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signals via a pathway involving c-Fos, which indicates the inhibition of excitatory C fibers and long-term depression. It has also been suggested to alter gene expression in neurons by means of neuromodulation. Another popular theory is the stimulation of the serotonergic and noradrenergic system and induction of descending pathways. In our clinical practice, we introduce the RF cannula between the S3–S4 foramina as has been previously described. We use this method for the treatment of coccygodynia and chronic orchialgia in our pain clinic and long-term follow-up results are satisfactory (1,2).

Pulsed radiofrequency and coccygodynia