P– Pelvic Structural Health

There are a wide variety of reasons women suffer pelvic pain. From interstitial cystitis to and overactive bladder, the causes of symptoms are diverse, but with new treatment protocols and advancing medicine, pelvic health is now easy to achieve.

At the HOPE Protocol we first examine for optimal pelvic structure, whether you suffer these conditions or not a healthy pelvic floor is essential for good organ function in that part of your body. Through treatment programs that involve the use of Platelet Rich Plasma (PRP) injections to the lumbar and sacral ligaments, we can rejuvenate the tissue in your lower back and pelvis and having you moving pain free for the first time in years.

These conditions can occur by themselves, or a patient may have several of them at once. Successful treatment depends upon proper assessment of symptoms and a deep understanding the interconnected pathology between each symptom.

Interstitial Cystitis

Interstitial cystitis (IC) is a chronic non-bacterial inflammation and/or breakdown of the bladder lining often associated with Chronic Pelvic Pain and Female Urethral Syndrome (FUS). Chronic Pelvic Pain Syndrome (CPPS)  is just what it sounds like — pain that may occur anywhere the pelvis. This type of pain may occur in several places at once or move around within the pelvis from one day to the next. It may also be localized pain or radiate from the lower back into the pelvis, which makes a diagnosis more difficult.

Interstitial cystitis (IC) is probably the most misdiagnosed urological condition — on average, a four-year delay exists between the onset of symptoms and an IC diagnosis. IC/CPPS is also a diagnosis of exclusion, often given to a patient after ruling out other potential problems. In addition, several studies suggest that the prevalence of IC in the United States is substantially underreported.

Pudendal Nerve Entrapment

Pudendal Nerve Entrapment (PNE)/Pudendal Neuralgia (PN) is the cause of chronic pain in which the pudendal nerve is entrapped or compressed. In this condition, the pudendal nerve becomes entrapped between the sacrotuberous and sacrospinous ligaments and a chronically tight piriformis muscle. Trauma, pregnancy, post surgical scarring, cycling, or any repetitive motion that affect these ligaments and the surrounding tissues can cause this condition.

In women (who suffer the majority of Pudendal Nerve issues), the PNE/PN pain is in the labia, vagina, perineum, or anorectal region.

In men, the pain is in his penis, scrotum, perineum, or anorectal region. The male symptoms from this type of nerve entrapment/impingement mimic symptoms of prostatitis, urinary obstruction, and sexual dysfunction.

Sitting for extended periods frequently aggravates PNE/PN pain in both women and men. The symptoms can include burning, numbness, prickling, and sometimes stabbing pain. Standing or sitting on a toilet seat often takes the pain away.

Other symptoms include fecal and urinary incontinence.

Gentle stretching of the pelvic muscles coupled with trigger point release work and relaxation techniques often help prevent symptoms.

The only way to successfully teat this is condition is through a multidisciplinary approach that includes various physical therapy modalities, acupuncture, joint mobilization/stabilization, joint and connective tissue injections, core muscle strengthening, and medications.