Pelvic Floor Dysfunction

Fissure like pains...anyone?

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Re: Pelvic Floor Dysfunction

Postby pafen » 25 Feb 2015, 21:03

Interesting read.

http://www.pelvicpainsa.com.au/wp-conte ... -Women.pdf

One particular paragraph reads:


"The most common cause of pelvic pain on one side is spasm of the muscle obturator internus, which lies inside the hips on the pelvic side wall, usually in the context of a flare of back- ground neuropathic pain. A typical history for obturator internus spasm includes pain on one side, sometimes bilateral, which has the following features: comes on suddenly; is worse with exercise or movement; may be worse on standing or sitting for a long time; may radiate into the anterior thigh"

My PT has palpitated my muscles internally and there is one spot on the left side of my rectum which feels extremely sharp and tender when she presses on it. Often after massage the pain is greatly relieved. However the next day it's usually back in spasm again.

I have still not tried Botox yet so might run it pass my pain specialist on the 4th of March. After reading this article it has made me believe I definitely do have an internal trigger point. Perhaps it is the obturator internus?
Hemroidectomy, anal abscess, fissure, LIS
Pelvic floor Dysfunction since late 2012
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Re: Pelvic Floor Dysfunction

Postby msimon » 25 Feb 2015, 21:20

I have been bothered for years by this muscle. I had botox into it and developed terrible pain in the rest of my hip muscles and back as they then had to compensate. Personally, would try trigger point injections into it before going to botox. It is such an important stabilizer of the pelvic. It is easy to check/find this muscle if you can get a finger in there (vaginally-female;rectally-male), aim for the side wall and then press outward with your leg. This will cause it to contract and you will feel a bulge under your finger.
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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Re: Pelvic Floor Dysfunction

Postby Alyssa » 26 Feb 2015, 00:39

My MRI came back clear... Yes it was an MRI to the spine... I was hoping that perhaps the MRI could shed some light but now I am more confused; nothing seems to be working to ease this sitting burning anal pain (pelvic floor physical therapy, biofeedback, Botox, nerve blocks, acupuncture, using a standing sitting desk)!
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
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Re: Pelvic Floor Dysfunction

Postby pafen » 26 Feb 2015, 17:34

Alyssa,

I am much in the same boat. I have tried many treatments but none have seem to hit the root of the problem. Perhaps it is nerves involved in the scarring from previous rectal/anal surgeries.

Convincing a surgeon to remove any scar tissue is hard though as they said it will just create more scar tissue when it heals. Pelvic floor physiotherapy I would have thought would have assisted in stretching out this scar tissue.

Could it be possible the rectal branch of the pudendal nerve was cut during some of the surgeries.

A lot of the specialists seem to guess also. None have been able to pinpoint or diagnose and say what the cause is. Everything is always it could be this or that etc....

If you can't pinpoint it after exhausting almost everything maybe the best approach is trying to manage the pain.

The trouble with the bowel is, you can't just rest it like an arm or a leg. It has to be used every/most days. If there is some hyper sensitivity from past trauma, its hard to avoid direct stimulus of this.

A stool softener can help, as well as a diet which enables you to empty your bowel completely with each movement. I find if any stool is left behind my rectum is sensitive to this.
Hemroidectomy, anal abscess, fissure, LIS
Pelvic floor Dysfunction since late 2012
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Re: Pelvic Floor Dysfunction

Postby Alyssa » 26 Feb 2015, 23:58

Pafen,

All this is so complicated... My physical therapist says my pain is because I have connective tissue restrictions on the skin which could explain why the burning pain starts while I sit down (stretches the constricted skin) I've mostly done myofascial release vaginally since its just too painful rectally...
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
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Re: Pelvic Floor Dysfunction

Postby owmybum » 27 Feb 2015, 03:56

Alyssa,

I too am in the same boat now.... Although I have not tried most of the treatments yet.

It may be time to manage your pain better whilst continuing to find the answer. Have you considered something like gabapentin or similar nerve pain blockers?

It's so soul destroying when every attempt to rid yourself of this rectal pain hell seems to hit a brick wall.... But keep looking, keep trying....... Collectively we will find an answer.

:smilyhug:

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fissure after hem banding and tag removal feb 11
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Re: Pelvic Floor Dysfunction

Postby Alyssa » 27 Feb 2015, 16:33

I have asked for pain medication but my doctor just says to take Tylenol... She is concerned that if I take any of those meds, they can constipate me. I am feign stuck.. I am f---- if I do and f---/ if I don't! I have a phone check in in with my doctor next week...I am thinking of writing down a journal of all the treatments I have done and the end result of each..
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
Alyssa
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Re: Pelvic Floor Dysfunction

Postby Alyssa » 27 Feb 2015, 17:58

Wanted to share another great blog about the diagnosis of pelvic pain

http://www.pelvicpainrehab.com/pelvic-p ... -recovery/
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
Alyssa
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Posts: 735
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Joined: 29 Apr 2014, 11:24
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Re: Pelvic Floor Dysfunction

Postby pafen » 28 Feb 2015, 17:01

Hi,

I am going to give this place a go. I haven't tried any biofeedback before. It is located about an hours drive from where I live but I may be able to get some patient travel subsidy seeing the service isn't available where I live.

http://www.ipphysio.com/index-3.html

Will do this plus see what the pain specialist can offer me.

Something has to work soon with all the stuff we are trialing.
Hemroidectomy, anal abscess, fissure, LIS
Pelvic floor Dysfunction since late 2012
pafen
Proctosphincteranalogist
 
Posts: 130
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Re: Pelvic Floor Dysfunction

Postby Alyssa » 28 Feb 2015, 20:43

I hope it helps with your pain and they finally figure out what is going on in there.. Keep us updated. Good luck!
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
Alyssa
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Posts: 735
Topics: 26
Joined: 29 Apr 2014, 11:24
Location: San Jose, CA
Has thanked: 136 times
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