Physical Therapy Made my Pain Worse

[2020bluesky]

Has anyone had internal physical therapy for pelvic pain trigger points and it made the pain worse? I have tried 5 different PT's and every time they do manual therapy on my trigger points, all it does it make the pain excruciating and the pain never goes away. I have a trigger point on my right Obturator Internus and another one near my vulva at 3 o'clock on left side. So far no one has been able to help me. I have been to many doctors and tried everything!

[Cardinal]

I've never had my pain get worse from internal therapy, but I have gotten worse from trigger point therapy externally on my butt. When I first learned I had myofascial pain syndrome and had a bunch of trigger points in my glutes, I tried the rolling the ball against the wall method and also simply using my fingers to press on them. I would flare up really bad the next morning or over night. One time it was so bad I made an emergency same-day appointment to see a doctor. It was a burning pain. If you also.experiemce a burning pain, I suggest you dont do the therapy that's causing it. It means that there are nerves in the area becoming irritated. I learned that for my external trigger points in my glutes and piriformis the best method was dry needling. Trigger point injections are somewhat similar and can sometimes help, but I've learned that the majority of doctors dont really understand how they work or where they should be doing them, so I've had better experiences with dry needling by an experienced physical therapist. I dont get the burning feeling when they needle. But when I have any kind of needling near or in my vagina it feels like I've been lit on fire, so I'm not sure how trigger points injections or needling would affect you if you need them so medial. There is such a thing as internal trigger point injections and some people dont react as strongly as I did, or you can ask for anesthesia.

[2020bluesky in reply to Cardinal]

Thank you. I have had trigger point injections with and without steroids. I am very very sore at injection site for days after. I have also had nerve blocks. I had botox last year. Was in excruciating pain after for days and days maybe weeks. Can't remember. I think it helped one trigger point and not the other. Go figure...The foam roller doesn't bother me but it doesn't provide relief for long either.

I don't know or think my problem is nerve related as Gabapentin and Lyrica don't help me. Neither does Cymbalta.

[kalecolbe12 in reply to 2020bluesky]

You may find that cyclobenzaprine muscle relaxer and or amitriptyline might help

[Doggiedogmom1973]

Hello, have you tried eating anti-inflammatory food, or gone to a dietitian to find out foods to prevent flare ups. Also have you tried deep breathing? Or have a bath with some bath salts. Try something to sooth your pain signals in your body to calm them down.

[2020bluesky in reply to Doggiedogmom1973]

Thank you. I have tried all of that. I just bought the DCT program and found that hanging from a Bar seems to be really helping. More than any PT or anything I've tried in a year.

[kalecolbe12 in reply to 2020bluesky]

How do you set up a bar in your house and hang from it or do you go to the gym?

[2020bluesky in reply to kalecolbe12]

I have a home gym in my basement that has a bar. I also go to the health club but you can buy a fitness bar at Walmart, Target, Amazon or anywhere. They hook on the doorway.

[Doggiedogmom1973 in reply to 2020bluesky]

😂i actually saw some humor in this unhumours subject, i never new hanging from a bar would help! I'm going to try. Do i hang from my hands or from my knees over the bar??

[2020bluesky in reply to Doggiedogmom1973]

Hang from your hands.

[Doggiedogmom1973 in reply to 2020bluesky]

Thanks very much, I really appreciate this one and going to try it. Xx

[Skye22]

I have been seeing my specialist physio for 3yrs now, after a lot of tests at hospital and systematically ruling out possible diagnosis, I have been diagnosed with levator-ani syndrome where my pubirectalis muscles "lock" causing extreme spasms and pain. Also diagnosed with pelvic floor dysfunction which affects my bowel and bladder and adhesions on abdomen, pelvis, bladder and bowel.

Treatments: vaginal trigger point therapy internal and external. Initially worse for a couple of days but I do get a lessening in intensity for about 4/5 days. In conjunction I also get botox into pubirectalis muscles, pain is definitely worse for about 3wks but the releif I get after lasts about 2/3mths. Intensity of pain is less but it doesn't eradicate it. I get days where I can sit on my bottom like A normal person but I still get breakthrough pain. It's not until injections wear off that you realize it has helped as the pain becomes unbearable. Just waiting to get my third round of botox, yes injections are painful as you have to be awake to allow doc to locate trigger points but it's a quick procedeure and it works for me.

It's taken 3yrs to get the combination of treatments and meds that work for me as we all react differently, I hope you find what works for you and stay strong.

[2020bluesky]

Thanks for your reply. I had botox last year. I was put under for it. Was in extreme pain afterwards. I think it helped one trigger point but not the other. I have had trigger point injections with and without steroids. The shots without steroids are useless for me. The shots with steroids give me alot of pain for days after. They seem to help one trigger point but not the other as well. Hanging from a bar the last 3 days has been helping more than anything I have tried.

[icrelief]

Many physical therapists follow the Stanford protocol for treating trigger points, which is to massage the trigger point with approximately 6 pounds of pressure for 30-90 seconds. For many patients, this causes the trigger point(s) to give, but it comes back with a vengeance.

The emerging evidence shows that in most cases, it is more effective to apply gentle pressure for 8 to 15 seconds, rest for 15-30 seconds before treating the same trigger point again. It should not be painful.

You can ask your physical therapist to treat you with less pressure and for 8-15 seconds; then go on to the next trigger point or allow you to rest 15-30 seconds, before treating the same trigger point again.

If your physical therapist refuses, then it may be time to seek another physical therapist or ask if you can self-treat in between your therapy sessions. Many physical therapist recommend a pelvic wand to help you self-treat.

There are several wands on the market. Stay away from acrylic, crystal and plastic wands; they are porous and can harbor bacteria. Silicone wands have miniature pours, so are less likely to harbor bacteria. Medical grade glass wands (ezwands.com) are non-porous, hypo-allergenic, can be cooled, warmed, & sterilized; and most importantly, they will not leach harmful chemicals into the body.

[2020bluesky in reply to icrelief]

Thanks, I have a wand that is silicone. Intimate Rose. I have been to 5 different PT's. Internal manual therapy has never helped me. The trigger points are a symptom of something else going on.. Weak Glutes, tight hamstring, etc. Nothing seems to help one trigger point near my vulva at 3 o'clock. Probably gonna try botox for it.

[kalecolbe12 in reply to icrelief]

I absolutely agree that the truth appoints should be pressed for no more than 15 seconds gently and then repeated that's what's worked for me if they press it too hard then I get a horrible flare up, but the gentle pressing is great!

[Pinky2233 in reply to icrelief]

After many pts the only pT treatment effective that I have found for deep tissue adhesions and deep trigger points is a highly specialized therapist who melts and stretches the tissue continuously in an effort to unwind it without coming out of the spot being worked on continuing deeper and deeper into the same spot for the whole session. Deepest layers could take 1.5 hrs or 2. Staying with the same spot and knowing how to break up the core in the deepest level of tissue once found is the key. The actual trigger point is usually pointy and sharp for the practitioner. Staying and non stopping for the entire time thereby getting deeper into the lower NON superficial tissue is important to getting to the root of the problem. The session is continuous and highly effective. The current protocal is non sufficient however difficult for the therapist.

(Dry Needling using the appropriate needle for the job as there are different types is also effective.)

[kalecolbe12]

Yes same..I can't have internal rectal trigger point massage because it makes pain worse....so my pt does external pudental nerve glides which frees up the tightness around pudental nerve and she also stretches muscles internal vaginally because mine is all in the rectal area....she sometimes does mobilization to to mobilize all my joints in the butt and the sacral area...the cyclobenzaprine muscle relaxer helps me a lot and I'm going to try gabapentin soon

[2020bluesky in reply to kalecolbe12]

How long have you had this issue? I'm so sorry, it sounds painful. I have tried Gabapentin several times. If your problem isn't nerve related, it probably won't help you. It makes you extremely tired at 1st, then just a "high" feeling. Sometimes this is ok when you're in extreme pain. I see reviews and some people swear by it. Have they ever told you what is the root cause of your problem?

[kalecolbe12 in reply to 2020bluesky]

Yes it's tight pelvic floor muscles from butt clenching for years living through a stressful marriage and other stressful events and illnesses....I have pelvic floor dysfunction with pudental nerve irritation...I figure it's taken years to get this way so it will take a while to reverse or make somewhat better ...I am sooo much better than I was but I have a flare up sometimes....I don't panic as much as I used to partly because I'm used to some pain now and also I have some tools to deal with it...most people says it's a it takes two to three years to see a big improvement ...I have had it for about 14 months and I do my stretches and breathing every single day and I'll have a flare-up I take my muscle relaxer and that takes care of it... But I will try the gabapentin soon just to see.... I'm not going to do Botox since I'm so much better but I've heard good and bad with it

[2020bluesky in reply to kalecolbe12]

Have you tried swimming laps? Freestyle or Backstroke, NOT Breaststroke ever. It helps alot

[kalecolbe12 in reply to 2020bluesky]

I don't do well with chlorine so no but I have heard that DCT David McCoids program which was invented for male pelvic pain and a lot of women are doing it now and I hear inversion and hanging from bars helps

[2020bluesky in reply to kalecolbe12]

Yes, I bought the DCT program on Thursday and its already helping. It's completely different than any PT I have ever had. It's great so far. Haven't you and I been talking about hanging from a bar? It's awesome. Also, some health clubs have saline or salt water lap pools...