I miss an area the first time or if there are multiple areas in spasm," Coletti said. "More work needs to be done, but the initial results have been promising."

While Coletti does not plan to open his own practice serving pain management patients, he is working with Dr. Uday Jani, who offers other alternative medicine therapies outside Lewes.

Coletti carries a massage table, his EMG and a small case of needles and vials with him to Dr. Jani's office. Patients have to meet specific criteria for pain management. It is only patients with long-term pain that will be treated, Coletti said.

Besides sciatica, Coletti has had success with tennis elbow, frozen shoulder, lower back pain and shoulder pain. In addition to calming the spasm, Coletti's goal is to help patients get off pain drugs.

“Little by little, I have had progressive success in may other sites and find relief can be obtained wherever tender muscles demonstrate spontaneous activity,” he said.

Coletti plans to move to Lewes with his wife full-time in the next year or two to pursue a part-time practice for pain management. He also serves as an emergency interventional cardiologist for Beebe Medical Center where he has hospital privileges.

For more information or to make an appointment, call the Delmarva Center for Aches and Pains at 302-645-1500 or go to