The effect of manual physical therapy in patients diagnosed with interstitial cystitis, high-tone pelvic floor dysfunction, and sacroiliac dysfunction

The Pelvic Floor Institute, Graduate Hospital, Philadelphia, Pennsylvania, USA.
Urology (Impact Factor: 2.19). 07/2001; 57(6 Suppl 1):121-2. DOI: 10.1016/S0090-4295(01)01074-3
Source: PubMed
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    • "Our clinical pelvic examinations found that many patients indeed have had trigger points in the pelvic floor musculature, including the levator ani, obturator, pubococcygeus, and deep transverse perineal muscles. Moreover, many researches have explored how the musculoskeletal system is involved in disorders such as vulvodynia, coccygodynia, levator ani syndrome, fibromyalgia, vulvar vestibulitis syndrome, dyspareunia, pelvic floor tension myalgia, urgency-frequency syndrome, and urethral syndrome.15,16,17,18,19,20 Therefore, to alleviate muscle pain itself is crucial in order to treat CPP caused by pelvic floor pain. "
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    ABSTRACT: Purpose The aim of this study is to explore non-steroid anti-inflammation drugs (NSAIDs) potency for pelvic floor muscle pain by measuring local concentration in a rat model. Materials and Methods We used nine NSAIDs, including nabumetone, naproxen, ibuprofen, meloxicam, piroxicam, diclofenac potassium, etodolac, indomethacin, and sulindac, and 9 groups of female Wister rats. Each group of rats was fed with one kind of NSAID (2 mg/mL) for three consecutive days. Thereafter, one mL of blood and one gram of pelvic floor muscle were taken to measure drug pharmacokinetics, including partition coefficient, lipophilicity, elimination of half-life (T1/2) and muscle/plasma converting ratio (Css, muscle/Css, plasma). Results Diclofenac potassium had the lowest T1/2 and the highest mean Css, muscle/Css, plasma (1.9 hours and 0.85±0.53, respectively). The mean Css, muscle/Css, plasma of sulindac, naproxen and ibuprofen were lower than other experimental NSAIDs. Conclusion Diclofenac potassium had the highest disposition in pelvic floor muscle in a rat model. The finding implies that diclofenac potassium might be the choice for pain relief in pelvic muscle.
    Full-text · Article · Jul 2014 · Yonsei Medical Journal
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    • "It represents a widely employed manual technique specific for fascial tissues, to reduce adhesions, restore and/or optimise fascia sliding mobility in both acute and chronic conditions (Barnes, 1996; Martin, 2009; Sucher, 1993; Walton, 2008). Some studies have shown the efficacy of MFR to decrease pain, improve posture, and quality of life (Barnes, 1990; Fernandez de las Penas et al., 2005; LeBauer et al., 2008; Lukban, 2001; Radjieski et al., 1998). However, according to Remvig (2008) " There are no published reliability studies documenting that the diagnostic method is reproducible and valid. "
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    ABSTRACT: Myofascial Release (MFR) and Fascial Unwinding (FU) are widely used manual fascial techniques (MFTs), generally incorporated in treatment protocols to release fascial restrictions and restore tissue mobility. However, the effects of MFT on pain perception, and the mobility of fascial layers, have not previously been investigated using dynamic ultrasound (US) in patients with neck pain (NP) and low back pain (LBP). a) To show that US screening can be a useful tool to assess dysfunctional alteration of organ mobility in relation to their fascial layers, in people with non-specific NP or LBP, in the absence of any organ disease; b) To assess, by dynamic US screening, the change of sliding movements between superficial and deep fascia layers in the neck, in people with non-specific NP, before and after application of MFTs c) To assess, by dynamic US screening, the variation of right reno-diaphragmatic (RD) distance and of neck bladder (NB) mobility, in patients with non-specific LBP, before and after application of MFTs d) To evaluate 'if' and 'at what degree' pain perception may vary in patients with NP or LBP, after MFTs are applied, over the short term. An Experimental group of 60 subjects, 30 with non-specific NP and 30 with non-specific LBP, were assessed in the area of complaint, by Dynamic Ultrasound Topographic Anatomy Evaluation (D.US.T.A.-E.), before and after MFTs were applied in situ, in the corresponding painful region, for not more than 12 min. The results were compared with those from the respective Sham-Control group of 30 subjects. For the NP sub-groups, the pre- to post- US recorded videos of each subject were compared and assessed randomly and independently by two blinded experts in echographic screening. They were asked to rate the change observed in the cervical fascia sliding motions as 'none', 'discrete' or 'radical'. For the LBP sub-groups, a pre- to post- variation of the right RD distances and NB mobility were calculated on US imaging and compared. For all four sub-groups, a Short-Form McGill Pain Assessment Questionnaire (SF-MPQ) was administered on the day of recruitment as well as on the third day following treatment. The Chi square test has shown a significant correlation (0.915) with a p-Value < 0.0001 between the two examiners' results on US videos in NP sub-groups. The ANOVA test at repeated measures has shown a significant difference (p-Value < 0.0001) within Experimental and Control groups for the a) pre- to post- RD distances in LBP sub-groups, b) pre- to post- NB distances in LBP sub-groups; as well as between groups as for c) pre- to post- SF-MPQ results in NP and LBP sub-groups. Dynamic US evaluation can be a valid and non-invasive instrument to assess and monitor effective sliding motion of fascial layers in vivo. MFTs are effective manual techniques to release area of impaired sliding fascial mobility, and to improve pain perception over a short term duration in people with non-specific NP or LBP.
    Preview · Article · Oct 2011 · Journal of bodywork and movement therapies
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    • "Most often QOL-improving therapy has been used for chronic pain problems, like vulvar vestibulitis syndrome (N = 35, 71–79% improved) (Schultz et al. 1996; Bergeron et al. 2002), suprapubic pain (Lukban et al. 2001), urinary frequency (N = 42, 82% improved) (Lukban et al. 2001; Weiss 2001), pelvic, perianal and perineal pain (N = 179, 87% good to very good response) (Markwell 2001). Recently infertility has also been successfully helped (Wurn et al. 2008). "
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    ABSTRACT: This paper reviews the medical (salutogenic) effect of interventions that aim to improve quality of life. Review of studies where the global quality of life in chronically ill patients was improved independently of subjective and objective factors (like physical and mental health, yearly income, education, social network, self-esteem, sexual ability and problems or work). The methods used were subtypes of integrative medicine (non-drug CAM) like mind body medicine, body psychotherapy, clinical holistic medicine, consciousness-based medicine and sexology. In about 20 papers on QOL as medicine, in cancer, coronary heart disease, chronic pain, mental illness, sexual dysfunction, low self-esteem, low working ability and poor QOL, the most successful intervention strategy seems to be to create a maternal, infantile bonding induced by a combination of conversation therapy and bodywork. The papers examined the treatments of over 2,000 chronically ill or dysfunctional patients and more than 20 different types of health problems. Global QOL measured by SEQOL, QOL5, QOL1, self-rated physical health, self-rated mental health, self-rated sexual functioning, anorgasmia, genital pain, self-rated working ability, self-rated relation to self, well-being, life-satisfaction, happiness, fulfillment of needs, experience of temporal and spatial domains, expression of life’s potentials, and objective functioning. We found “QOL as medicine” able in the treatment of physical disorders and illnesses including chronic pain (Number Needed to Treat (NNT)=1–3, Number Needed to Harm (NNH)>500), in mental illness (NNT=1–3, NNH>500), in sexual dysfunctions (NNT=1–2, NNH>1,000), self-rated low working ability (NNT=2, NNH>500), and self-rated low QOL (NNT=2, NNH>2,000). We found that QOL improving interventions helped or cured 30–90% of the patients, typically within one year, independent of the type of health problem. “QOL as medicine” seems to be able in improving chronic mental, somatic and sexual health issues without side effects. KeywordsQuality of life–Salutogenesis–CAM–Alternative medicine–Evidence based non-drug medicine–Holistic medicine–Clinical medicine–Healing–Therapeutic touch–Chronic disease–Mental disorders–Pain–Cancer–Coronary heart disease
    Full-text · Article · Feb 2011 · Social Indicators Research
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