Male chronic pelvic pain

Aug 6th, 2015
Not a member of Pastebin yet? Sign Up, it unlocks many cool features!
  1. Chronic Pelvic Pain Syndrome
  2. Expand Messages
  3. forest_dobbs
  4. Message 1 of 8 , Today at 9:32 AM
  5. View Source
  6. Male patient 28 yo with chronic pelvic pain syndrome - pain on tip of penis and pain during orgasm, sometimes pain on urination. Onset was in 2014 from a hiking trip where he pulled an adductor muscle and the syndrome has never resolved. He has been seeing a Pelvic PT specialist and has been getting relief and the condition is mostly under control. Muscles most affected Superficial Transverse Peroneal and Pubococcygeous. He uses a therawand for intra-anal pelvic floor release. He notices the syndrome is worse with stress. When he goes on vacation with very little stress the symptoms completely go away. Medication - amitriptyline 25mg. Acupuncture has not been beneficial to date. If anyone has any resources or treatment ideas that may shed some light on this that would be wonderful.
  7. 23andMe will be run to look at methylation, MAO, COMT, etc. factors possibly contributing to increased pain presentation and patients difficulty to cope with stress and OCD behavior.
  8. Normal Labs - ANA & IFA Panel, CRP, CMP, CBC with diff (although hematocrit is slightly elevated), Ferritin, Total Testosterone, Free Testosterone.
  9. Abnormal Lab
  10. Vitamin D,25-OH - 22ng/ml
  12. Thank you and blessings.
  13. Forest Dobbs
  14. Seattle, WA
  18. Virginia Oram, ND
  19. Message 2 of 8 , Today at 11:48 AM
  20. View Source
  21. Maya Abdominal Therapy may be helpful. See for certified practitioners. He can learn to do it himself as self care daily too.
  22. Virginia Oram ND
  23. Eugene, OR
  27. sherri jacobs
  28. Message 3 of 8 , Today at 1:19 PM
  29. View Source
  30. Consider looking at a low oxalate diet or testing for oxalates via organic acids test.. I use Great Plains.
  31. Sherri Jacobs
  32. Chas sc
  36. dralpinewellness
  37. Message 4 of 8 , Today at 6:17 PM
  38. View Source
  39. I have mainly treated females with chronic pelvic pain. Some things I have noted:
  41. 1. Acupuncture can be less than efficacious if the three dimension aspect of the channel system is not considered. Sometimes the use of techniques that stimulate the luo-connecting channels, sinew channels, or divergent channels (as opposed to primary channels) can be helpful. There is an excellent paper on this topic in the recent Journal of Chinese Medicine (107, Feb 2015) by Jack Schaefer. I have also found extraordinary meridian treatment on the lower Ren channel (in addition to St 30 and K13) helpful, as well as moxa for Cold type conditions. You can teach the patient how to use moxa and then have them do it at home.
  43. 2. Compounded topicals can be of value with symptom control. Agents such as gabapentin, amitriptyline, cyclobenzaprine, etc. delivered as a suppository might be useful. Topical ketamine and diazepam are also helpful but we cannot prescribe them in WA State. A good resource here is a talk by Natalie Gustafson, Pharm D on Compounded Specialty Prescriptions in Women’s Primary Care, July 20, 2014. Tree Farm has it on CD.
  45. 3. Electrotherapy: frequency specific microcurrent (FSM) has been useful in some of the cases I have treated.
  47. 4. HeartMath: good set of tools for managing stress. You can simply review some of their techniques (Neutral, Freeze Frame, Heart Lock-in, etc.) and then teach it to your patients (they are not difficult to learn or teach) or you can spring for the software and training, which is around $1000 when they are offering the special package deal.
  49. 5. Breathwork: subclinical hypoxia from shallow breathing can contribute to muscle pain. Just teaching a basic breathing technique and having them do it for 10 min at bedtime can be a useful way to begin to change less than optimal breathing habit.
  52. Gary Piscopo, ND, LAc
  53. East Wenatchee, WA
  57. Eric Blake
  58. Message 5 of 8 , Today at 8:54 PM
  59. View Source
  60. Hi Forest
  61. I contributed 2 chapters on naturopathic approaches to the textbook:
  62. Chronic Pelvic Pain and Dysfunction - practical physical medicine, a multidisciplinary pelvic pain management textbook
  68. Jill Evenson, ND
  69. Message 6 of 8 , Today at 8:57 PM
  70. View Source
  71. Interesting resource is the book 'A Headache In the Pelvis'.
  73. In addition to the previously recommended Frequency-Specific Microcurrent, consider cold laser therapy.
  75. Also rule out Bartonella and/or smoldering Chlamydia infection(s) if the picture fits - both have an affinity for the nerves of the pelvic floor.
  77. Jill Evenson, ND
  78. Wisconsin
  82. Eric Yarnell
  83. Message 7 of 8 , Today at 10:21 PM
  84. View Source
  85. See my extensive prior posts on chronic prostatitis. Hopefully new textbook on the subject will be out this year or early next year.
  87. Cheers,
  89. Eric Yarnell, ND
  90. Seattle, WA
  94. forest_dobbs
  95. Message 8 of 8 , Today at 10:36 PM
  96. View Source
  97. Thank you everyone for your ideas and insight. I had no idea treating chronic pelvic pain would be this complicated. My head is spinning as I have gotten information from 3 other naturopathic chat groups on treatment ideas. It will take some time to simplify my treatment strategy.
  99. To Both Erics, i look forward to referring to your books.
  101. Blessings,
  102. Forest dobbs, ND
  103. Seattle, WA
RAW Paste Data