His and Her Health

my lower back has started hurting so much since my diagnosis of levator ani/vestibulodynia-
would you know why that might be?
Also, botox- Has anyone ever had problems after having botox treatments for this?

Levatorani:
Low back pain is also a common symptom when someone has pelvic floor dysfunction. The tension in the pelvic floor muscles as well as the tension in the pelvic girdle (gluts, thighs, etc) may result in alignment issues and joint mobility issues. Also, there is commonly weakness in the core muscles which can also result in the low back pain.

As for Botox, there are risks of course. I think most people fear the incontinence risk. I think so far I have had one patient complain of some incontinence post Botox which was short lived.

Thanks Niva, I was worried about that risk in particular. How about results? Does it seem like it helps??

thanks so much~!

I think it does. Definitely to the muscular aspect of the issue...

Niva

How do you work on botoxed muscles though, wouldn't everything be paralyzed- how would u find the trigger points, etc
I would think it would be easier to work on someone without botox? And why would there be a need for pt, if the muscles are botoxed?

thanks!

You can still do the techniques on the pelvic muscles after botox. botox works, but is not a miracle. my patients still need work done on the internal muscles. don't forget, i also work on their alignment, core strengthening, etc...

<small>[ 03-11-2009, 08:48 AM: Message edited by: Moderator ]</small>

Has any studies been done on which way botox is more effective- vaginally or thru buttocks?

Also, my doctor touched my pudendal nerve and it hurt, could it hurt because of the muscles or when touching it and it hurts does that mean definitely neurological?

thanks

Yes, tension in the muscles can lead to nerve irritation.

<small>[ 03-12-2009, 06:23 PM: Message edited by: Moderator ]</small>

Niva,

How can ya decipher if its the nerve causing the muscles to spasm or like you said tension in the muscles causing nerve irritation?

If there is hypertonus and PFM tension then I know it can be adding to the nerve irritation. I use the patients initial symptoms or cause of pain to see if it may have been a nerve injury first or a muscular issue. At the time that the nerves are irritated and muscles are tense, there is a loop feeding each other.

thanks Niva I really appreciate your info. I guess its the same with the vulvar pain (vestibule) if your muscles are tight would that cause the pain in that area? or should I be treating that area as something separate. I have read so much about estrogen creams, nerve pain meds etc- but my doctor just suggested pt and nothing else?

If PT alone is not helping, ask your doctor is there is anything else he can offer. I am seeing less patients being prescribed nerve meds. Many are on valium either oral or suppository form. Some, NOT ALL, are on estrogen/testosterone cream.

ok thanks, I just read Sarahs email and was wondering now about the trigger point injections myself as I am scheduled to get more done soon!!