Pelvic floor physical therapy - Pelvic Pain Suppo...

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Pelvic floor physical therapy


I am just curious to see if how many people have had pelvic floor physical therapy that has helped them especially if they've had pudental neuralgia or pelvic floor dysfunction.It has helped me a lot but has taken 8 months, along with muscle relaxers and neuromodulation meds as needed also home exercises stretches breathing etc

27 Replies

I had P T for p n foe six months it did nothing for me and I stopped because it was so costly. l never had more than two exercises to do at home. I gave up.

My husband has been having pelvic floor PT for nearly a year with no results. He was given an internal anal message of the pudendal nerve area and he was in such excruciating pain for 2 days he nearly went to the emergency room for pain treatment. He states he will never have that done again. He is scheduled for bilateral pudendal nerve blocks at the University of Washington in Seattle on February 4th. It’s a series if 4 bilateral injections one week apart. I’ll let you know his outcome. Praying he finds relief!

I have found that muscle relaxants combined with pelvic PT help...but no internal rectal PT she does them pudendal nerve glides which are on the outside and then she does the mobilization which is on the outside if they do anything internally hurts me for 2 days after at least it did but I think things are settling down now finally after a year also... Haven't done nerve blocks because the pain is going down by about 70% but awesome I have gabapentin which is a neurological if I need it... I may try that everyone responds completely differently and I'm afraid to do nerve blocks but I don't think I need them now at this point

Thank you! Yes, he was in excruciating pain after the internal PT but has never had external pudendal nerve glides. We’ll talk to his pain dr about a new PT.

AuntieH in reply to kalecolbe12

How does your PT do external pudendal nerve glides?

Yes please let me know how the nerve blocks work for him as it's important for us all to support each other

What kind of dr will be administering the nerve blocks? Are these CT guided nerve blocks? I live in a small city and am having trouble finding anyone who does them.

Hi, he is having them done at the University of Washington in Seattle by Dr. Michele Curatolo, an anesthesiologist that specializes in pain management. He does them under CT guidance and bilaterally. My husband will have 4 sets, one week apart starting on Feb 4th. I’ll let you know the exact outcome of each. He has been suffering for 2 years now.

PatientRN in reply to PatientRN

I wanted to add that the dr recommended a ganglion of impar block but our insurance would not cover it so he is starting with the pudendal nerve block first. My husband has every symptom of PN but has not been diagnosed. If the PN blocks don’t work we will pay out of pocket for the impar blocks.

Thank you. Praying that they will help him.

I wanted to additionally ask if your husband has tried the cyclobenzaprine muscle relaxer or the gabapentin neurological med and or what medications he has tried.

I may be just getting used to a little bit of pain but I do know when I have a flare up it's a lot easier to get it under control because we have built a platform with the pelvic floor physical therapy for muscle memory... I was also wondering if he had an MRN which is the MRI of the nerves? Also if he has tried some CBD with a little THC in it? One lady on here said it took her three years to get about 80% better and I believe it

My husband cannot take cyclobenzaprine because he is on the highest dose of amitriptyline. It could cause a serotonin reaction. He cannot take gabapentin because it causes extreme diarrhea which makes his pain even worse

Oh yes I think you had said that in a prior post...I wonder if it would be time to try one of the other meds used for pudendal neuralgia instead of amitriptyline or perhaps amitriptyline and something complimentary like cymbalta... I am still wondering if he has had an MRN which is the MRI of the nerves ...okay sorry for all the questions just trying to get educated on this

He has tried Cymbalta and gabapentin but both give him uncontrolled diarrhea which aggravates his pain even more. He has never had an MRN. It’s never even been mentioned to him. He’s too afraid to go off amitriptyline., but I’d like to see him weaned off and I believe a muscle relaxant could truly help him. Your suggestions are highly regarded and we will talk to his physician. Thank you so much..

rozamond in reply to PatientRN

I would very much like to know how he responds to this

PatientRN in reply to rozamond

I will definitely let you know how he responds.

Hi I was trying to get ahold of you guys just to see how things were going?

I had pelvic Physiotherapy for over 3 years. It took several months before I noticed any improvement at all, and the overall cost, including travelling, was very expensive, so I almost gave up. I had joined a health cash-back scheme through my employment and this helped to reduce the overall cost of the treatment. I eventually found another physio who was nearer to my home and she continued the work. She did internal and external work, plus acupuncture at the end of each session. Gradually I noticed that my pain had changed and that I could manage any mild flare up fairly easily. I am not cured, but my condition is now much more manageable, despite not having had physio for several months.

kalecolbe12 in reply to Joolibee

Can I ask what kind of acupuncture she did and where

Pelvic floor PT has been essential in my treatment for nerve pain (pudendal) and tight pelvic floor muscles. I saw one PT for 6 mths at the beginning. She helped some. They discharged me well before I was ready.

Then I found another PT who was willing to really try and help. I'm nearly fully recovered, but it has taken 2.5 yrs!


kalecolbe12 in reply to lalab

Can I ask you if you've been taking medication too or just the pelvic floor physical therapy I'm about 14 months in and I've had 8 months of pelvic floor physical therapy which I know has helped me of course sometimes I flare up afterwards

lalab in reply to kalecolbe12

Yes... pelvic PT as well as Desipramine (75 mg) and Flexeril when I feel I need it.

I've recently started with a pelvic floor OT (same practice as the PT). The OT has done quite a bit of myofascial release in my abdomen and thighs. So helpful!

She also does internal trigger point release.

Also, I occasionally do a nerve glide I was taught by a different PT (lay on side, legs bent slightly, top leg lift up and bend at knee-- out and in-- ).

My Pain is caused by tight pelvic floor muscles as well as tight hip flexor. The thinking is that the tight muscles are basically compressing the nerve.

kalecolbe12 in reply to lalab

Yes that's what they think with me too .. mine is rectal more but she does vaginal internal trigger point release because I cannot tolerate anything rectally because of the nerve being irritated but she reaches all the same muscles vaginally... Sometimes I have a flare after PT but it has to be done.... I am also finding the curable app helps which is the mind-body calming system

kalecolbe12 in reply to lalab

Oh and I also wanted to ask what she does in the physical therapy as far as does she do pudendal nerve glides mobilization and where was your pain rectal vaginal etc

Yes its up and down...such a roller coaster ride!!I am in a year now and I feel the pt helps a lot and also just having that support....what kind of pt did they do ?I have gotten pudental nerve glides,obturator internus trigger points but on out side because I couldn't tolerate internal because of triggering the pudental nerve pain...also did home stretches and breathing....I I have some weeks no pain and then I will have a fare up but now can handle it...other thing that has been helpful is cyclobenzaprine muscle relaxer...mine has been mainly inferior rectal branch of pudental nerve so some prep h with lidocaine and and suppositories with valium and baclofen helped pain doc said it's a multifaceted approach which is true...did you take meds? And by the way yes I think it takes around two years sometimes three for the nerve to come back to someone normal

I have been suffering for five did not help I had both internal and external procedure. Only went for s short time as it was so costly.

I never thought I’d say this but I’ve made more progress with mind/body work in the last 3 months than I have with a year of pelvic pt. The Pain Psychology Center is a great resource for this approach and will provide a free consultation. Also TMSwiki has a free pain program from Alan Gordon that is fantastic. Again, I couldn’t have gone into this more skeptical but after months and months of procedures and massages and injections, the thing that has actually helped is dealing with my preoccupation and my fear.

Sounds impossible when you’re deep in it, I know, but little by little, with genuine commitment it works. But you have to be open to the idea that your brain is driving the pain and symptoms.

Good luck!

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