High voltage electrogalvanic stimulation for levator ani

[ramana]

Aetna seems to have standardized on this for levator ani spasms
http://www.aetna.com/cpb/medical/data/600_699/0679.html

I contacted Dr Norman Sohn for more info and he said search for providers (which I couldn't). Anyone else does? I don't have Aetna so cannot call and ask them to find out.
This is next on my line (before Botox) if the current treatment fails

[kevin]

Interesting. Let us know how that turns out.

[mbaker]

I have Aetna, but they don't have a search feature on illnesses or treatments. Only on type of speciality.

--mb

[tiger]

I have been having electrical stimulator therapy for about 10 minutes for the last 3 visits to my PT - in addition to the trigger point therapy. There is a 1.25 inch probe that is inserted into the rectum and I can dial in the level of electrical stim. Is this what you are talking about? I don't consider it High Voltage, it is similar to an EGS machine.

I was going to write a post today asking if anyone has had success with home use of an electrical stimulation device such as this. My PT has found numerous trigger points.

[Clay]

This treatment says it is for proctalgia fugax, which I thought was different from CPPS. It consists of single short (to 20 minute) attacks of very strong pain, usually at night, only a few times a year for many people. My wife gets this occassionally. It isn't thought to be from trigger points, is it?

Am I missing something?

[webslave]

Proctalgia fugax spasms, which usually occur after a bowel movement and can be controlled by getting into a hot bath or putting a hot water bottle or heating pad against the anus, is NOT CP/CPPS in any way.

It is also called:

• Pain in the rectum
• Levator syndrome
• Rectal Spasms
• Paroxysmal proctalgia
• Anorectal spasm
• Anal Pain, Rectal Pain, Pain in the Anus, Pain in the butt, Pain in the Rear.

Proctalgia fugax is transient, severe rectal pain related to spasm of levator ani and coccygeal muscles.

[boulder]

Umm, Webslave, I'm confused. You said that "levator ani syndrome is a subset of pelvic floor dysfunction" here: viewtopic.php?t=1887

And this paper, which you posted, would seem to suggest that chronic prostatitis / chronic pelvic pain syndrome and levator ani syndrome are related: viewtopic.php?t=610

"Pelvic floor muscles are composed of the bulbospongiosus, ischiocarenosus, transversus, sphincter ani, levator ani, coccygeus, and obturator internus (Fig. 1). TrPs in these muscles cause poorly localized pain symptoms called coccydynia, levator ani syndrome, or proctalgia fugax."

TrPs in these same muscles also cause CPPS, so while these various syndromes may not be the same, aren't they all at least closely related? Aren't they all members of the same nasty family of PFD involving trigger points?

I'm sorry if this sounds like nit-picking, it may be just the terminology that's confusing me. I know all those posts I linked to are several years old, but I wanted to ask if the thinking is still the same and if I'm understanding it correctly. I recently posted something related on another thread ( viewtopic.php?t=5078 ), so I want to make sure I'm not putting out bad info. I'd appreciate your take on this.

And perhaps I should add that I'm not asking this in relation to the therapy under discussion, but just to clarify the relationship between these different maladies...

[webslave]

Nah, it's the old nomenclature chestnut, which is why I like "pelvic myoneuropathy". Proctalgia fugax does not involve trigger points, as far as I am aware. "Levator ani syndrome" is a loosely used term that has been applied to chronic prostatitis / chronic pelvic pain syndrome is the past by some people, incorrectly.

[webslave]

I recently posted something related on another thread ( viewtopic.php?t=5078 ), so I want to make sure I'm not putting out bad info. I'd appreciate your take on this.

My take on that is that what you said in that thread is incorrect.

[boulder]

[edited twice, as I misread the above the first couple times around]

Thanks for the quick reply! This "nomenclature chestnut" can be a pain. A chestnut in the mind, hindering my understanding of a headache in the pelvis!

OK, so getting my head around this:

1) Levator ani syndrome (aka proctalgia fugax) is like chronic prostatitis / chronic pelvic pain syndrome in that it is a form of PFD, but levator ani syndrome is unlike chronic prostatitis / chronic pelvic pain syndrome in that- at the very least- it does not involve trigger points.

2) chronic prostatitis / chronic pelvic pain syndrome is sometimes misdiagnosed/mislabelled as levator ani syndrome.

Does this sound right?

Sorry for derailing the discussion...

[ramana]

Thanks everyone for their replies:
mbaker: If you call Aetna, they will probably help you locate a provider. At least bluecross tried to locate a pelvic pain PT on their panel. Usually an insurance company will have only the search for specialities as you have mentioned. For any other queries - one has to call customer service and try to persuade them to do some research. Of course, at the end of it , it is all luck....

tiger: I have not done any electrical stimulation so far but am planning on trying it. I am assuming that by EGS you mean electrogalvanic stimulation.
This is the manufacturer listed in the paper http://www.egs-emhi.com/.
More importantly, can you please post your experience with the machine.

webslave / boulder: Well I am confused now. I was diagnosed with levator ani . Confirmed by Dr Rodney anderson. I went to Dr Wise clinic and Tim found a whole lot of trigger points. So I don't really understand how levator ani syndrome differs from chronic prostatitis / chronic pelvic pain syndrome on the basis of trigger points.

At the time of Dr Wise clinic - I only had rectal pain. Now I have testicular pain as well. So now what is it?
Also I have gone to pelvic pain therpaists (apart from tim) and all of them have found trigger points. (I haven't though).


This posting has gotten into multiple but related issues. If there are more posts - maybe we can try a separate thread of chronic prostatitis / chronic pelvic pain syndrome vs levator ani.
Thanks

[ramana]

I finally got to speak to a person at http://www.egs-emhi.com/. Given the lack of improvement with PT , I am trying out other ways. Looks like they have not sold anything in N. Cal (Bay Area) since 1996. However, USC colorectal / UCLA have this and use this regularly. The device that is used most often is EGxtra.

Has anyone else in LA/San Diego ever got a chance to visit USC/UCLA? Any other person who tried it please post. Dr Norman Sohn in NY is the person who found use of this way back in 1980s. Not a cure but at least it seems to have helped.

Thanks

[scoobysnacks]

I had bouts of Proc Fug prior to my onset of CPPS. For me it was a warning sign, but I did not heed it. I do think it signifies undue stress on the pelvic floor. I would be walking or sitting and I'd get a REALLY intense almost electrical like pain, then it was gone. I still sometimes get it, but I know I have trigger points as I can work them out and relieve all symptoms.....now just working on getting them to stay in the good spot....

Ss