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Pelvic Pain and Bladder Problems
Most types of pelvic pain respond well to a course of either acupuncture or gentle manipulation or a combination of both.
Pelvic pain is pain which is felt in the pelvis or perineum which has lasted longer than 3 months and isn't linked to a urinary tract infection.
Symptoms may come and go and pain can range from mild discomfort to debilitating. The pain may radiate to back and rectum, making sitting difficult. Dysuria (pain on passing water), joint pains, muscle pains and aching, unexplained fatigue, abdominal pain, and frequency may all be present.
Pelvic pain can affect both males and females and there is sometimes an overlap with bladder problems. It is also called chronic pelvic pain syndrome (CPPS).
Male Pelvic pain
Post-ejaculatory pain (pain after intercourse) from the action of nerves and muscles, is a classic symptom of male pelvic pain and serves to distinguish pelvic pain patients from men with Benign Prostatic Hypertrophy. Some patients report low libido, sexual dysfunction and erectile difficulties as well as constant burning pain in the penis. Male pelvic pain may also be due to chronic prostatitis.
Female Pelvic Pain
Pelvic pain can affect women of all ages and is often associated with pregnancy. If during and after pregnancy you notice pain in your pelvic joints when walking, climbing stairs, or turning in bed you may have pelvic girdle pain. This is due to a slight misalignment or stiffness of your pelvic joints at either the back or front of your pelvis. Pelvic girdle pain may affect up to 50% of pregnant women and it can vary from mild discomfort to being completely disabling. Acupuncture has been shown to be very good at relieving the symptoms of pelvic pain in pregnancy.
Vulvar pain or vulvodynia
A particularly distressing form of pain for women is Vulvodynia - pain in the perineum and vagina which is described as 'burning, stinging or rawness'. "Conventional treatment is notoriously difficult and a large group of patients do not respond to the conventional approaches which include steroid creams, local anaesthetic gel or amitriptyline. There is hope though in acupuncture. In a small trial 3 out of 4 of the women treated for a few weeks had some improvement and judged acupuncture more effective than any other treatment - some considered themselves cured" (Powell J 1999).
Bladder problems are common, affecting approximately 5 million women and 2 million men in the UK. These conditions affect men and women of all ages.
The commonest symptoms are bladder pain, frequency (going to the loo very often) and nocturia (having to get up at night, often frequently) but patients are often more distressed by the depression, fatigue and anxiety that go with bladder problems. The term bladder problems describes a set of conditions including overactive bladder syndrome, irritable bladder syndrome and painful bladder syndrome. These conditions often overlap with pelvic pain problems.
How can Bladder Problems be treated?
Most patients respond well to 6 sessions of treatment with acupuncture and electroacupuncture, and the effects are lasting, although some people need top up or maintenance treatments from time to time. Acupuncture and nNEAP are excellent alternatives for those patients who have had little success with conventional drug treatments or who do not want to pursue a surgical route.
Bladder Problems following treatment for cancer
Many patients who have had radiotherapy to the pelvic area during their treatment for cancer will unfortunately develop some distressing symptoms due to the radiation. These can include pain, frequency and urgency. The symptoms may be substantially helped using acupuncture, and this is now widely used at the Royal Marsden Hospital in London, which is the UK's top cancer hospital.
Piriformis Syndrome - an overlooked cause of bladder problems
Piriformis Syndrome describes the symptoms which can occur when this muscle in the backside or buttock is irritated or goes into 'spasm'. Usually it will cause low back pain and pain which radiates into the buttock on that side or down the leg, sometimes with pins and needles, even as far as the foot.
What is often overlooked in treating bladder problems is that tis muscle, if it presses on the sciatic nerve (the major nerve to the leg) can also cause bladder symptoms - frequency, bladder pain, urgency and so on. It may also give rise to chronic pelvic pain and problems with intercourse for both men and women (dyspareunia or impotence).
When piriformis is disturbed, then other muscles may also be affected and our examination will include searching for myofascial trigger points in muscles of the pelvis and also the upper leg. If present, these can be treated with gentle manipulative techniques or trigger point needling.
For more information on piriformis syndrome click here.
A recent study showed that 73% of patients had positive responses to acupuncture, with 40% of them showing complete resolution. No conventional intervention for pelvic pain was shown to be effective.
Lee SWH et al. Acupuncture versus sham acupuncture for chronic prostatitis/chronic pelvic pain. The American Journal of Medicine 121(1) Jan 2008
Decrease of pregnant women's pelvic pain after acupuncture: a randomized controlled single-blind study. Lund I, et al. Acta Obstet Gynecol Scand 2006:85(1):12 - 19
Powell J, Wojnarowska. Acupuncture for vulvodynia. J R Soc. Med 1999; 92; 579-581
In a pilot study presented to the American Urological Association in 2009, acupuncture was tested against responses to conventional treatments.
Before the study all patients had pain and frequency and 20% had pain on intercourse. Following a course of acupuncture, all patents reported an improvement in their symptoms, and quality of life improved for an astonishing 86%. In contrast, only 8% had been helped by hydrodistension, only 36% had found Cystistat helpful and none had been helped by Lyrica.
Success of acupuncture in the treatment of interstitial cystitis. Reeves, Chapple and Pullman: Journal of Urology 2009:181:23 Abst. 62.