His and Her Health

Can you please tell me if botoxing the pelvic muscles relieves the horrible burning pain at the bottom part of the vestibule ( I guess it would be like 4-6-8 positions. My worst symptom is when I press that area, it feels awful. I would be willing to go through with the botox injections if I knew that it could relieve the pain on the outside. Can you please let me know

thank you

Stacy

Stacy, you should ask the person whom is treating you. Botox is injected into the muscles. There should be increased tone or increased tension in that area/the muscles in that area in order to inject Botox. Have you spoken to your physician regarding Botox?

thank you my doctor told me that she felt the muscles were causing the pain there, I recently read about botox and was wondering if I got injections if that would take away the pain there, since she feels the muscles are my primary problem. When I do pt, its not my inside muscles so much that hurt, but the external area (vestibule)

thank you for answering

If it is the muscles, then the Botox should help. I sometimes notice in patients "stubborn" muscle which just don't want to release, or always return to the tight state. If this patient type chooses Botox, commonly there is a decrease in their pain and PT becomes more beneficial.

<small>[ 07-03-2009, 09:27 PM: Message edited by: Moderator ]</small>

Hi Niva

Im not really following why botox into the muscles would alleviate the pain at the vestibule? My doctor said she thinks my muscles are causing the pain there, so the patients that you treat that have had botox into the muscles, was the pain at the vestibule alot better?
and if so, do you know which muscles were botoxed

thanks!

S

Yes, the patients saw a reduction of pain. The muscles injected depended on the patient. You are all individuals. Not every patient will have the same muscles injected. Yes there are common ones that are tight, but again not everyone gets the same injections.

<small>[ 07-05-2009, 10:22 PM: Message edited by: Moderator ]</small>

Niva

Do you know of any incidences of incontinence that happened with botox?

Fortunately, none of my patients have had these issues, but yes it is a risk.

<small>[ 07-06-2009, 11:23 PM: Message edited by: Moderator ]</small>

Niva

Are the doctors that do the botox for your patients mostly in NYC, could I email you to find out names. I would rather go to someone with a good track record for botox

thank you

Yes presently I work with NYC doctors doing this type of procedure.

Niva

I hope you don't mind, I just emailed you about botox. thanks!

S

Niva

I read an article today about the pudendal nerve being irritated causing the muscles to spasm. Why is pt recommended if that is the case and not something to treat the nerve?

It is difficult to say whether the muscles cause the nerve to be irritated or the nerve irritation aggravates the muscles. Either way, you need to calm down the muscles, relax and lengthen them, so that they don't continue to aggravate the pudendal nerve. There are certain medications that help calm down the nerve pain, but that is not always necessary.

Even if the muscles are in spasm due to the nerves irritated, you still want to address the muscles. A medication treating the nerve will help in calming that part, but the muscle may not be treated, especially if this has been going on for a while. Muscles have memory and when they start to spasm, after a while they start remembering this is their new position. Also, I have seen many patients have to try different medications prior to finding the one to work. In the meantime, the muscle spasm may continue.
The best way to approach these issues is through multidisciplinary approach!

<small>[ 07-16-2009, 10:44 PM: Message edited by: Moderator ]</small>

NIva

What is the muscle/muscles located right inside the anus to the left? It hurts when I press that area, but seems to help my vulvar pain? Does this make sense? Was curious what muscle that is as it throbs alot and when I press it, it hurts. The right side has no pain

thanks