This is a pretty significant result. Over a third of patients who once took medication ceased all medication after 6 months of treatment.Chronic Pelvic Pain Syndrome: Reduction of Medication Use After Pelvic Floor Physical Therapy with an Internal Myofascial Trigger Point Wand.
This study documents the voluntary reduction in medication use in patients with refractory chronic pelvic pain syndrome utilizing a protocol of pelvic floor myofascial trigger point release with an FDA approved internal trigger point wand and paradoxical relaxation therapy. Self-referred patients were enrolled in a 6-day training clinic from October, 2008 to May, 2011 and followed the protocol for 6 months. Medication usage and symptom scores on a 1-10 scale (10 = most severe) were collected at baseline, and 1 and 6 months. All changes in medication use were at the patient's discretion. Changes in medication use were assessed by McNemar's test in both complete case and modified intention to treat (mITT) analyses. 374 out of 396 patients met inclusion criteria; 79.7 % were male, median age of 43 years and median symptom duration of 5 years. In the complete case analysis, the percent of patients using medications at baseline was 63.6 %. After 6 months of treatment the percentage was 40.1 %, a 36.9 % reduction (p < 0.001). In the mITT analysis, there was a 22.7 % overall reduction from baseline (p < 0.001). Medication cessation at 6 months was significantly associated with a reduction in total symptoms (p = 0.03).
Internal pelvic physical therapy and relaxation practice decreases medication use in CPPS
Internal pelvic physical therapy and relaxation practice decreases medication use in CPPS
Age: 26 | Onset Age: 23 | Symptoms: Neuropathic-like pain and hyperalgesia (lateral/anterior thighs mostly, but distributed throughout body); Pain (penis shaft, right side, when erect for long or excess masturbation) | Previous Symptoms: Pain (testicles; penis underside, mostly near base and running up urethra, sharp/burning; perennial region, dull; ejaculatory; post-ejaculatory); Urinary (moderate incomplete voiding; moderate frequency and pain on bladder filling); Sensations (cold in head of penis) | Helped By: Stretching (especially hip rotators and flexors); Yoga (especially lunges, warrior 2, and pigeon) Trigger point release (abdominals; iliopsoas; gluteus muscles and piriformis; bulbospongiosus & ischiocavernosus; thigh adductors); Meditation (mindfulness); Walking & Aerobic Exercise | Worsened By: Stress, anxiety, too much alcohol, lack of sleep, sitting at length | Current prescriptions: nortriptyline (10 mg, 1x at night; for CNS sensitization and IBS) Previous prescriptions: hydroxyzine (10 mg, 1x at night; for urinary symptoms/mast cell stabilization; useful), clonazepam (0.25-0.5 mg, 1x at night; for anxiety/CNS sensitization; useful for short time)