Muscle Spasm - So Many Associated Problems!

alprost · Post by **alprost** » Sat Nov 15, 2003 10:17 am

Although pelvic floor muscle spasm is suspected to be a primary cause of symptoms in a large proprtion of chronic prostatitis / chronic pelvic pain syndrome patients, I realised yesterday that I have had a range of other associated problems which have needed to be treated by a variety of different approaches:

- Trigger Points on pelvic floor muscles - Treated by myofascial release.
- Trigger Points on Obturator Internus - Treated by myofascial release.
- Urethral Hypersensitivity - Treated by low dose Neurontin.
- Suspected pudendal nerve irritiation (caused by spasm of obturator internus) - Need to avoid prolonged sitting & allow time to heal.
- Inflamed sacro-tuberous ligament - Treated by manual physiotherapy - stretching & massage.
- Trigger Point on Abdominal muscle - Treated by myofascial release.
- Muscle spasm in absence of trigger points - Treated by pelvic floor relaxation exercise protocol.

I think the above shows that there is no one easy answer, and that both doctors and patients may need to seek out help from a variety of specialists and use a range of therapies.

Anyone had a similar experience?

Paso · Post by **Paso** » Sat Nov 15, 2003 10:24 am

I think all your "things" consists of one major factor. Like described in AHIP you maybe had/have a unintentional tension pattern in your body?

Just a thaugh. However I am glad you are better and that you can help others.

/Paso

alprost · Post by **alprost** » Sat Nov 15, 2003 10:36 am

Paso wrote: I think all your "things" consists of one major factor.

Yeah - I agree that they are all related to the muscle spasm. I was really just trying to highlight that there a range of associated factors in addition to the 'trigger points'.

Paso wrote:Like described in AHIP you maybe had/have a unintentional tension pattern in your body?

I don't think so in my case - It appears to have been caused by a really bad bout of Prostatitis which caued my pelvic floor muscles to go into spasm. Since I have started biofeedback and relaxation training I rarely catch myself 'tensing' my pelvic floor muscles, and EMG tests show that my resting tone is normal - I just don't seem to have the habit of focussing tension there. I am also sensitive to the slightest change in tension, and can predict quite accurately how strongly they are contracting in EMG tests.

The funny thing is that since I have been doing the relaxation training the places I do seem to store tension when I am busy is not in my pelvis but in the sides of my face and my neck/trapezius muscles - I better watch out or I might get a 'Headache in the Head'!

MS · Post by MS » Mon Dec 01, 2003 11:44 pm

Suspected pudendal nerve irritiation (caused by spasm of obturator internus) - Need to avoid prolonged sitting & allow time to heal.

Alprost,

Have you tried "dry needling" on the obturator. My physical therapist was able to find and release myofascial trigger points. Also, the Pectineus muscle was a cause of myofascial pain in my case.

I know it's controversial, but procaine and, more recently Botox, has helped me tremendously on most of the PF muscles.

alprost · Post by **alprost** » Tue Dec 02, 2003 9:19 am

MS wrote: Alprost,
Have you tried "dry needling" on the obturator.

My physio would usually end each session with 'dry needling', but my obturator internus spasm was resolved by manual therapy, although it did take a few sessions! My pelvic floor EMG is now normal, and I now feel I'm at the stage where my 'sitting' pain is coming from the sacrotuberous ligamant, (which didn't have to do much work when my pelvic floor was in spasm for over a year) being stretched and becoming inflamed when sitting for long periods. You could be right about looking at other muscle groups, as my physio has recently been working on points in my abdomen and groin.

budgie · Post by **budgie** » Sat Dec 06, 2003 1:45 am

Have you tried "dry needling" on the obturator.

What is dry needling?

Thanks

Neil

scotsman · Post by **scotsman** » Sat Dec 06, 2003 9:07 am

Is it acupuncture?

Post by **webslave** » Sat Dec 06, 2003 2:55 pm

Yes, it is a form of acupuncture. Here's an interesting paper:
http://www.coccyx.org/medabs/gunn.htm

budgie · Post by **budgie** » Sun Dec 07, 2003 1:53 am

Actually, thinking about it, my specialist at Cambridge, Dr Munglani, together with another doctor, has been using a type of acupuncture into muscles whereby the needles I think are left in the muscle for a short period until it starts to either contract or relax (I can't remember which) and then it is removed. I wonder if this is the same principle?

Here's an article I found
http://www.intramuscularstimulation.com/media.htm

Thanks for the info though, very useful.

Neil

MS · Post by MS » Sun Dec 07, 2003 3:47 am

What is dry needling?

Is it acupuncture?

"Dry needling" seems to be a generic term for inserting a needle into a muscle, without any injection.

The dry needling I was referring to above is performed by a specialist who identifies myofascial trigger points (e.g. Obturator muscle), and inserts an acupuncture needle into the trigger point.

Dry-needling differs from acupuncture in that it focuses on those specific trigger points, as opposed to the Meridians of the body.

Myofascial Trigger points are:

"...hyperirritable bundles of fibers within a
muscle that become "˜"˜knotted'' and inelastic and unable
to contract or relax. The hallmarks upon physical examination
are marked muscle tenderness, loss of range
of motion, and muscle weakness. Myofascial treatment
in the form of injection of local anesthetic and/or dry
needling followed by a specific, supervised, therapeutic
stretching program aims to reestablish a painless, full
range of motion."

Source: http://ucpps.men/1/docs/IC_pelvicpain.pdf
(you need Acrobat reader to view)

Here is another excellent resource on myofascial pain and needling:

http://www.aafp.org/afp/20020215/653.html

scotsman · Post by **scotsman** » Sun Dec 07, 2003 10:40 am

The acupuncture that my physio does isn't into the trigger points (so not really dry needling), it's a couple needles at the top of my public hair line above my penis to treat the pudendal nerve (Alan - is this the same for you or does Bill do other areas?).

Richard.

alprost · Post by **alprost** » Mon Dec 08, 2003 12:14 pm

Earlier in my treatment he put the needles directly into the muscle itslef, but he has mentioned that accupuncture can be used in a variety of ways, including: Needling muscles/trigger points etc; nerve treatments, and also using traditional Chinese medicine accupuncture points.

GregT · Post by **GregT** » Tue Dec 30, 2003 10:53 pm

Richard, if the pudendal nerve is your problem, then I don't think that accupuncture is going to cure you. You should be tested for PN (pudendal neuropathy) by one of the experts in the country. I would recommend either Dr. Thomas Benson in Indianapolis or Dr. Renney (a former PNE sufferer himself) in Houston, TX. I may not have the time to check back on this site to see if you're interested, so either join http://www.pudendal.info and look around and ask questions or email me at [email protected]

Greg

scotsman · Post by **scotsman** » Wed Dec 31, 2003 9:51 am

Thanks Greg - I don't think my pudendal nerve is the root of my problems and sitting doesn't increase my symptoms as much as it did in the early days before physio.

Richard.

GregT · Post by **GregT** » Wed Dec 31, 2003 4:03 pm

Richard, what exactly is physio? Greg

UCPPS - Prostatitis, Interstitial Cystitis Forum

UCPPS - Prostatitis, Interstitial Cystitis Forum

Muscle Spasm - So Many Associated Problems!

Muscle Spasm - So Many Associated Problems!

Dry Needling