My PT I'd been seeing for 4 mos moved out of the area and I had to find another one. There aren't many in the DC area, but I was lucky to find a highly qualified one. During the initial visit after we caught up on where I was at, she began the exam and quickly (within a couple of minutes) zero'd in on my coccyx. She pressed on that area (externally) and man did it hurt. She'd apply pressure to move it and it hurt big time.
Her comment to me was "we've gotta get that fixed before we focus on the internal stuff". Although I do my own self work, this was an eye opener. She said that the coccyx can keep pelvic pain going no matter how much self work you do. I was a bit taken aback although she's totally up on HITP, the SP, and so on. She's booked months in advance and I was lucky to get in as quickly as I did by virtue of cancelations. Anyway, when I got home I checked the HITP book and sure enough Dr Wise mentions the coccyx being a "perpetuator of pelvic problems" in the pictorial area describing TPs in the pelvic floor. Scan for that picture in the HITP book and read the commentary. She then moved to some external places to get to my internal obderator muscles and zowie! she hit a couple more very sore spots. Her comment was "we've got work to do".
Anyway, I know some of you guys have had this problem for a long time. Not sure if you've looked at the coccyx area specifically but if not, you might take a look or have your PT do so. I was surprised, you might be too.
--MB
note: not medical advice, just my experience.
remember the coccyx
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mbaker
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remember the coccyx
Age: 45; Onset: Jan 2007; Initial | Symptoms: perineal, pubic, penile, right testicle pain, pain while sitting; Current | Symptoms: 95% better; very seldom do I have pain now; caffeine was the culprit; Helps: No caffeine (even decaf), Red tea, Getting exercise, Pure Encapsulations Nutrient 950 multi-vitamin; Hurts: Caffeine, sometimes when my l5s1 back issue acts up.
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scotsman
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The coccyx has always been a major trouble spot for me and I have to treat it most days.
Good advice to focus some effort there.
Richard.
Good advice to focus some effort there.
Richard.
Not medical advice: Read my progress to date : Read about my W-A clinic visit
Age: 54 CPPS: 20 Yrs Recovery Status: 95% Symptoms: Pain around perineum Makes Worse: Tension, sitting Makes Better: Stretching, triggerpoint therapy, relaxation
Age: 54 CPPS: 20 Yrs Recovery Status: 95% Symptoms: Pain around perineum Makes Worse: Tension, sitting Makes Better: Stretching, triggerpoint therapy, relaxation
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Howden
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Interesting. I have a therapist who has recently started work on the coccyx and it also hurts like hell. Results vary between flare up to practically no pain. From all I read here, flare ups could mean she's hitting the right spot so I guess the right thing to do is to keep her at it.
Age: 71; age at onset: 65; symptoms: initially rectal spasms; currently anal pain, pereneal pain, buttock pain; all pain on the right side; early diagnosis: chronic non bacterial prostatitis; treatments 4 long courses of antibiotics, accupuncture, naturopathy; current treatments: gabapentin, terasozin, Celeza, PT.
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mbaker
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Scotsman,
What is your method of treatment ?
--MB
What is your method of treatment ?
--MB
Age: 45; Onset: Jan 2007; Initial | Symptoms: perineal, pubic, penile, right testicle pain, pain while sitting; Current | Symptoms: 95% better; very seldom do I have pain now; caffeine was the culprit; Helps: No caffeine (even decaf), Red tea, Getting exercise, Pure Encapsulations Nutrient 950 multi-vitamin; Hurts: Caffeine, sometimes when my l5s1 back issue acts up.
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scotsman
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Two fold - first is I sit on the toilet and using a Theracane I reach between my legs and externally treat that area. Sitting on the toilet and squatting like that really opens up and stretches the muscles - so I can dig in deep with the Theracane. I treat it this way every night.mbaker wrote:Scotsman,
What is your method of treatment ?
--MB
Probably once every couple weeks I also do internal work, where I lie on my side and reach round the outside of my legs and insert my finger, hook it inside the sphincter/coccyx and stretch/trigger-point it.
It's usually very painful to touch during the internal work but it does feel like it's lessening the tension in there.
Richard.
Not medical advice: Read my progress to date : Read about my W-A clinic visit
Age: 54 CPPS: 20 Yrs Recovery Status: 95% Symptoms: Pain around perineum Makes Worse: Tension, sitting Makes Better: Stretching, triggerpoint therapy, relaxation
Age: 54 CPPS: 20 Yrs Recovery Status: 95% Symptoms: Pain around perineum Makes Worse: Tension, sitting Makes Better: Stretching, triggerpoint therapy, relaxation
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ppp
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Re: remember the coccyx
I am sorry, I am new to the new forum (not the old one; I am back after years of silence). I am finding trouble "pm"ing people here. I was looking for a PT in DC and I see this post by you MBAKER. If you can PM me or just give me her name i would be GRATEFUL. You know it can be hard to find someone.
Age: 33| Onset Age: 24 | Symptoms: dull ache in pelvic area, tension, feeling the need to urinate, frequency, dribbling after urination, ED symptoms started 6 moths after the onset wrecking my life since, abdominal tension, tension in my thighs. | Helped By: stretching/massage , benzos | Worsened By: Mainly sex, but also sitting and anxiety| Other comments: I have seen periods of substantially less flare-ups, but now I am at a steady state where it comes back almost always after sex.
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mbaker
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Re: remember the coccyx
Hey,
Not many PTs in the DC area that will work on men. Only one I found that I can speak to is Jennifer Chu at ITR Physical Therapy in McLean. Her website is www.itrehab.com. Her focus for men is treating external issues rather than internal ones.
Take care,
mb
Not many PTs in the DC area that will work on men. Only one I found that I can speak to is Jennifer Chu at ITR Physical Therapy in McLean. Her website is www.itrehab.com. Her focus for men is treating external issues rather than internal ones.
Take care,
mb
Age: 45; Onset: Jan 2007; Initial | Symptoms: perineal, pubic, penile, right testicle pain, pain while sitting; Current | Symptoms: 95% better; very seldom do I have pain now; caffeine was the culprit; Helps: No caffeine (even decaf), Red tea, Getting exercise, Pure Encapsulations Nutrient 950 multi-vitamin; Hurts: Caffeine, sometimes when my l5s1 back issue acts up.
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ppp
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Re: remember the coccyx
Many thanks. Problem is she seems to advertise for women (which makes it a bit weird going there 
) but I will contact her .
It is too bad that here in DC is not like LA. There I found 2 PTs that were really good and understand the importance of internal. None, nada ?
Thanks again.
) but I will contact her . It is too bad that here in DC is not like LA. There I found 2 PTs that were really good and understand the importance of internal. None, nada ?
Thanks again.
Age: 33| Onset Age: 24 | Symptoms: dull ache in pelvic area, tension, feeling the need to urinate, frequency, dribbling after urination, ED symptoms started 6 moths after the onset wrecking my life since, abdominal tension, tension in my thighs. | Helped By: stretching/massage , benzos | Worsened By: Mainly sex, but also sitting and anxiety| Other comments: I have seen periods of substantially less flare-ups, but now I am at a steady state where it comes back almost always after sex.
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russeld
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Re: remember the coccyx
As an LMT here, we can't go into any orifice (maybe oral with the pterygoids) professionally.
Just a question as a newb here...who is teaching you all these methods (NMT, etc)? Without extensive education in anatomy and neuroanatomy, I wouldn't go poking around inside my rectum to try to self-Tx my coccyx...and believe me, I have severe coccydynia and am certified NMT and LMT...are you all self-taught? Please note, I am not criticizing anything that works for you (I'm all for doing what works for you, as some docs can't figure it out for you), just curious as to how some of you came upon your knowledge...self-taught, well-read???
BTW, I do know how, and have Tx friends via this way, just not professionally.
Just a question as a newb here...who is teaching you all these methods (NMT, etc)? Without extensive education in anatomy and neuroanatomy, I wouldn't go poking around inside my rectum to try to self-Tx my coccyx...and believe me, I have severe coccydynia and am certified NMT and LMT...are you all self-taught? Please note, I am not criticizing anything that works for you (I'm all for doing what works for you, as some docs can't figure it out for you), just curious as to how some of you came upon your knowledge...self-taught, well-read???
BTW, I do know how, and have Tx friends via this way, just not professionally.
Born...bilateral clubfoot deformity, corrective surgery=unstable base of ambulatory support developmentally through childhood. Though of myself as Evel Knievel and had straddle injury after straddle injury until scar tissue closed my urethra when I was a Junior in HS(84)..had Stricture removed and self-cath-ed for 1 1/2 years. Have endured periodic excrutiating spasms in the pelvic/perineum area ever since I was about 12.
Recently, about 2 1/2 years ago, after hemorrhaging after a "routine" dilation, I said ENOUGH and me and my Uro. agreed on Buccal Mucosa Graft Urethroplasty...it failed, and about last November I started feeling the stricture symptoms, couldn't relax pelvic floor muscles to pee, etc. and have since had TWO, in one month Urethrotomy with stricture release and have been, and am, self-cath-ing which is extremeley painful and sets off a whole inflammatory, fight/flight cycle=This will never end as long as there is a stricture, which is, unfortunately, my fate...Sally forth.
Recently, about 2 1/2 years ago, after hemorrhaging after a "routine" dilation, I said ENOUGH and me and my Uro. agreed on Buccal Mucosa Graft Urethroplasty...it failed, and about last November I started feeling the stricture symptoms, couldn't relax pelvic floor muscles to pee, etc. and have since had TWO, in one month Urethrotomy with stricture release and have been, and am, self-cath-ing which is extremeley painful and sets off a whole inflammatory, fight/flight cycle=This will never end as long as there is a stricture, which is, unfortunately, my fate...Sally forth.
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Jay
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Re: remember the coccyx
Hi Russel,
Some people here are self-taught, but the majority first learn to treat themselves with the guidance of a qualified physical therapist specialized in the pelvic floor. There aren't too many of them; most PTs with the appropriate training are located near major cities in the US.
After reading about the physical therapy in A Headache In The Pelvis (it's a book detailing this approach, FYI, written by Drs. Wise and Anderson), I began treatment with the blessings of my urologist. My PT held a doctorate and taught at the University of Miami, and other PTs pursuing this approach tend to be similarly qualified. Paired with the clinical studies out there, you can rest assured that there's nothing woo-woo about it.
Myofascial trigger point release doesn't require a great deal of pressure to be applied internally, certainly not enough to damage nerves or organs. The idea is to apply pinpoint pressure to release areas of tension.
Some people here are self-taught, but the majority first learn to treat themselves with the guidance of a qualified physical therapist specialized in the pelvic floor. There aren't too many of them; most PTs with the appropriate training are located near major cities in the US.
After reading about the physical therapy in A Headache In The Pelvis (it's a book detailing this approach, FYI, written by Drs. Wise and Anderson), I began treatment with the blessings of my urologist. My PT held a doctorate and taught at the University of Miami, and other PTs pursuing this approach tend to be similarly qualified. Paired with the clinical studies out there, you can rest assured that there's nothing woo-woo about it.
Myofascial trigger point release doesn't require a great deal of pressure to be applied internally, certainly not enough to damage nerves or organs. The idea is to apply pinpoint pressure to release areas of tension.
I am not a physician. This is not medical advice. Consult your doctor!
Age: 26 Onset Age: 17 Symptoms: Shooting, nerve-like pains throughout the penis, which abruptly hit and leave. Testicular pain, perineum pain, burning/irritative urination, extended pain after ejaculation. Occasionally, some allodynia or ache in the coccyx/sacrum/thigh/buttocks/legs. Diagnosis: Pelvic floor dysfunction, degenerated lumbar disk, and mildly herniated lumbar disk. Helped By: Physical therapy, pain management doctor, hot baths, therapy pool, stretching regimen, breathing exercises, relaxation, distraction. Worsened By: Arousal/ejaculation (worst), constipation, panicking/obsessing, other triggers depend upon current symptoms. Tests/Prior Treatments: Too many antibiotics to count, multiple urine tests (all normal), testicular ultrasound (normal), bladder and renal ultrasound (normal), lumbar and pelvic MRI with and w/o contrast (revealed disk problems), Elavil 25mg (caused retention), Flomax 0.4mg.
Age: 26 Onset Age: 17 Symptoms: Shooting, nerve-like pains throughout the penis, which abruptly hit and leave. Testicular pain, perineum pain, burning/irritative urination, extended pain after ejaculation. Occasionally, some allodynia or ache in the coccyx/sacrum/thigh/buttocks/legs. Diagnosis: Pelvic floor dysfunction, degenerated lumbar disk, and mildly herniated lumbar disk. Helped By: Physical therapy, pain management doctor, hot baths, therapy pool, stretching regimen, breathing exercises, relaxation, distraction. Worsened By: Arousal/ejaculation (worst), constipation, panicking/obsessing, other triggers depend upon current symptoms. Tests/Prior Treatments: Too many antibiotics to count, multiple urine tests (all normal), testicular ultrasound (normal), bladder and renal ultrasound (normal), lumbar and pelvic MRI with and w/o contrast (revealed disk problems), Elavil 25mg (caused retention), Flomax 0.4mg.
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russeld
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Re: remember the coccyx
Don't get me wrong, I believe in this modalities efficacy 
...you have been blessed with those who surround you who have helped to teach you these techniques...I said in another thread, I have some childhood sexual abuse issues going on as well, so anything that has to do with that whole area, HAS to be approved by my subconscious, and I don't think I'm at that point where I can let someone else do any release rectally....like I said also in another post, I have done some of these releases myself, but have also set off SI joint issues whilst doing so.
...you have been blessed with those who surround you who have helped to teach you these techniques...I said in another thread, I have some childhood sexual abuse issues going on as well, so anything that has to do with that whole area, HAS to be approved by my subconscious, and I don't think I'm at that point where I can let someone else do any release rectally....like I said also in another post, I have done some of these releases myself, but have also set off SI joint issues whilst doing so.Born...bilateral clubfoot deformity, corrective surgery=unstable base of ambulatory support developmentally through childhood. Though of myself as Evel Knievel and had straddle injury after straddle injury until scar tissue closed my urethra when I was a Junior in HS(84)..had Stricture removed and self-cath-ed for 1 1/2 years. Have endured periodic excrutiating spasms in the pelvic/perineum area ever since I was about 12.
Recently, about 2 1/2 years ago, after hemorrhaging after a "routine" dilation, I said ENOUGH and me and my Uro. agreed on Buccal Mucosa Graft Urethroplasty...it failed, and about last November I started feeling the stricture symptoms, couldn't relax pelvic floor muscles to pee, etc. and have since had TWO, in one month Urethrotomy with stricture release and have been, and am, self-cath-ing which is extremeley painful and sets off a whole inflammatory, fight/flight cycle=This will never end as long as there is a stricture, which is, unfortunately, my fate...Sally forth.
Recently, about 2 1/2 years ago, after hemorrhaging after a "routine" dilation, I said ENOUGH and me and my Uro. agreed on Buccal Mucosa Graft Urethroplasty...it failed, and about last November I started feeling the stricture symptoms, couldn't relax pelvic floor muscles to pee, etc. and have since had TWO, in one month Urethrotomy with stricture release and have been, and am, self-cath-ing which is extremeley painful and sets off a whole inflammatory, fight/flight cycle=This will never end as long as there is a stricture, which is, unfortunately, my fate...Sally forth.
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webslave
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Re: remember the coccyx
As a matter of interest, did the abuse involve anal penetration? I'm interested if this particular form of abuse correlates with pelvic clenching.
Good News! The great ProstaQ is BACK at last! You must try it.
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russeld
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Re: remember the coccyx
Other things occurred and "that" was threatened verbally, so I went into a state of fight or flight and clenched to make sure nothing ever got in....my PM doc is big on this correlation as well and was part of his intake questions, as he has found, as have many, that many CP pts have endured childhood phys/sexual trauma.webslave wrote:As a matter of interest, did the abuse involve anal penetration? I'm interested if this particular form of abuse correlates with pelvic clenching.
Born...bilateral clubfoot deformity, corrective surgery=unstable base of ambulatory support developmentally through childhood. Though of myself as Evel Knievel and had straddle injury after straddle injury until scar tissue closed my urethra when I was a Junior in HS(84)..had Stricture removed and self-cath-ed for 1 1/2 years. Have endured periodic excrutiating spasms in the pelvic/perineum area ever since I was about 12.
Recently, about 2 1/2 years ago, after hemorrhaging after a "routine" dilation, I said ENOUGH and me and my Uro. agreed on Buccal Mucosa Graft Urethroplasty...it failed, and about last November I started feeling the stricture symptoms, couldn't relax pelvic floor muscles to pee, etc. and have since had TWO, in one month Urethrotomy with stricture release and have been, and am, self-cath-ing which is extremeley painful and sets off a whole inflammatory, fight/flight cycle=This will never end as long as there is a stricture, which is, unfortunately, my fate...Sally forth.
Recently, about 2 1/2 years ago, after hemorrhaging after a "routine" dilation, I said ENOUGH and me and my Uro. agreed on Buccal Mucosa Graft Urethroplasty...it failed, and about last November I started feeling the stricture symptoms, couldn't relax pelvic floor muscles to pee, etc. and have since had TWO, in one month Urethrotomy with stricture release and have been, and am, self-cath-ing which is extremeley painful and sets off a whole inflammatory, fight/flight cycle=This will never end as long as there is a stricture, which is, unfortunately, my fate...Sally forth.
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webslave
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Re: remember the coccyx
Interesting!
Good News! The great ProstaQ is BACK at last! You must try it.
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