Treat Stress Related Pelvic Pain physically. Wait, what?!

Apparently, there is a new to treat stress-related pelvic pain on the market. How? With a $4,300 gadget and training package that also treats relaxation skills.

Would it make more sense to treat stress-related pelvic pain by treating... I don't know... the stress? And what they describe sounds exactly like TMS. Dr. Sarno even describes a patient in The Divided Mind who had TMS that was misdiagnosed as prostitis (which is what happened to these people)

And the crazy thing is that they list all of these people who have been through every procedure possible and it hasn't helped them. One had surgery to sever a ligament near the pudendal nerve. No luck. Others had a hernia operation (that found no hernia) or a colostomy so they poop through a bag. No luck. Others had a testicle or their tailbone removed. No luck.

But still they want to try a new gadget, that, honestly, looks quite humiliating to use. I can only sympathize because I know how bad the pain can be. However, modern medicine is in an awful state if they can't figure out that it would simply be easier wouldn't it be easier to just treat the stress?!





David Wise, who devised the pelvic pain protocol with Dr. Rodney U. Anderson, holding the therapeutic wand that is used to gently press on trigger points in pelvic muscles that are in spasm. Men must insert it rectally. A small number of women use it vaginally.


December 30, 2013
A Fix for Stress-Related Pelvic Pain

STANFORD, Calif. — An unorthodox device for treating pelvic pain was recently approved by the Food and Drug Administration, and its inventors say it could help legions of men in misery from what are misdiagnosed as prostate problems.

The therapeutic wand resembling a longshoreman’s cargo hook, but made of plastic, is used to gently press on “trigger points” in pelvic muscles that are in spasm. What makes it unorthodox is that men must insert it rectally; a small number of women use it vaginally.

The treatment, known as the Stanford pelvic pain protocol or the Wise-Anderson protocol, includes extensive relaxation therapy and sessions of mapping the internal points to be stretched.

“People who see us have failed all other treatments,” said David Wise, a psychologist, who devised the protocol with Dr. Rodney U. Anderson, an emeritus professor of urology at Stanford’s medical school, and Tim Sawyer, a physical therapist.

“They’ve been on antibiotics, anti-inflammatories, Flomax,” Dr. Wise continued. “Some have had wicked surgeries. Some have lived with pain for 20 years. Quite a few are mad at their doctors.”

Since 1995, the three men have taught the protocol to 2,500 patients; after clinical trials, the wand won F.D.A. approval late last year.

As a treatment for pelvic pain, the technique has been accepted by the American Urological Association, said Dr. J. Stuart Wolf Jr., chairman of the association’s guidelines committee.

The wand costs $800, but is available only as part of a set of training sessions. Its inventors hold six-day workshops for $4,300, but doctors and therapists in other cities and overseas set their own fees. Health insurers usually pay for the physical therapy but not the relaxation techniques or the wand itself, Dr. Wise said.

Urologists frequently misdiagnose pelvic pain as a prostate problem, Dr. Anderson said. Cancer must be ruled out, of course, but the pain typically starts in a person’s 20s or 30s, when prostate cancer is uncommon.

Wendy W. Isett, an association spokeswoman for the urology association, declined to comment on Dr. Anderson’s assertion, saying, “We do not have any reliable data on the diagnostic patterns.”

Like tension headaches or nocturnal tooth grinding, the pain appears to be a response to stress. “In some men, stress makes them clench exactly the way a frightened dog does when it pulls its tail between its legs,” Dr. Wise said. “They get a charley horse in the pelvis, but one that can’t be stretched out.”

Mr. Sawyer, the physical therapist, said that patients tended to be driven men, many of them athletic and in good health. The pain often begins after a personal failure like a divorce or a job loss.

The first twinge is sometimes described as a golf ball in the rectum or stab in the groin. It starts in the web of muscles that move the pelvis, push food through the intestines and control the bladder, sphincter and ejaculation, but can radiate to the back, the testicles or the penis. Sex, urination or bowel movements can set it off, and sitting, driving or even wearing underwear can become excruciating.

Telephone interviews with nine male patients, who spoke on the condition that they be identified only by first name, echoed those descriptions.

Most were professionals — physicians, lawyers or business executives. All had endured years of intermittent agony and had seen several doctors before hearing of the protocol, usually through a web search that turned up the book “A Headache in the Pelvis,” by Dr. Wise and Dr. Anderson, published in 2003.

Several mentioned considering suicide.

“I’m not depressive,” said Isaac, a lawyer in New York. “But I thought, I can’t live with this for the rest of my life. If I lost an arm, it would heal. But this was unrelenting.”

All had been prescribed multiple drugs, including antibiotics, prostate-shrinking medicines, anti-inflammatories, antidepressants, anti-anxiety pills, vitamins, steroid injections, even methadone.

“I consulted with several urologists,” said Allen, an internist in Los Angeles. “Almost to a man, they called it chronic prostatitis.”

“In retrospect, it seems incredible,” he continued. “There was nothing wrong with my prostate.”

Several said surgeons suggested operations, and two had surgery to sever ligaments around the pudendal nerve.

“That not only didn’t help, but I got additional scrotal pain,” said Eric, a doctor in Washington. “That really scared me.”

Another patient had a hernia operation that found no hernia.

Others have had a testicle removed, and one patient had his coccyx, or tailbone, removed, Dr. Wise said. Another had a colostomy because defecation was too painful.

Several described explosions of agony the first time Mr. Sawyer touched their internal muscles.

“My pain went through the roof,” said Al, who works in financial services in Los Angeles. “But that was a real light bulb going on — that’s where the pain was.”

Trigger point therapy — pressing on knotted muscles to relax them — has been used by physical therapists for decades. (Acupressure, in Chinese medicine, uses similar points.) Dr. Janet Travell, the first woman to serve as White House physician, used trigger point therapy to treat President John F. Kennedy’s back pain; Mr. Sawyer studied under Dr. David G. Simons, a protégé of Dr. Travell.

The germ of the protocol emerged in 1994, Dr. Wise said, as he visited yet another urologist during a flare-up of what by then was 22 years of pain.

While trying to massage his prostate for fluid to test for bacteria or cancer, he said, the doctor pressed instead on the nearby levator ani muscles. “It was probably an accident,” Dr. Wise said, “But when I left, I was pain-free for a few days.”

He began pressing the spot with one of his fingers, which was awkward, and consulted a therapist who treated women. He also used relaxation techniques he was trained in..

A year later he visited Dr. Anderson. In an interview in his house on the Stanford campus, Dr. Anderson said he saw patients “who were at their wits’ end, while their own urologists considered them a nuisance because they couldn’t help them.”

Dr. Wise and Dr. Anderson formed a joint practice, later recruiting Mr. Sawyer.

In a telephone interview, Mr. Sawyer said: “You think: Rectal exams? Jeez, that’s not what I got into this business for. But there was a need, and seeing the first 400 patients with internal trigger points convinced me it wasn’t crazy.”

In the beginning, men had to reach their own trigger points, see therapists frequently or ask someone for help. “We taught the spouses,” Dr. Wise said, “but it’s not the greatest thing for a marriage.”

In 1996, they visited Good Vibrations, a San Francisco sex-toy emporium.

“We were the only guys with ties and no tattoos,” he said. “But nothing was quite right. There were S-shaped glass things for stimulating the prostate, but they weren’t safe. People sometimes had to go to the E.R. to get them taken out.”

So they commissioned the wand, a two-foot bend of medical-grade plastic with a fingertip-like rubber end and a pressure gauge to keep patients from pressing too hard.

Up to 30 attend each California workshop, and several said they previously thought themselves alone in their suffering. “It’s not coffee-table talk, and no one’s wearing pink ribbons for it,” said John, a Memphis lawyer. “But tons of people have it.”

 

Ah, and here I was journalling and talking about my stress. I was missing out on all the fun

 

Yikes!

 

I actually considered attending this stupid clinic this month....but that was before i heard about tms...as soon as i read about tms my symptoms went away it was like magic....now the symptoms i have are all psychological and i'm trying to work through them. all the best guys. And screw david wise, he is robbing people and is an extremely rude man to speak to on the phone with no real sympathy or compassion for anyone.

 

Hey, Mindfulliving, that's great your pain went away just hearing about TMS. You saved a lot of money not getting pelvic pain gadget!
Amazing how anyone would fall for the Wise gizmo. Not very wise!

 

Just looking at that thing gives me shivers. I think the clear acrylic thing on the right of the photo is so that you don't insert it too far by mistake. The clear acrylic thing on the left of the photo is a crossbar handle so that you can get some leverage and really push.

AAAAaaaaaaaaaghghghhhh! (runs screaming from keyboard)

 

I saved my rectum more like it....haha this guy wise is jokes....i once called him and while questioning about his clinic details....he goes : "any more queries and i'm going to have to start charging you" ..."i'm dead serious"....i asked him whether he'd be able to come overseas all expenses paid for a 3 day trip and he quoted me 100,000 dollars....i think he is seriously nuts....someone needs to please educate people over at pelvic pain forums that its TMS....because david wise is using the same personality traits as tms....i think he feels rather threatened by sarno and his theories...

 

People don't really fall for it...they see it as hope...and as you all know...hope is what keeps all of us tms'ers going..or has been at some point until we are cured at least...this man is exploiting desperate people who are truly suffering...my heart goes out to them and i hope they find this forum soon...

 

Miffybunny, did you get my reply about offering to let you read the manuscript of the book
Herbie and I are writing about TMS healing? I don't see it here.

 

Miffybunny, my reply is in the general forum under Question for Forest, near the top of the list of posts.

 

My husband and I agree that this device just proves that this pain (which is my main TMS symptom) is caused by the mind. What a stupid idea to try to mechanically un-knot the muscles and tendons instead of trying to get the mind to stop doing it. I wouldn't be surprised if you could really hurt yourself with this thing!

 

I spoke to this man on the phone a few weeks ago. He was very rude and it was incredibly disheartening. After reading his book and believing my pelvic floor was ruined, I found this. I am beginning to believe it is TMS. He insisted I drop everything and fly across the country to see him and pay to do his clinic right away. He also informed me (without my asking) that he does not give discounts.

 

Wow. It's great to read of all of you who were considering this crazy option and took the TMS treatment option instead... and finding relief with it.

 

Dr. Wise's premise is accurate, that the muscles clench when the body is in a state of fight or flight. Interestingly, he just has a different read on it. He thinks that the source of the tension is the muscles themselves, whereas we look at the source being neural pathways in the brain, the tensing of the muscles is just the consequence. In my opinion, he just treats the symptoms of the fight or flight-generated tension,, not the cause. I'd be curious to see if some of his successful patients went on to develop pain syndromes in other areas of their body.

 

What is there to do with the remaining overly toned and dysfunctional muscles? Should they eventually weaken to a normal state by following TMS treatment?

 

The muscles are perfectly functional and perfectly toned already.

There is nothing you need to do, Alysa, to your muscles to make them better. Honestly, that type of thinking, while intuitive, serves to perpetuate your symptoms. It keeps you focused on believing that there's something physically wrong with you that needs to be fixed to become pain free.

If you were to clench your fist for 30 minutes, you would develop pain. There would be nothing wrong with your fist. You wouldn't need to strengthen it, weaken it, or modify it any way. All you would need to do is unclench it.

Neural pathways in the brain have the capacity to unconsciously "clench" muscles, so they feel tighter. And they are tighter. But just as the brain can clench muscles, the brain can unclench muscles.

There's nothing wrong with your muscles. Focus on trusting that, and try to work on calming your primitive brain. Bringing her out of a state of fight or flight. Letting her know that her life's no longer in danger. Letting her know that she's safe. She will unclench.

Listen to this clip. You are safe.

http://www.tmswiki.org/ppd/TMS_Recovery_Program#Provide_Comfort

 

Coming to this thread late. I attended the Wise-Anderson Clinic a few years ago and was trained with the trigger point device described here. Both internal and external trigger points were identified. I performed the treatment protocol, and it worked. Part of the treatment protocol involves relaxation techniques to calm the brain. Wise understands that it is the brain that is causing the muscles to clench. He does not claim that it is the muscles themselves producing the problem. In his book, he writes extensively about this being a mind-body issue. His program does aim to treat the cause as well as the symptoms. At least in my case, I did not find that my brain could unclench my muscles just as it clenched the muscles, and here is the rub. It took about 45 years of my brain reacting to fight or flight for my pelvic floor muscles to reach the point where I was symptomatic. A lifetime of tensing the pelvic floor. I suppose I could have spent another lifetime of "unclenching" the muscles with my brain for the problem to resolve, but I chose to combine mental unclenching with a physical release of the trigger points to obtain relief. Travel and Simons were not idiots. They studied myofascial trigger points for many years, and these can now be seen by certain kinds of imaging. They do exist. Perhaps some people can unclench them without ever treating the muscle, but I don't think it is unreasonable to believe that physical therapy can be useful. The only problem I see with David Wise's approach is that he thinks everyone with pelvic pain will benefit from his treatment protocol, and it's not true. Many people do obtain benefit (see the dang article, folks), but for some people it may be TMS, or a nerve-related issue that does not respond to PT, or something else. One size does not fit all, and that applies to the TMS advocates as much as anyone else, with due respect.

 

Thanks for sharing your experience. It's always good to hear from people who have "Been there and done that." It sounds like the device worked well for you. How are your symptoms doing now?

 

I had a bout of prostititis,once, 28 days before my 50th Birthday! I also have had pelvic pain due to hernia surgeries and scar tissue. Of course I now know it was tms knockin!. But I had a virus which attacked the prostate.........I was so sick......
I can't imagine using this device for ANYTHING......except laughter!

 

Janet Travell,was a brilliant physical who lead the way as regards muscle issues, I would imagine some of her work is required learning in university's.