Alternative to SP - Dr. Glazer & Biofeedback

[atma]

Hey all,

Don't let the subject anger you :). But I visited a PT this past week for the 1st time and she was very familiar with Dr. Wise, SP, and A HEADACHE IN THE PELVIS. She has been dealing with PFD in women for 30 years and recently has been seeing a majority of her patients being male. After our first visit, I got the feeling she is somewhat biased toward one Dr. Howard Glazer (http://www.vulvodynia.com/about.htm) who uses a biofeedback technique which Dr. Wise does not believe is useful in CPPS. In the past his research was around women, but it appears he is opening his research to include men.

I have not fully read over Dr. Glazer's web site fully, but I have not run across his name that much. He is in the process of adding his male work to the site.

It appears my Physical Therapist is part of his study/team. Well if I want to be part of some study, I think the sessions should be free :) My insurance does not cover Biofeedback, but it does cover ITP, ETP, and some relaxation material.

Question is would one want to experiment with this methodology or stick with a typical SP? My argument to try this new method is that I still have the option of attending the true SP with Dr. Wise (assuming I have $$$$), and be able to provide feedback to the group on this style of treatment.

I want to make sure I determine the treatment not the Therapist because hers might be directed by funding, or other grandiose ideas.

What do you all think?

Thanks,
atma

[webslave]

His area of expertise is clearly not our patient group. I would suggest you look at all his published research, which you can read here.
http://tinyurl.com/glazer

If you think he may have knowledge that would be useful, email Wise and ask him what he thinks about it. I am not aware of any negative information about Glazer at this stage, although I seem to remember that Wise was not keen on biofeedback (do a search in the older posts here).

[calguy]

Biofeedback has helped men on this board, I just can't remember who exactly. In fact I was going to try it because of some of the posts I read. I do not believe it is a substitute for PT which has been huge for me.

[Jay]

Hi,

My (admittedly incomplete) understanding is that biofeedback can be helpful with monitoring tension levels and learning to ease holding patterns. However, it does not resolve shortened muscle or trigger points, which require manual intervention.

[pminturn]

My urologoist originally had me doing biofeedback. It did absolutely nothing for me. If anything, it made my frequency worse.

[LifeInTurmoil]

I once tried biofeedback where you put a probe up the rectum and then monitor tension with the "beeps" from the electronic unit. It did absolutely NOTHING for me except make me MORE anxious. The therapist who did this with me knew "squat" about the Stamford Prot. even though she said she did. I would imagine though, that if biofeedback were used IN CONJUNCTION with both internal and external muscle stretching it may help you to possibly learn to relax those tense muscles. Alone though, I would not place much hope in it. No matter how you look at it, actual PHYSICAL WORK is REQUIRED to eventually conquer CPPS......unless you are VERY, VERY lucky!!

[kevin]

As I understand it, Howard Glazer is in a different camp from Dr. Wise as far as treatment strategy goes. The biofeedback he does is not the type most people here would expect. I corresponded with a former patient of his who told me that the treatment was more similar to kegels (using the biofeedback machine to push yourself above a certain threshold) than to relaxation exercises (using the biofeedback to keep yourself below a certain threshold).

[Jay]

Hi,

Going by what Kevin has presented, that sounds rather unwise to me. PTs can tell by touch whether muscle is strong/weak/contracted/relaxed. This is how we came to the conclusion that things like Kegel exercises were bad for us. We don't need more tension, we need less, yet Dr. Glazer's approach seems to encourage heightened contraction?

I'm admittedly ignorant here, but going by what has been said, I can only imagine that he's trying to either improve muscle control or exert the pelvic floor into releasing via exhaustion. That, or he takes an entirely different view on CPPS, not even acknowledging what we know about PFD.

[atma]

Well,

I had my second apt with my PT that is part of Dr. Glazer's study. I informed her I communicated with him and while he was quick to reply he was rather short and terse. He provided little documentation on case studies of Male Pelvic pain. On his web site, he seems too concerned with cost as he mentions all these prices along the journey into his web site. I understand there is a cost associated with all medical procedures, but the fact that he makes it available to individuals without proper training in person does not sit well with me.

The PTs argument was that you cannot believe everything you read online. I think most of us realize that the majority of people that visit forums are ones looking to vent, complain, or have declared failure. In my experience, after a problem is resolved, we very rarely will go back and continue to support the cause or the site that provided us with the solution. I believe this site is different. While some success stories come and go, chronic prostatitis / chronic pelvic pain syndrome really never goes away. I understand her argument, but Dr. Glazer could not provide evidence of his protocol as it applies to males with CPPS. [Off my soapbox now]

OK....So, after some further discussions, especially wrt the effectiveness of kegels as used with sEMG and biofeedback, she performed the internal TP and then used ultrasound to heat the muscles along the lower tailbone. That actually provided a lot of relieve. She then had her massage therapist come in and perform the external TP and skin rolling.

If the biofeedback was part of a free study, I would sure be part of it, but not without first going through the SP. Part of me wants to do the study just to see the results. But like SP, the Glazer Protocol is a long process. Don't want to waste 6 months(minimum) on something that has already been shown not to work. But I also believe there has to be more than one way to skin a cat......

Like everything else related to CPPS, there is no universal solution, drug, or procedure. Too bad some things come down to cost.

ATMA